Category Archives: Social

Are YOU drinking too much?

Two articles that appeared in the news last summer that feel like they would be good to share now when we have our hair shirts on rather than our Hawaiian one’s!  One is from the UK Daily Mail and asks the question of ‘are we drinking too much?’ and the other is from the US and says the answer is yes!  Both are incidentally talking about the same JAMA paper that was published in August 2017.

Study Warns Of Binge-Drinking “Crisis” As Alcoholism Rates Spike 49%

The prevalence of 12-month DSM-IV AUD increased significantly from 8.5% to 12.7% (change, 49.4%) in the total population. Significant increases in AUD were seen in all subgroups except Native Americans and those residing in rural areas. Notable increases were found among women (83.7%), racial/ethnic minorities (51.9% for Hispanic and 92.8% for black individuals), adults 65 years and older (106.7%), those with a high school education (57.8%) and less than a high school education (48.6%), those earning incomes of $20?000 or less (65.9%), those living within 200% of the poverty threshold (range, 47.1%-55.8%), and those residing in urban areas (59.5%)”

From The Daily Mail article:

A DANGEROUS LINE

But when do your long lunches, after-work drinks or that ‘decompression’ glass of wine at home become a cause for concern?

‘Not everyone who drinks heavily will become dependent, or an alcoholic,’ explains Dr Mohiuddin. ‘But some of us are definitely predisposed to it.

‘It’s a mixture of genes and environment. Many people with a drinking problem have a family history of it – a parent, aunt/uncle, a grandparent. It doesn’t mean everyone in a family will suffer.

‘However, if the environment is there – perhaps a job with a heavy drinking culture – a problem can develop.’

Around 20 percent of people in Britain and the USA drink to a hazardous level, figures show.

‘It’s easy for many people to get through a bottle of wine a night, and over time, this can creep steadily upwards, to two or even three,’ says Dr Mohiuddin.

‘In my experience, a lot of heavy drinkers – both men and women – steadily move onto harder things. 

‘They may start with beer or perhaps wine and then progress on to heavy spirits such as vodka or whiskey.

‘However it’s not necessarily what you are drinking or where, it’s the amount and the effect it’s having on your life (see below). Some people will be able to cut down, while others will try and then realise they can’t – a sign of dependence.

‘There is a significant proportion of heavy drinkers who don’t realise or are in denial that they could be functioning – albeit progressively less functioning – alcoholics.’

THE WARNING SIGNS

‘The main problem is that it’s quite easy for some people to slip into drinking regularly – and the soothing effect it gives you becomes like using a tranquilizing medication such as diazepam,’ explains Dr Mohiuddin.

‘But over time, the benefits wear off quicker and you need more alcohol to get the same effect.’

‘Many people associate being an alcoholic with drinking in the morning, the old adage of ‘vodka on the cornflakes’ or sitting on a park bench with a can of cider – but there are many more subtle signs of dependence and/or alcoholism.’

The Royal College of Psychiatrists has produced a list of classic symptoms that show your drinking has stepped up to a worrying level. These include:

  1. You regularly use alcohol to cope with anger, frustration, anxiety or depression – instead of choosing to have a drink, you feel you have to have it.
  2. You regularly use alcohol to feel confident
  3. Your drinking affects your relationships with other people – they may tell you that, when you drink, you become gloomy or aggressive. Or, people around/with you look embarrassed or uncomfortable when you are drinking.
  4. You stop doing other things to spend more time drinking – these other things become less important to you than alcohol.
  5. You carry on drinking even though you can see it is interfering with your work, family and relationships.
  6. You hide the amount you drink from friends and family
  7. Your drinking makes you feel disgusted, angry, or suicidal – but you carry on in spite of the problems it causes
  8. You start to drink earlier and earlier in the day and/or need to drink more and more to feel good/get the same effect
  9. You start to feel shaky and anxious the morning after drinking the night before
  10. You get ‘memory blanks’ where you can’t remember what happened for a period of hours or even days

Before I stopped I had all 10 warning signs.  The articles recommendation:

HOW TO CURB YOUR DRINKING BEFORE IT’S TOO MUCH

  • Set yourself a target to reduce the amount of alcohol you drink.
  • Avoid high-risk drinking situations and work out other things you can do instead of drinking.
  • Opt for lower-strength options, such as 4 percent beers or 10 percent wines.
  • Involve your partner or a friend who can help agree a goal and keep track of your progress.

