Category Archives: Alcohol research findings and media coverage

Risky Drinking

So this premiered on HBO in the US in December 2016.  Luckily for us the documentary Risky Drinking has now appeared on Youtube so we can watch it too 🙂

Here’s a synopsis/review from Esquire:

To qualify as a risky drinker, a woman has to drink more than three drinks in one day, or more than seven drinks in a week. A man must have more than four drinks in one day, or more than 14 in a week. The risk itself from breaching these limits isn’t simply defined; it ranges from increased risk of violence, accidents, and self-injury to increased risk of sexual assault. It means an increased risk that something will happen that will irreversibly change someone’s life.

Or, as the new documentary Risky Drinking from HBO and the National Institute of Alcohol Abuse and Alcoholism shows, risky drinking could have already changed someone’s life. Now, the risk is that their life will spiral completely out of control.

The documentary follows four individuals, each on the spectrum for at-risk drinking, and each on the verge of toppling further into their dependencies. Kenzie is a young professional who parties on weekends; most binge drinkers are in her age group, 18 to 34. She downs shots and dissolves into tears each night out. “We haven’t gotten raped or murdered yet,” says her friend. Then there’s Mike, who is on the verge of domestic violence with his wife, and Noel, whose dependency affects her two daughters. The last is Neal, a grandfather so dependent on alcohol that he thinks he’s going to die (and who violently shakes when off the drink).

Risky Drinking doesn’t finish their stories. All we know is that each tries to get help, whether from medication, support groups, or moderation management, which is a treatment plan that doesn’t require total abstinence. Whether they are successful—whether they can get out of range of “alcohol use disorder,” which makes up one third of the drinking spectrum—is left unanswered. It’s a frustratingly open ending. But then, frustration is what you feel as you watch Kenzie, Mike, Noel, and Neal drink themselves stupid.

As the documentary points out, 70 percent of Americans drink alcohol. It’s worth knowing the risks, even if most Americans aren’t at the disorder stage—at least not yet. Risky Drinking assumes you already know this. It’s just showing you what risky drinking itself looks like for real people, if you care to watch.

Edited because original link to full documentary film on YouTube has now been removed.  Here’s the trailer:

And if you want to watch the full documentary film go here:

http://www.hbo.com/documentaries/risky-drinking

Interestingly in looking for the new link for you to watch I came across this panel interview with the experts featured and this is what they had to say:

“Alcohol is a bigger cost on society than all the rest of the drugs combined.” – George Koob, Ph.D.

“It’s the worst drug of all and it’s hidden in plain sight. – Stephen Ross, M.D.

“People don’t drink because they’re crazy; they drink because it works in some way.” – Carrie Wilkens, Ph.D.

“We do have a large epidemiological study in the field now that is looking at rates of fetal alcohol spectrum disorder and we’re hopeful, but the early evidence is concerning.” – Deidra Roach, M.D.

Here’s the panel discussion in full:

Improve services to address addiction related unemployment (this is not a love song)

So maybe not the sexiest post-Valentine subject matter but important none the less – and an excuse to feature a Banksy which is always a bonus! 😉  This was a report on service provision to address addiction related unemployment featured by Alcohol Policy UK in December.

Over to Alcohol Policy UK:

Dame Carol Black’s review into the effects on employment outcomes of drug or alcohol addiction and obesity has been released by the Department for Work and Pensions.

The review sets out a series of recommendations to improve options and support for those with drug and alcohol dependence, and does not endorse restricting benefits as was speculated in 2015.

Whilst the scope of the report covers also the role of obesity on employment outcomes, it states the issue is ‘different’ to substance addiction and ‘is treated seperately’. Specifically on alcohol, the report states:

‘Alcohol misuse may also be a cause or a consequence of unemployment. It is certainly a predictor both of unemployment and of future job loss, but evidence also suggests that increased alcohol consumption may follow job loss. Unlike dependence on heroin and crack cocaine, alcohol dependence is not strongly associated with lower socioeconomic status although the resultant health harms are. Nevertheless, the employment rate for those who develop problematic dependence is less than half that of the rest of the population’.