WHAT TO KNOW IF YOUR’E DRINKING HEAVILY

If you are drinking heavily, do not stop suddenly – see your GP or another medical professional, says Dr Mohiuddin. 

‘Some people manage to stop suddenly without any problems, but others may have withdrawal symptoms such as nausea, vomiting, shakiness, sweating, increasing anxiety, headache and even hallucinations. In fact, going ‘cold turkey’ if you’re a very heavy drinker is highly risky and could be fatal. Hence, it is not recommended.’

And if you fear you can’t stop or cut down on your own, there are many specialist alcohol workers who can help. Your GP should be able to tell you about services available in your area.

Some people, especially those with a possible or real dependence, will need more comprehensive help and treatment. For example, says Dr Mohiuddin, if you’ve been using alcohol as a de-stressor, or to try and block out your worries, therapy can help you address these issues and find other, non-destructive ways of dealing with them.’

In the case of alcohol and certain drugs a medical detox is essential – there can be serious health implications linked to sudden withdrawal. 

There are also a wide range of tests to help staff ascertain the damage done to the body by drugs and alcohol, allowing patients to get tailored treatment plans that suit their needs with the help if therapists, doctors and a full nursing team.

‘Another option is to attend a support group for drinking problems, such as Alcoholics Anonymous, where there are other people in your situation who understand and can give you support,’ says Dr Mohiuddin. 

‘There are meetings all over the world and they’re free to attend.’

And for friends or relatives worried about someone they know or suspect has a drinking problem, there is Al-Anon – a spin-off of Alcoholics Anonymous. 

All good advice which I would advocate.  You can always reach out to me here and I will do my best to signpost you to the relevant services and support you need.

Guest Blog Post from Alcohol Concern and Dry January

It’s almost that time of year again!  Today I’m honoured to feature a guest blog post written for the blog by Alcohol Concern to promote their soon to be active Dry January campaign which kicks off in a few days!

Over to Alcohol Concern:

Dry January feels like it’s been around forever, doesn’t it? It’s as ubiquitous to January as New Year’s resolutions and the post-Christmas belly. But how much do you know about it?

Dry January is an annual behaviour change campaign, which encourages people to give up alcohol for the month of January. A YouGov poll commissioned by charity Alcohol Concern has revealed that an estimated 3.1 million people[1] in the UK are already planning to do Dry January in 2018. They will ditch the booze for one month to feel healthier, save money and re-set their relationship with alcohol.  

The campaign is run by national charity Alcohol Concern, which merged with Alcohol Research UK in April to become an even stronger advocate for a world in which alcohol causes no harm.  

In 2012 a woman named Emily Robinson joined Alcohol Concern. She had decided to give up alcohol for January, and absolutely everyone wanted to talk to her about it. She was having lots of conversations about alcohol and the benefits of taking a break from drinking – just the kinds of conversations Alcohol Concern wants to have on a wider scale. The national Dry January campaign was born.

Dry January has gone from zero to over five million participants in five years. This is its sixth year running, and we’re expecting the biggest year yet. Dry January now looks suspiciously like a movement – a movement of people who want to be in charge of when, what and how much they drink. Someone you know will be doing it. Probably more than one. Maybe your whole family. Maybe your whole office. Probably not the whole country but hey – we can dream.

Dry January is  quite different to Sober for October (run by Macmillan Cancer Support) or the Dryathlon (run by Cancer Research UK), because it’s about YOU. It’s not about raising money for charity (though if you want to, you can do that through Dry January). It’s not about giving something up.