Overall the review describes the importance of employment in supporting addiction ‘recovery’, but neither drug and alcohol or job support services are sufficiently meeting the needs of service users. As such it recommends ‘practical interventions, including changes in services, practices, behaviour and attitudes.’

Three main areas where action is needed in relation to drugs, alcohol and employment are identified:

  • Addiction treatment does not, in itself, ensure employment, though it brings other social gains. Work has not hitherto been an integral part of treatment, and it needs to be if progress is to be made.
  • The benefits system, which has a central role in helping people enter or return to work, requires significant change. The system is hampered by a severe lack of information on health conditions, poor incentives for staff to tackle difficult or long-term cases, and a patchy offer of support for those who are reached.
  • Employers are the gatekeepers to employment and, without their co-operation employment for our cohorts is impossible. Employers are understandably reluctant to hire people with addiction and/or criminal records. They have told us that they need Government, quite simply, to de-risk these recruitment decisions for them.

Specific challenges are also identified, including ‘fractured commissioning responsibilities and lines of accountability’ that undermine efforts to develop co-ordinated responses. Whilst recognising low waiting times for alcohol treatment, stakeholders reported that alcohol services were ‘still inadequate to meet need in a number of areas’. The Government’s 2010 Drug Strategy, which listed a series of recovery-focused aims, ‘has yet to be realised’, in part owing to the ‘failure of the benefits systems to identify addiction (and indeed other relevant health conditions)’.

A series of recommendations include ‘the introduction of an expanded recovery measure that includes work and meaningful activity (including volunteering)’ as part of the outcomes monitoring for drug and alcohol treatment. It also proposes to trial discussions with a healthcare professional for welfare claimants to discuss ‘the impact of their health condition on their ability to work’. Initiatives to support employers in actively recruiting those in recovery will need to ‘de-risk’ companies from doing so, as explored in an FT blog.

David Best, Professor of Criminology, commented:

“How to read policy reviews? It correctly identifies a gap in supporting the employment needs of alcohol and drug users in employment, and also identifies two key issues – DBS checks and the ‘benefit trap’. The Black Review correctly identifies gaps in provision and joined up working and makes some interesting suggestions around including employment and volunteering in outcome measurement; suggests the use of peer mentors; and has some interesting ideas about collocating workers. But it all feels a bit tame and safe. There is no real drivers for the inter-agency working and pathway modelling that would be required of each workforce and the idea of partnership seems optimistic. There is also little adequate differentiation of the needs of problem drinkers who will typically have a different work history from problem drug users. Individual examples of good practice and innovation are all very well but what is lacking in the review is suggested mechanisms for making these more than beacons of hope in the darkness. So the review is encouraging in as far as it goes… but that is not very far”

A Collective Voice post said the report was a ‘real opportunity for the alcohol and drug treatment sector which we must seize’. According to LocalGov, the Local Government Association (LGA) welcomed the report but warned it was not ‘radical’ enough. See also reports in the Telegraph and Guardian.

Earlier this year the BMA released an updated briefing for medical and other professionals on addressing alcohol and drug use in the workplace, including guidance on supporting or recruiting employees with histories of substance misuse.

Agree with all of the above and know that Focus12 is supportive of these recommendations both in theory and in practice – says she who was a volunteer for them to help my own recovery 🙂

It feels only right to follow this blog up with this sober jukebox tune 😉

Manifesto for Children of Alcoholics – Launched Today

Another email from Liam Byrne today launching the children of alcoholics – manifesto for change yesterday, so on Valentine’s Day no less ….

Dear Friend

Today the All-Party Group launches the first ever manifesto for children of alcoholics.

Thank you for all your help in putting this together!

The hard-hitting manifesto, published to coincide with International Children of Alcoholics Week, sets out a 10-point plan to help Britain’s 2.6 million innocent victims of drink – the children of hard-drinking parents.

It is co-written by children of alcoholics, policy makers and experts from charities, interest groups and medicine.

You can read it here:

Children of Alcoholics – A Manifesto for Change
 
I’ve also launched a petition calling on the Government to back the manifesto. Please consider adding your signature and sharing with your friends and family.