Cutting alcohol out for a month can result in some amazing benefits to health – alcohol puts strain on the body, can disrupt sleep, have a negative impact on skin, and cause weight gain. Going dry for a month can work wonders for people financially, as the average person in the UK spends £50,000 on booze over their lifetime. Additionally, Dry January allows people to develop a new relationship with alcohol and learn the skills needed to say no when they don’t fancy a drink. Two-thirds of people who attempt Dry January make it through the month without drinking, while 72% maintain lower levels of harmful drinking than before Dry January six months later. [2]

Public Health England has endorsed Dry January, saying “Dry January is based on sound behavioural principles and our previous evaluation of the campaign shows that for some people it can help them re-set their drinking patterns for weeks or even months after completing the challenge.”

People can sign up for Dry January at dryjanuary.org.uk, or by downloading the Dry January & Beyond app via the App Store or Google Play. People who sign up to Dry January are more likely to make it through to the end of the month without drinking. They get access to support, tips and tricks, prize draws, and the app, with features including a unit calculator, calorie counter and money-saved tracker. Dry January is for anyone and everyone. Even if you already don’t drink, signing up and sharing the campaign can encourage others to do the same.

To sum up, here’s a quote from blogger Jenna Haldene, who reckons you should give Dry January a go.

“I didn’t think I felt bad at the time. I assumed that it was normal to feel tired and slightly sluggish, and that it was just a side effect of getting older. It wasn’t until I gave my body a much-needed break from alcohol that I realised how much potential I had to feel amazing.”

Sign up for Dry January now.

Read Jenna’s whole blog about cutting out booze here.

If you drink very heavily or experience physical withdrawal symptoms when not drinking alcohol, then Dry January is probably not for you. Instead, you should seek support from your GP or alcohol services; find out what’s available in your area here. Unsure if this applies to you? Try our alcohol audit.  

[1] The poll found that 6% of UK adults are planning to do Dry January. Figure of 3.1 million UK adults planning to do Dry January: total population aged 18+ in the UK 51,767,543 (ONS, Population Estimates for UK: mid-2016, table MYE2); 51,767,543 x .06 = 3,106,053.  

[2] Evaluation by University of Sussex, School of Psychology 2014

Drugsland

So although this blog is primarily about alcohol addiction, substance abuse and misuse isn’t that neat and tidy and many of us have/had multiple addictions to many substances and behaviours.  I recently watched the BBC series Drugsland which I was really impressed with and learnt a great deal hence wanted to share here for those of you who may also be interested.

The image on this blog post comes from an organisation called The Loop:

The Loop is a not for profit Community Interest Company established in 2013 which provides drug safety testing, welfare and harm reduction services at nightclubs, festivals and other leisure events.

We also provide staff training on drugs awareness, in-house welfare service delivery, the prevention of drug related harm at events, and the delivery of ethical ‘front of house’ drug safety testing services.

This part of their service really struck me as vital:

To provide an opportunity to engage with hidden and hard to reach user populations who are predominantly not in touch with drugs services and who are unlikely to get the opportunity to have any other advice or brief interventions

Such a brilliant organisation and much needed service.

Here is the link to the episode of Drugsland which features Prof David Nutt and Dr Ben Sessa talking about the 1971 Misuse of Drugs Act which at over 45 years old still governs the legal, and therefore criminal processes, here in the UK.  There is also an interesting discussion about how alcohol and tobacco should be made illegal if there are no changes to current drugs laws!

Drugsland: The Fix

And this one is also well worth a watch:

Drugsland: Dying to Get Clean

To be honest all four episodes are excellent although at times I found them hard to watch.  I agree with all that David Nutt and Dr Sessa say and believe it is time to review and revise the policy around drugs including decriminalisation so that drug testing and harm reduction services could be more widely expanded to support public health and safety.  I would have happily used the services of The Loop if they had been available in my past and would encourage anyone to use them if they are present at an event you are attending.  New Years Eve used to be a big night out back in the day so sharing this felt timely as we approach just that night.

If you’re concerned about your drug taking and need advice and support the Drugsland website also provide an excellent list of resources:

Information and Support

 

Xmas Sober Jukebox (Wish you were here)

 

 

 

 

 

 

Don’t think she’s sober but I love the quote! Merry Xmas from all the HOF clan! 🙂

If you’re needing some advice to get you through today then Hannah Bett’s wise words will be the perfect (non-alcoholic) tonic 😉

A teetotaller’s guide to drinking less alcohol this Christmas (and why dry Yule is best)

And if you are a child or young person reading this who are struggling with parental drinking concerns then check out the support at Nacoa including their #AdventCare messages.  They are there today and every day over Xmas & New Year between 12 – 6 pm if you need to speak to someone: Free Helpline: 0800 3583456 & helpline@nacoa.org.uk

David Bowie RIP – sober hero since the late 70’s when he was given custody of his son

Wish you were here ……

Minimum unit pricing to go ahead in Scotland after 5 year legal battle

MUP is a more effective means of reducing socioeconomic inequalities in health than taxation ( Colin Angus‏ @VictimOfMaths)

From Alcohol Policy UK today:

Today the UK Supreme Court delivered the final verdict on Scotland’s long running legal challenge to introducing Minimum Unit Pricing (MUP). The Scottish Government first passed legislaton in 2012 but a number of industry bodies spearheaded by the Scotch Whisky Association (SWA) forced a series of challenges under EU which some public health figures have described as ‘delaying tactics’.

The legal challenge rested on the argument that MUP contravened EU competition law, arguing instead that taxation would be a more appropriate means of achieving its aims. However the Supreme Court disagreed stating health objectives and the free market were “two incomparable values” and declaring MUP a “proportionate means of achieving a legitimate aim”. The court also rejected the appeal’s claim that the Scottish Government should have committed to going further in assessing market impact as unreasonable, acknowledging its commitments to evaluating the impacts and the five year sunset clause. 

Public health groups and academics involved in MUP took to Twitter to express relief and comment on the judgement and next steps. The SWA have issued a brief statement on the decision whilst a Spectator article by veteran ‘anti-nanny state’ commentator Christopher Snowden says MUP ‘won’t end alcoholism’. However James Nicholls suggested this was a ‘straw man’ argument and has written a response to the ruling outlining MUPs aims and key considerations. The news has also been covered by the BBC, Telegraph, The Scotsman and Guardian, with further coverage and comment likely throughout the week.

Absolutely delighted that minimum pricing has been upheld by the Supreme Court. This has been a long road – and no doubt the policy will continue to have its critics – but it is a bold and necessary move to improve public health.

— Nicola Sturgeon (@NicolaSturgeon) November 15, 2017

Where next?

The Scottish Government will no doubt hope to see MUP come into effect as soon as possible; indeed the likely impact (see latest Sheffield modelling here) of the 50 pence per unit floor price will be significantly lower than had it been introduced in 2012, though its level can be addressed as part of the legislation. Wales and Ireland will also be welcoming the ruling having taken their own legislative steps to introduce MUP.

As for England, further pressure will no doubt be placed on the Westminster Government who, after David Cameron’s infamous 2012 u-turn, have committed only to monitoring Scotland’s proceedings. Watch this space.

Absolutely bloody brilliant news!!!

Edited to add:

Scottish Government minimum pricing consultation & evaluation details
Wales MUP evidence heard as consultation closes

Alcohol Awareness Week 2017, 13-19 November: ‘Alcohol and Families’

Courtesy of Alcohol Policy UK – Alcohol Awareness Week 2017, 13-19 November: ‘Alcohol and Families.’

Alcohol Concern have announced this year’s Alcohol Awareness Week (AAW) will take place from 13-19 of November on the theme of ‘Alcohol and Families’. The charity, which has recently merged with Alcohol Research UK, has partnered with Adfam, a charity that supports families affected by drugs and alcohol.

As with previous years, Alcohol Concern hope AAW will prompt conversations about the impact of alcohol, this year ‘to help break the cycle of silence and stigma that is all too often experienced by families’. This may also help people access services or support either directly or via signposting from professionals.