(Click on the image below to access the petition)

I welcome any feedback

Very best


Liam Byrne MP

I’ve signed the petition and hope you will too 🙂

Edited to add: picked up by The Guardian too!

MPs and peers launch manifesto in support of children of alcoholic parents

Group behind initiative reveal feelings of shame and fear of own childhoods and call on ministers to tackle UK’s ‘secret scandal’

A third Labour MP has spoken of the “secrecy, shame and fear” of living with an alcoholic parent, as she urged more government action to help the children of people with alcohol problems.

Byrne, whose late father, Dermot, had alcohol problem, said the issue was “the biggest, dirtiest secret in Britain”, adding: “The challenge for the children of alcoholics is they fall through the cracks.

“They are on the cusp of these three different systems. Their parents are covered by the adult social care system, they themselves are covered by the children’s social care system, then there is the public health system.”

The manifesto was produced by the all-party parliamentary group on children of alcoholics, supported by the archbishop of Canterbury. It found an absence of strategies to deal with the issue and a lack of funding in many areas.

It also issued 10 demands for government action, including better education for children and professionals, better support or families and action on availability and promotion of alcohol.

Alcohol marketing rules failing to protect our youth

Too much news not enough blog posts!  I’m already writing posts for May so time to squeak in some extra one’s with important news stories.  Thank you marketing week for the image 😉

The top story from the Institute of Alcohol Studies for January was the headline grabbing blog post title that alcohol marketing rules are failing to to protect our youth.  To which I cynically want to respond: no shit sherlock!

Greater exposure raises likelihood of earlier and heavier drinking (10 January)

Young people across the world are over-exposed to extensive alcohol marketing practices, claim leading public health experts, who want governments to renew their efforts to address the problem by strengthening the rules governing alcohol marketing with more effective independent statutory regulations.

Their call coincides with the publication of a series of reports in a special edition of the scientific journal Addiction that presents the latest evidence on alcohol marketing and its impact on children. Key findings from the collection of peer-reviewed manuscripts include:

  • Exposure to alcohol marketing is associated with youth alcohol consumption
  • Analysis of alcohol promotion during the 2014 FIFA World Cup indicates alcohol marketing practices frequently appeared to breach industry voluntary codes of practice’
  • Alcohol industry self-regulatory codes do not sufficiently protect children and adolescents from exposure to alcohol promotions, especially through social media.

The Addiction supplement comprises 14 papers, with research presented from around the world.

Alcohol is the leading cause of death and disability for young males aged 15–24 in nearly every region of the world, and young females of the same age in the wealthy countries and the Americas.

The new systematic review – which identified 12 additional studies – found an association between level of marketing exposure and youth drinking behaviour, and found that exposure to ads was even more strongly associated with progression to binge drinking than with initiation of alcohol use.

“This latest review of the scientific literature adds stronger evidence to the claim that exposure to alcohol marketing among youth is linked to more underage youth drinking and, in particular, binge drinking,” said study leader David Jernigan, PhD, the director of CAMY and an associate professor in the Department of Health, Behavior and Society at the Bloomberg School.

The supplement’s lead editor, Professor Thomas Babor of the University of Connecticut said: “Governments are responsible for the health of their citizens. No other legal product with such potential for harm is as widely promoted and advertised in the world as alcohol. These papers provide a wealth of information to support governments in their efforts to protect children and other vulnerable populations from exposure to alcohol marketing.”

Methods

The researchers relied upon four different medical and scientific databases to identify articles for possible inclusion in the review. Studies were included in the final review if they met a number of criteria, including whether they used original data and included measures of marketing exposure and alcohol consumption for at least 500 underage youth. Studies were included only if they used self-reported and observed actual alcohol use such as binge drinking, as opposed to just measures of intentions to consume alcohol in the future. The studies were conducted in seven countries and involved more than 35,000 participants.

Several of the included studies found that levels of marketing exposure appear to be as high or nearly as high among younger adolescents as they are among older adolescents and young adults, suggesting that current voluntary alcohol industry marketing codes are not protecting kids as young as 10 years old.