Alcohol Concern will release a number of online resources that will be free to download, including:

  • Expert factsheets on various issues associated with alcohol and families
  • An easy to understand, visual depiction of the Chief Medical Officers’ guidelines for low-risk drinking for print and social media use
  • A bank of statistics for you to use

To receive this pack directly to your email, please click here. Alcohol Concern will be sharing information, resources and stories throughout the week on Facebook and Twitter using the hashtag #AAW2017. Family members who have been affected by a relative’s drinking and wish to share their story can get in touch with Alcohol Concern at contact@alcoholconcern.org.uk.

Protecting families and children: more to be done?

Earlier this year a manifesto for action to support ‘Children of Alcoholics’ (COAs) called upon the Government to take ten key actions including a targeted national strategy, local funding to support alcohol services, a plan to change attitudes and action on price and availability.

In 2014 a report from the Children’s Commissioner looked at the number of children affected by parental alcohol misuse and at the help available to them, calling for further action by services and local authorities. An Alcohol Hidden Harm Toolkit was also released to support managers, commissioners and practitioners involved in designing, assessing or improving Alcohol Hidden Harm services for children and families. Many will bee hoping AAW 2017 helps not only raise awareness of the issue, but also prompts further attention and resources for prevention and support

Links to all #AAW2017 content

Resources

Case studies

And this valuable research was released recently too:

Drugs for the treatment of alcohol dependence: insufficient evidence?

Plus this was published yesterday – more support for MUP when the Scottish decision is finally announced:

The killer on Britain’s streets – super-strength alcohol 

And an update from Alcohol Policy UK today (14th Nov):

Alcohol Awareness Week 2017 kicks off in week of MUP decision

It’s a big week!

New drug strategy prompts calls for clear national alcohol policy

Another great post from Alcohol Policy UK regarding the Govt’s 2017 Drug Strategy released in July.

The release of a new national drugs strategy for England and Wales has prompted revised calls for a new national alcohol strategy that includes minimum unit pricing (MUP).

The last national alcohol strategy was released in 2012 promising MUP, followed by an infamous U-turn. MUP has of course still yet to be implemented in Scotland, though a final legal ruling is expected this month following a drawn out legal challenge, with Ireland and Wales also committed.

MUP aside, alcohol objectives feature across several other policy domains, including as part of a Modern Crime Prevention Strategy, various PHE guidance and a national CQUIN incentivising brief intervention delivery across hospitals.

The new drugs strategy though refers to drugs and alcohol throughout, thus in the context of treatment for alcohol problems it may be seen as reflecting national alcohol ambitions for treating and preventing all substance dependence. Indeed a section on alcohol states:

While the focus of this Strategy is on drugs, we recognise the importance of joined-up action on alcohol and drugs, and many areas of the Strategy apply to both, particularly our resilience-based approach to preventing misuse and facilitating recovery. Alcohol treatment services should be commissioned to meet the ambitions set out in the Building Recovery chapter that are relevant to them, and in line with the relevant NICE Alcohol Clinical Guidelines. Commissioning of alcohol and drug treatment services should take place in an integrated way, while ensuring an appropriate focus on alcohol or drug specific interventions, locations, referral pathways and need.

In addition, local authority public health teams should take an integrated approach to reducing a range of alcohol related harm, through a combination of universal population level interventions and interventions targeting at risk groups. The Modern Crime Prevention Strategy 2016 highlights alcohol – as with drugs – as a key driver of crime and sets out a range of actions to tackle alcohol-driven crime.

The strategy though is not titled a ‘drug and alcohol strategy’, and some argue that there are many issues with providing alcohol treatment – or indeed strategies – under the same roof. Until April 2019 the ring-fenced but still shrinking Public Health Grant to local authorities will require local authorities to ‘have regard to the need to improve the take up of, and outcomes from, drug and alcohol services’, but not thereafter. The strategy also highlights the UK devolved administrations have ‘their own approaches to tackling drug and alcohol misuse and dependence in areas where responsibility is devolved’. 

Where next for national alcohol policy?

Calls for a single national alcohol strategy seem logical, if not at least to make clear the Government’s ambitions across the wide range of areas where alcohol harm and policy can reach. As well as a national drug strategy, a new tobacco control strategy has also been released, further highlighting an apparent gap. From a political perspective however, a lesson from the 2012 alcohol strategy appears to be not to commit to ambitious policies with powerful opponents; at least not until the path is clearer. Indeed since the MUP U-turn, Ministers have said on MUP they would be waiting to see what happens in Scotland.

Other alcohol policy areas are seemingly in an ongoing state of political bargaining. Marketing and availability are hotly contested areas, with health groups calling for the adoption of key approaches including taxation and effective levers identified in the recent PHE evidence review. Translating such calls into action is of course complex and faced with opposing voices, as debates over licensing policy have recently demonstrated.

The drug strategy though has received some praise for highlighting the need for evidence based approaches to prevention and treatment, and the need for addressing multiple-needs and overlapping issues including mental health. Others have argued it as the ‘same old rhetoric’, particularly when treatment budgets are ever shrinking.

Last year a small drop in the number of people accessing alcohol treatment was seen, though unlikely to be linked to the downturn in overall consumption since 2004. Other alcohol trends present a complex picture yet overall alcohol-related hospital admissions are still rising. Regardless of the various trends, many consider the scale and reach of alcohol problems deserve a single national policy for England and Wales. Given that no alcohol strategy will be universally praised or indeed gain much in voter popularity, some may consider its absence suggests political expediency has come first.

I know I sound like a stuck record about MUP but it’s because I agree with those who keep proposing it!

Tighten alcohol availability to reduce alcohol-related harms

Following last weeks blog post about alcohol availability this feels like the perfect follow on.  As reported by Alcohol Policy UK in June IAS in the UK & FARE in Australia released this report looking at tightening alcohol availability to reduce alcohol-related harms.

A new report has called for tighter restrictions on alcohol availability to help address alcohol-related harms, including pressures on emergency departments, hospitals and the police.

The report Anytime, Anyplace, Anywhere? [pdf] reviews fourteen alcohol licensing policies in Australia and the UK rating them for their effectiveness in reducing harm. It follows recent research identifying the extent of alcohol availability in England, and a recent call from the Lords Licensing Review Committee for a fundamental overhaul of the Act.

Produced jointly by the the UK Institute of Alcohol Studies (IAS) and the Foundation for Alcohol Research and Education (FARE) in Australia, the report makes ten recommendations for reducing alcohol-related harms through existing licensing policy frameworks including:

  • Restricting trade hours of on-licence venues to limit the availability of alcohol in the early hours of the morning
  • Enhancing community involvement, better facilitating the engagement of local residents with licensing systems
  • Adding / prioritising public health and / or harm minimisation objectives in alcohol legislation
  • Restricting the sales of high risk products in areas of concern; and
  • Deprioritising government support for industry voluntary schemes in place of policies supported by evidence.

In the document’s foreword, Professor Robin Room states:

“The availability of alcohol is a crucial element in what happens with consumption trends and with rates of alcohol-related harm. Public policy needs to prioritise evidence-based controls on the availability of alcohol to reduce rates of harm.”

Ahead of the launch of the report, Kypros Kypri, Professor of Public Health at University of Newcastle, Australia said:

“There is strong evidence to show that earlier closing times can make a significant difference to the strain alcohol places on emergency services. In Sydney, bringing forward closing times to 3am was associated with a 25% reduction in alcohol-related presentations to the local hospital.”

UK policy calls – falling on deaf ears?

In 2016 the IAS released an extensive report on the 2003 Licensing Act, which said the interests of the licensed trade have benefited over those of local communities. Despite mounting calls to review licensing legislation in England, including from the subsequent Lord’s licensing committee, there appears no intention to fundamentally change national policy – perhaps not surprising within the immediate political climate.