Reaction

Alcohol NGOs and health experts welcomed the findings as further evidence of self-regulation’s failure to curb alcohol marketing to young people. Chris Brookes of the UK Health Forum noted that: “Governments have previously approved self-regulatory measures on alcohol advertising; however, we can no longer say that they might work to protect our young people – they don’t. In a literature review of more than 100 studies, none was identified that supported the effectiveness of industry self-regulation programmes.”

However, the advertising industry regulator has criticised the research, claiming that the UK’s regulatory framework has had a positive impact on recent official figures showing under-age drinking at a record low and a decline in binge drinking.

“Alcohol policy is clearly on the right track and alcohol advertising – which protects children and respects adults – is an important part of that,” says Ian Barber, the AA’s director of communications.

In the UK, advertising for alcoholic drinks follows a code enforced by the Advertising Standards Authority, while the packaging and branding of the products is subject to self-regulation. And according to the Guardian, AB Inbev and Diageo, two of the world’s biggest alcoholic drinks makers, have reported ploughing as much of 15% of their annual global sales back into marketing, amounting to £5.75bn and £1.6bn respectively.

Ian Hamilton, lecturer in the Department of Health Sciences at the University of York, whose interests include substance use addiction, told the newspaper the AA’s claim that the UK’s alcohol advertising rules are among the strictest in the world, major operators had nevertheless found ways to evade marketing legislation the UK.

“Some of the messages are quite subtle, but they are persistent,” he said. “So this idea that alcohol is necessary for social success, or is both a stimulant as well as a sedative, that it removes sexual inhibition, that it improves – bizarrely – your sporting and mental abilities.

“Of course, the way they do it is they don’t say go and buy Carlsberg, but they’ll do endorsed interviews with celebrities or they’ll offer free music downloads or notices of events, so they do it in quite subtle and clever ways.”

Solutions

The papers offer guidelines to developing more effective alcohol marketing regulations:

  • The most effective response to alcohol marketing is likely to be a comprehensive ban on alcohol advertising, promotion and sponsorship, in accordance with each country’s constitution or constitutional principles
  • Regulations should be statutory, and enforced by an appropriate public health agency of the local or national government, not by the alcohol industry
  • Regulations should be independent of the alcohol industry, whose primary interest lies in growing its markets and maximising profits
  • A global agreement on the marketing of alcoholic beverages would support country efforts to move towards a comprehensive ban on alcohol advertising, promotion and sponsorship
  • Collaboration with other population-level efforts to restrict marketing of potentially harmful products, such as ultra-processed food, sugary beverages, tobacco, and breast-milk substitutes, should be encouraged and supported.

“It is clear that self-regulation is not working and we welcome calls for greater action from governments to protect children from exposure to alcohol marketing,” said Prof Sir Ian Gilmore, chair of the Alcohol Health Alliance (AHA), an umbrella group of more than 40 UK health NGOs, including the Academy of Medical Royal Colleges.

Hamilton also warned that a blanket ban on alcohol advertising could be seen as “taking a sledgehammer to crack a nut”, with the danger that such a policy could give drinking a kind of outlaw prestige that might increase its appeal to some. But he admitted that a similar policy on tobacco advertising had apparently proved successful in diminishing the appeal of smoking. “I think the state does have some kind of responsibility,” Hamilton said. “We can’t have do-it-yourself regulation by industry whose prime motive is to find the next generation of consumers.”

The Addiction supplement, ‘Alcohol marketing regulation: From research to public policy’, is freely accessible from the Wiley Online Library. You can also listen to David Jernigan talk about the supplement’s findings in greater depth in our Alcohol Alert podcast.

The latest Institute of Alcohol Studies (IAS) Alcohol Alert: January 2017 in its entirety is now available (here for PDF version).

Alcohol Policy UK picked up on the special issue of Addiction also which you can read here.

And Liam Byrne interviews Alaistair Campbell about this very thing!

PS New follower on Twitter:

Looking for volunteers for research studies in alcohol addiction, sobriety, weight loss and weight gain. QMUL Led by

If you’d like to volunteer tweet him 🙂

Breakthrough in campaign for children of alcoholics

An update from Liam Byrne following today’s House of Commons debate about alcohol harm and the need for a plan from Government to support Britain’s 2.5 million children of parents who drink too much.

Liam Byrne today welcomed a breakthrough in the campaign for Britain’s children of alcoholics after a new commitment was made by Government to sit down with campaigning MPs to develop the first ever national strategy for children of alcoholics.

The commitment came from the Public Health Minister in a Westminster Hall debate in the House of Commons on alcohol policy called by Liam Byrne, Fiona Bruce and Bill Esterson.

In a powerful and moving speech, Labour’s Shadow Health Secretary Jon Ashworth told his personal story as the child of an alcoholic and made a bold offer to work across political divides to develop a strategy to help Britain’s 2.5 million children of hard-drinking parents.

Responding, the Public Health Minister Nicola Blackwood was moved to tears as she urged MPs to carry on their work.

Liam Byrne MP, founder and chair of the All-Party Parliamentary Group on Children of Alcoholics, said:

“This is a breakthrough. For over a year we’ve tried to make sure that the voices of children of alcoholics are heard in Parliament. Now the Government has listened. The Government has agreed to sit down and hammer out a plan. Crucially, Ministers have agreed with our number one goal: no child of an alcoholic should ever feel alone”.

The response of the Public Health Minister reduced me to tears …..

Alcohol misuse most often treated in middle age

This report featured in the Institute of Alcohol Studies report in November 2016.  This report struck me because I stopped drinking just before my 45th birthday.

Average age of alcohol only clients seeking treatment is 45 years (04 November)

Drinkers in their forties make up the most number of alcohol only treatment users for substance misuse in England, according to new figures published by Public Health England (PHE).

The National Drug Treatment Monitoring System (NDTMS) report ‘Adult substance treatment activity in England 2015-16’ shows that in the 12 months to 31st March 2016, clients exhibiting problematic or dependent drinking represented a total of 144,908 individuals, the second largest group in treatment (see pie chart, illustrated right). Of these, 85,035 were treated for alcohol treatment only and 59,873 for alcohol problems alongside other substances.

The overall number of individuals in treatment for alcohol fell by 4% compared to 2014-15, with the numbers for alcohol only decreasing by 5% since then, to reach its lowest total since 2009-10 (illustrated below). However, this figure still represents more than double the annual number of alcohol only clients recorded since records began in 2005-06 (35,221 clients).

The report noted that those in treatment for alcohol only and opiates tend to be much older than individuals who have presented for problems with other substances. The median age of alcohol only clients was 45 years, with 68% aged 40 or over and 11% aged 60 years and over.

Roughly three-fifths of alcohol only clients were male (61%) although this was a lower proportion than those representing the entire treatment population in 2015-16 (70%). The report’s authors suggested that this finding is “likely (to) reflect the differences in the gender prevalence of problematic alcohol and drug use.” PHE will be releasing estimates of alcohol dependency late 2016.

Individuals starting treatment in 2015-16 were most likely to present with problematic alcohol use (62%, or 84,931 new clients) (illustrated, below). But alcohol only clients also had the highest rates of successful exits of all clients presenting for treatment, with just under two-thirds (62%) successfully completing treatment, up on 61% in the previous year.

However, there were also more deaths among those accessing treatment for alcohol only problems; there were 817 deaths in 2015-16, 3% more than the previous year.

The report also noted that since alcohol service providers started reporting to NDTMS in 2005-06, alcohol citations have remained relatively stable, although the gathering of information on alcohol treatment service providers since 2008-09 may have been one of the main drivers of an overall increase in clients seeking treatment for substance use in general over the last decade.

Responding to the latest figures, Rosanna O’Connor, Director, Alcohol, Drugs & Tobacco within the PHE Health and Wellbeing Directorate, said:

“It is clear from the data that there is an increasing need for services to meet the complex needs of older more vulnerable drug and alcohol users in treatment as well as finding ways of helping those accessing services for the first time to get the treatment they need and move on with their lives.