Currently national policy may be best inferred from the 2016 modern crime prevention strategy which sets out three main alcohol-related crime and disorder objectives, including a pledge on ‘equipping the police and local authorities with the right powers’. Critics of the current Act though have also argued that enforcement powers are not fully utilised, possibly reflected by the falling number of premises being called for review. In addition the crime strategy emphasises building local partnerships through industry led schemes – an approach the latest IAS & FARE report calls to be replaced by those supported by firmer evidence. Indeed questions have been raised over the lack of evidence to support the impact of voluntary partnerships schemes, notably ‘Community Alcohol Partnerships’ (CAPs). In contrast, Cumulative Impact Policies do find overall favour in the latest report, albeit with some limitations.

Read the full report here

Friday Sober Inspiration: Out of Time (Midlife, if you still think you’re young)

Prim recently lent me this book to read ‘Out of Time‘ – a book about midlife, or as Carl Jung called it the ‘midlife transition‘ between youth and old age.  As I approach both my 4th soberversary and my 49th birthday it feels hugely prescient.  Thank you Prim! 🙂

And as you would hope there was a passage about stopping drinking as part of that experience.  Over to Miranda:

An old friend of mine gave up drinking when he was 45 (I was 6 weeks before my 45th birthday).  He says: ‘I decided I was going to divide my adult life into two halves.  Twenty five years’ boozing.  And twenty five years without booze.’

He gave up after a many-week bender that took him to New York, then Manchester – partying ‘with a bunch of doctors and judges, everyone off their tits’ – then out to the countryside and a New Year’s Eve on the Jim Beam and the JD and the charlie: ‘I was totally out of it for a month.’  He woke up on New Year’s Day and couldn’t get out of bed until 6pm.  His kids were worried about him, he was three stone overweight and he was in agony.  I thought: ‘This is going to finish me off, if I carry on like this.  Don’t get me wrong, as a swan song, that month was brilliant.  But I had to stop.’

So he did.  No drink, no drugs.  His social life had to change, obviously, but he gave himself some rules.  Now, if he’s going out with friends, there has to be a purpose to the evening – ‘a third-party stimulus’ – like a meal, or a comedy night, or a film.  If he’s going to a party, he will stay only two hours: ‘9.30 till 11.30.  And then I leave.  It’s fine. Nobody cares.’

He says: ‘There’s nothing so good as a night out on the piss.  And I’ll always have the Pub Years.  But I’d like to live the life I’m living until I’m 70, to be active and thoughtful, to work and engage with things.  You get less sharp as you get older and I don’t want to do anything to make that worse.’

We talk about the difference between drinking in your twenties and early thirties and drinking when you’re older.  His forty-something boozing resulted in him getting into some proper scrapes.  The drinking kept him behaving as though he were younger, as though he was the same age as when he’d first started properly drinking.  It helped him ignore the fact that his life had changed, that it involved other people: wife, kids, workmates.  It made him continue to take risks, to believe himself hilarious and invicible.  To suppress his psychological baggage by never confronting it.  To drag his angst around, through being drunk or hungover all the time.

‘And then’, he says, ‘I stopped drinking and discovered I was far less complex than I thought.  My main problem was I was a pisshead.

‘Also, why pretend you’re young?  You’re less interesting when you’re young.  At uni, what are you going to talk about after you’ve banged on about your parents and your course?  You have to drink to hide your inadequacies.  But at our age, if you can’t find something interesting to talk about with someone for two hours, with all the shit you’ve done and all the stuff you know, then that is pathetic, really.  Middle-aged people have a lot to say, and it can be really fascinating.  You don’t need to drink to get you through that.’

So so true for me all of that, like the biggest loudest ‘amen brother’.  And Miranda writes a brilliant description of what we have chosen to leave behind too:

Madness is doing the same thing over and over, expecting different results.  Your reaction to drink and drugs changes as you age.  Especially the aftermath.  The hangovers arrive like a hostile alien invasion.  They swarm you, you cannot fight.  You are pinned down, poisoned, from head to heart to soul.

And why would I miss that exactly? 😉

And now the only tune I can follow this with …..

Ever present alcohol

This was an excellent guest post for Alcohol Policy UK in May which I am sharing again here about alcohol availability in England – or as I see it ‘ever present’.