“Within the data there is much to be hopeful about… But we certainly can’t be complacent – PHE, national and local government and providers, all need to enhance our efforts to ensure that treatment is a safe platform from which to achieve recovery.”

Before you pick up a drink again maybe reflect on this data and if you are in this age range perhaps ask yourself the question whether you really want to go back to that cycle of drinking or whether a longer period of abstinence might be helpful to evaluate your relationship to drinking further?  Just a thought 🙂

Do I Drink Too Much?

So it’s the last day of January and to those of you taking part in Dry January congratulations if you made it this far.  Have you been reflecting on whether you drink too much as part of that month off?  Perhaps on your last night of sipping sparkling water you might want to watch this documentary which aired in December on BBC Wales.  Thanks to my friend Libby for bringing it to my attention!

Lib featured it as part of her News and Update round-up for December on Alcohol Policy UK and if you wish to read all of it you can find it here:

News & updates December 2016: middle-age health, drink-driving, the rise of alcohol-free & the return of benchgirl

Public Health England publish review of evidence on alcohol

Public Health EnglandThis summary report was published by Alcohol Research UK in December.  It looked at Public Health England’s new published review of evidence on alcohol.

Public Health England has published a review of international evidence on alcohol policy and harm reduction.  The new report, based on almost two years of research and analysis, addresses a number of key policy areas.

These include:

  • The price of alcohol and its effect on consumption
  • The impact of both the number of alcohol outlets in a given area, and the times at which they operate, on a range of potential harms
  • The effectiveness of existing controls on marketing, sponsorship and promotion
  • The role of ‘brief interventions’ in preventing harmful drinking
  • The effectiveness of schools-based education programmes
  • The evidence on alcohol treatment in tackling harmful and dependent drinking

We welcome this important contribution to the literature on alcohol harm prevention. It provides both a resource for identifying key evidence and an evaluation of the relative effectiveness of policy interventions based on an extensive process of reflection and review.

Today’s report also provides a new analysis of drinking trends and their economic effects. It confirms that average consumption has been falling in the UK for over ten years, especially among young people. However, it also shows that trends vary between social groups, reminding us that average consumption provides only a rough guide to where harms are concentrated, and that harms can rise even when overall consumption falls.

Importantly, the report confirms previous studies showing that around one third of all the alcohol consumed is drunk by the heaviest drinking 5% of the population.  This demonstrates not only how heavy drinking is concentrated, but the very high proportion of alcohol that is sold to people with serious drinking problems.

The report draws particular attention to the impact of alcohol on economic productivity: suggesting that drinking causes more years of life lost to the workforce than are caused by the top ten most common cancers combined. While the precise social costs of alcohol remain hard to quantify, this report shows clearly that heavy drinking creates an enormous burden for the wider economy.

The PHE report echoes previous evidence reviews in demonstrating that price is a key policy lever in shaping consumption. Its findings suggest that a combination of minimum pricing and more targeted taxation could reduce both harmful drinking and health inequalities (especially the so-called ‘alcohol harm paradox’). Clearly, this is a significant finding as the Scottish Government continues to deal with a prolonged legal challenge to MUP from the Scotch Whisky Association.

The report also argues that while evidence on factors such as outlet density is less compelling than is the case for price, nonetheless limiting hours of sales can reduce antisocial behaviour and drink-driving. While, in the UK, evidence on the relaxation of licensing hours since 2005 has not shown a clear effect in terms of crime, disorder or hospital admissions the authors point to international studies and reviews that show a stronger correlation.

The report also follows previous reviews in pointing to evidence that exposure to marketing can lead to earlier and higher levels of consumption among young people. It finds no robust evidence that existing marketing controls are effective in preventing youth exposure to marketing, and so will strengthen calls for a reassessment of the current regulatory framework.

It also finds no clear evidence that voluntary industry-led partnerships (including the recent ‘Responsibility Deal’) reduce alcohol harms. This is partly because there are insufficient independent and robust evaluations of such schemes to provide clear evidence of an effect, and also because it has been argued that many of the changes introduced under the Responsibility Deal would have happened anyway.

While the report confirms that, from a public health perspective, price, availability and marketing are key issues, it also addresses questions around treatment and interventions. This is especially important as the impact of austerity continues to be felt in widespread cuts to budgets for treatment services across the country.

The review finds considerable evidence that screening and brief interventions in primary care can help prevent harmful drinking. On a policy level, a key question now is how to support GPs in actually carrying out screening and delivering interventions effectively where there is a need. Currently, delivery of interventions in primary care remains low so work to better incentivise and train GPs is needed. The review, however, also notes that the evidence for the effectiveness of brief interventions in other settings (such as the workplace or local pharmacies) is much less robust..

In line with most previous reviews, the report finds that while education can play an important role in raising awareness and knowledge, the evidence for its effectiveness in changing behaviour is weak. This is not necessarily because schools-based prevention and education is wholly ineffective, but because its impact is inevitably limited (behaviours are driven by far more than simple knowledge of harms) and because the delivery of programmes is often highly inconsistent.

Finally, on drink-driving, the review finds strong evidence that reducing the blood alcohol limit is effective in reducing accidents. England and Wales currently have a BAC limit of 0.8 g/l – the highest in Europe, alongside Malta.

Overall, this report represents a key summary of the available evidence on alcohol. It confirms that there are policy levers available to Government that can have a measurable impact on alcohol harm reduction. Clearly, alcohol policy needs to balance a range of interests, but if the Government is serious about seeking to reduce the health impacts of alcohol then this evidence review is of critical importance.

The PHE report is based on a very wide-ranging analysis of available research and an extensive process of peer review. We hope that it forms a key element in the development of alcohol policies in future.

So 5% of the population equates to approximately 2.6 million people here in the UK …… (source).  And Alcohol Policy UK pose the prompted question which I’d like to know the answer to as well:

PHE evidence review 2016: will Government policy respond?

 

 

Alcohol-related cancers projected to rise – can mass media campaigns help?

cruk-university-of-sheffield-logoThis was published by Alcohol Policy UK in December regarding alcohol-related cancers.

Increasing recognition of the risks of alcohol-related cancer has been a priority for a number of health organisations, with recent research identifying limited levels of awareness and projected rises in incidences.

report released last month commissioned by Cancer Research UK (CRUK) attracted significant media coverage of its findings that alcohol-related cancers could cause around 135,000 deaths over the next 20 years in England. The modelling was carried out by Sheffield University and analysed figures under a number of consumption forecasts, and also provided updated estimates of the potential benefits of Minimum Unit Pricing (MUP). A 50 pence MUP could reduce all alcohol-attributable deaths by 7,200, including 670 cancer deaths over the next two decades, reducing alcohol-related healthcare costs by £1.3 billion.

The report follows findings released earlier in the year by CRUK stating the understanding of the link between alcohol consumption and cancer was “worryingly low”; only 13% identified cancers as a possible risk when asked to identify alcohol-related health conditions associated with drinking too much. Recognition improved when prompted with possible cancer types, but those such as breast cancer had far lower recognition than less prevalent alcohol-related cancers. See here for a CRUK alcohol and cancer page.

Data used from the report though has just been published in BMC Public Health journal revealing significantly higher awareness of the links in the North East region, where Balance North East has been conducting media campaigns including TV advertswww.reducemyrisk.tv and #7cancers Twitter activity.

Media campaigns: a question of behaviour change?

Health groups though tend not to want to see health campaigns in isolation owing to the limited impact on behaviour. Indeed similar debates have taken place with regard to the awareness of the revised drinking guidelines and the limitations of their impact on consumption.

Ealier this year Chief Medical Officer Dame Sally Davies attracted controversy for suggesting drinkers should think ‘Do I want the glass of wine or do I want to raise my own risk of breast cancer?’ each time they drink. Whether any significant number of people have taken on the CMO’s advice – or indeed deliberately rejected it – will remain unknown, but based on the evidence of the complexity of behaviour change it would seem unlikely.