In this guest post, Colin Angus, a Research Fellow at the University of Sheffield, explores recent research on alcohol availability in England and considerations for policy.

A recent study from the Sheffield Alcohol Research Group highlights how widely available alcohol is in England, and how this has changed in the last decade. The study explores the availability of alcohol through measuring travel distances to the nearest outlet selling alcohol and counting the number of places where alcohol could be bought within walking distance (1km). Researchers looked at how availability had changed between 2003 and 2013, particularly changes in the type of outlets where alcohol was sold, and how availability was related to socioeconomic deprivation.

The key findings include:

  • The average distance from the centre of each postcode to somewhere selling alcohol was 323m, with 85% of postcodes being within 500m of an alcohol outlet.
  • The average English postcode has 31 outlets selling alcohol within walking distance (1km) of its centre
  • Alcohol is more available in the on-trade (places like pubs and restaurants where alcohol is sold for consumption on the premises) than the off-trade (shops where alcohol is sold for consumption elsewhere) based on numbers of licensed premises
  • The most deprived 20% of postcodes have around 3 times as many outlets selling alcohol within walking distance of their centre as the least deprived 20%
  • A rapid proliferation of convenience stores and metro supermarkets since 2003 has meant that access to pubs and bars has decreased by 8%, while access to off-trade alcohol has increased by over a third.
  • Pub closures have been far more common in deprived areas while pub access has increased slightly in other areas.

There are many possible explanations for these findings. Significant changes to licensing were introduced in the 2003 Licensing Act, which came into force in 2005 and made it substantially easier to apply for new off-trade licenses. It is also likely that the economic pressures of the recession have had a major part to play in the economic viability of many pubs, as well as the effects of the 2007 smoking ban. This may explain the more acute declines in deprived areas where the recession has hit harder and smoking rates are higher.

What does this mean for public health?

The physical availability of alcohol is clearly not a barrier to obtaining alcohol in this country. Whilst there is a strong body of evidence showing that reducing the availability of alcohol reduces alcohol-related harm, this evidence is overwhelmingly from countries such as Australia and the USA where there are substantially fewer places to buy alcohol from in the first place. Although a steady reduction in the number of UK alcohol outlets may yield benefits in the long-term, it seems less likely that the closure of a small number of outlets will result in significant reductions in harm as long as alcohol is still widely available.

Declining availability in the most deprived areas, which suffer the most alcohol-related harm, may be seen as a good thing. However, shop-bought alcohol is generally substantially cheaper than that bought in pubs and bars, and access to shops selling alcohol has increased. Some have also expressed concern that a shift from drinking in pubs to drinking at home may bring increased risks to health; pubs may potentially offer a more controlled drinking environment where bar staff and patrons act as a moderating influence on levels of consumption.   

Two recent studies have found an association between higher levels of licensing activity in local authorities (in terms of challenging license applications and introducing cumulative impact policies) and greater reductions in alcohol-related hospital admissions and crime. Our findings suggest that unless a radical change in levels of availability can be achieved, local licensing boards may be more likely to have a greater impact on harm if they focus on particular problem outlets. Seeking to address other aspects of availability may also be more fruitful, such as opening hours or the selling of high strength low price products, rather than seeking to reduce the overall number of outlets in an area.

The findings also suggest that licensing actions and government legislation over the past decade or so has done little to directly address the shift in availability from on- to off-trade. Indeed, recent cuts to alcohol duty rates, whilst portrayed by some groups as a boost for the pub industry, have increased the relative gap in prices between the on- and off-trades, potentially accelerating this trend. Whatever the underlying causes of this shift may be, cheap alcohol is easier to access now than at any point in recent history.  

This research was part-funded by Alcohol Research UK (R 2014/03).

I find some of those statistics staggering particularly these two: 85% of postcodes being within 500m of an alcohol outlet & the average English postcode has 31 outlets selling alcohol within walking distance (1km) of its centre.

Both shocking and unsurprising to me, how about you?