As such health groups, including CRUK, not only wish to see media campaigns and improved information through mandatory labelling, but also action on price, availability and marketing. Such levers have considerably stronger evidence to support an impact on drinking behaviours, but are of course opposed by those who may support informed individual decision making but not the Government in influencing it via regulation.

As for the near future, momentum may continue with a general trend in increasing awareness of alcohol health harms. Whether this will be supported in England by legislation to ensure mandatory labelling on containers, or indeed change environmental influences, is uncertain. In the meantime, alcohol-related cancers are likely to rise before they fall, even should consumption fall further.

estimated-trends-in-annual-alcohol-attritubutable-cancer-deaths-following-reduction-in-consumptionA picture paints a thousand words ……

And edited to add this small celebratory footnote: Voted  Top 100 Addiction Blogs Winner from thousands of top Addiction blogs in Feedspot’s index using search and social metrics.  Ranked 53rd based on Google reputation and search ranking, influence and popularity on Facebook, Twitter and other social media sites, quality and consistency of posts and Feedspot’s editorial team and expert review 🙂

Guest Post: Finding the Link Between Substance Abuse and Schizophrenia

pt_figure_dopamine-pathways-in-schizophrenia_53127-pngI was contacted on email by Justin in November who said; “I am a recovering addict and content writer interested in providing a guest post article.  In my path to recovery I’ve taken to writing content about addiction, recovery and substance abuse through my treatment program.”  Here’s what he wrote about substance abuse and schizophrenia:

New studies have found a link between substance abuse and schizophrenia.  While the relationship between mental health and substance abuse is an incredibly complex one, a group of Denmark researchers have determined that abuse of virtually every type of drug can contribute to mental deterioration and eventual, schizophrenia.

A common misconception about schizophrenia is that those afflicted have split personality disorder or multiple personalities.  However, this has been determined false, as most people suffering from schizophrenia are non violent and lead fairly normal lives, posing no immediate threat to others. Per the National Institute of Mental Health:

“Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.”

Rather than split personality disorder, which is a separate diagnosis, those suffering from early onset schizophrenia can experience a decrease in mental processing, rational thinking and general mental well being.  Furthermore, in can take years for schizophrenia to fully develop and during this time, can manifest itself as more common mental health disorders like depression and anxiety.

So what environmental and societal factors can worsen these symptoms into full blown schizophrenia?

The new Denmark study has determined that substance abuse can not only trigger schizophrenia in people genetically at risk, but also increase the chances of developing schizophrenia by up to six times.

While the direct cause and effect relationship between substance abuse and schizophrenia is tremendously complex, the study found the following increases in risk:

  • Cannabis: 5.2 times
  • Alcohol: 3.4 times
  • Hallucinogenic drugs: 1.9 times
  • Sedatives: 1.7 times
  • Amphetamines: 1.24 times
  • Other substances: 2.8 times.

The study notes, while the effects are not often immediately noticed, symptoms of schizophrenia as it relates to drug abuse, often surface later in life: sometimes ten to fifteen years after the substance abuse diagnosis.

Mental health and substance abuse treatment centers often offer dual diagnosis programs for this exact reason, noting that symptoms of schizophrenia can be coupled with drug use.

A particularly worrisome finding of the study is the risk found with two of the most prevalent substances, marijuana and alcohol.  While marijuana is federally illegal, it is used medicinally and recreationally in many stages, including California.  A large factor in the correlation found between cannabis and schizophrenia is due to the fact that people can be exposed to it second hand.  That is to say, unlike most other substances (not smoked), marijuana can be introduced to people’s systems indirectly, simply by being in close proximity of someone that is using the drug.

Alcohol on the other hand, tops the list, as it’s the most socially acceptable and easily obtainable substance given it’s legal place in American media and culture.

While the newly discovered findings presented by the Denmark study do not provide us with a black and white relationship between schizophrenia and substance abuse, the evidence is undeniable: The prolonged abuse of illicit drugs and alcohol increases the risk of developing schizophrenic tendencies and symptoms later in life.

Article courtesy of the team at Muse Treatment

Thank you Justin!