Monthly Archives: November 2015

Sober Advent Calendar

So it is that time of year again when not drinking can get more tricky than usual.  Christmas parties, drinks with friends, the excuses to have a tipple can seem endless as we crank up our Christmas cheer!  It is the most booze soaked month of the year to contend with and I always feel like I have to gird my loins a bit.

A Royal Hangover

Plus I am aware that my blog can sometimes feel a little lacking in Christmas cheer because of its somewhat sobering content so there will be no doom and gloom news stories or research till we’re nursing hangovers or polishing our sober halos come Boxing Day morning.  I’ll save most of them up for January when we’ve all got our hair shirts back on! 😉

So with that in mind I’ve enlisted the help of the lovely Arthur and Gabrielle from A Royal Hangover to give us a sober advent calendar to remember!  If you haven’t watched their brilliant documentary film yet maybe it could go on your list for Santa? 😀  You can find it on iTunes here.

For the next 24 days there will be no written content from me.  As if you were opening up the window of an advent calendar you will find an image and quote from someone male or female (who is probably quite famous) but more importantly is also one of our sober brethren.

When the going gets tough the tough get going and these daily reminders will hopefully help you stay strong by remembering that you are not alone and that you are standing besides giants in your quest to do and be different which makes you a sober star in my book 🙂

PS Day 800 …….

Holy sh*t – how did that happen?! Seriously if I can get to 800 days so can you.

Edited to add:  To accompany your daily sober advent calendar can I recommend visiting Prim’s blog to collect your AF cocktail each day too 🙂

Arguments in the supermarket drink aisle

So two spoofs hit my inbox in one day in November so to me that’s a sign 😉 Thanks to one of the lovely FB Swans who linked to the Daily Mash Lidl supermarket piece and to Jussi over at Club Soda for sharing the Finnish Booze Day link 🙂

The Adbusters Media Foundation has created many print and commercial spoof ads that are hard hitting and controversial.   As they say sometimes truth is stranger than fiction …

Lidl Christmas advert shows argument in drink aisle

LIDL has unveiled its Christmas advert about a husband attempting to justify the purchase of thirty cans of bitter.

The bargain supermarket chain has premiered its festive offering, which shows how a couple’s drink-related dispute leads ultimately to a grudging reconciliation.

In the advert ‘Cathy’ is buying food for when her parents visit, while husband ‘Martin’ tries to sneak large amounts of competitively priced beer into the trolley.

Creative director Julian Cooke said: “She has a massive go at him about blowing all their money on booze and he mutters something about how she ‘never used to be such a moody cow’. That’s a great moment which is both sad and funny.

“However the advert ends with reconciliation as they agree to put back the potatoes and carrots so they can have a large bottle of her favourite tipple, Lidl’s own-brand Putinoff vodka.”

Mother-of-two Emma Bradford said: “I liked it, it combined a good story and real emotion with some solid factual information about drink prices.”

And here’s the link to the Finnish booze day spoof with this intro:

Sometimes, going shopping is hard for kids too. The Finnish Booze Day sketch got the annual award for promoting temperance in 2015.

Let the booze silly season commence.  Stay strong sober warriors – December is our biggest test of the year!

What a difference two years makes!

So I’m slipping in this extra post because it feels important.  Last night I went to the Xmas dinner of the drug and alcohol treatment centre where I volunteer and oh boy what a difference to past experiences.

bills bseThe reason this evening was so striking was because of how I felt the last time I went on an Xmas dinner night out which was two years ago and I wrote about it here.  This is an excerpt of what I wrote:

Most of my colleagues were drinking and the table was crowded with glasses of fizz and wine but that was okay.  Although my new colleagues were warm and friendly I was having an excruciatingly difficult time of it.  Alcohol had always been my social lubricant and without it I felt lost and incapable.  I wasn’t me and I didn’t know who ‘me’ was without alcohol in this situation.”

So the key difference between the two evenings were then I was only just 11 weeks sober and so it was all very new.  These were nursing colleagues and there was an expectation to drink I felt (although I’m sure that was more in my head than being expressed by them).

This time I’m at over 2 year sober (in fact I’m  2 days away from 800 days!!) and so it is very normal for me now.  I was with staff from a recovery facility so most people weren’t drinking and there was no expectation to drink.

But most importantly it was how I felt that was the game-changer.  I felt relaxed, chatty, present.  I felt like ‘me’ and it felt good.  If I had known this back then it would have helped me enormously to challenge and manage my own weighty self-expectations.  The difference in my thinking and how I feel about myself is difficult to put into words –  but it is in a profoundly positive way.  To use an AA truism: don’t give up before the miracle happens!! 🙂

And no hangover this morning *deep happy sigh* 😉

Health information on alcoholic beverage containers

untitledThis was an Addiction research report published online last month looking at health information on alcoholic beverage containers: has the alcohol industry’s pledge in England to improve labelling been met?

Aims:  In the United Kingdom, alcohol warning labels are the subject of a voluntary agreement between industry and government. In 2011, as part of the Public Health Responsibility Deal in England, the industry pledged to ensure that 80% of products would have clear, legible health warning labelling, although an analysis commissioned by Portman found that only 57.1% met best practice. In a research report for Addiction it was assessed what proportion of alcohol products now contain the required health warning information, and its clarity and placement.

Design: Survey of alcohol labelling data.

Setting: United Kingdom.

Participants: Analysis of the United Kingdom’s 100 top-selling alcohol brands (n=156 individual products).
We assessed the product labels in relation to the presence of five labelling elements: information on alcohol units, government consumption guidelines, pregnancy warnings, reference to the Drinkaware website and a responsibility statement. We also assessed the size, colour and placement of text, and the size and colouring of the pregnancy warning logo.
The first three (required) elements were present on 77.6% of products examined. The mean font size of the Chief Medical Officer’s (CMO) unit guidelines (usually on the back of the product) was 8.17-point. The mean size of pregnancy logos was 5.95mm. The pregnancy logo was on average smaller on wine containers.
The UK Public Health Responsibility Deal alcohol labelling pledge has not been fully met. Labelling information frequently falls short of best practice, with font and logos smaller than would be accepted on other products with health effects
The full conclusion went on to say:
New labelling guidance could be derived from existingguidance on consumer products, such as that used on medicines, tobacco packaging and other products which, like alcohol, carry known health risks. Further research with consumers to explore the legibility and comprehensibility of text and logos is also warranted. Compliance with any labelling guidance also needs to be monitored and reported on entirely independently of alcohol industry bodies [23]

Full pdf

If the industry agrees to self-regulate and then falls short of its own standards where there is a health implication then the responsibility should become more formalised and independent in my opinion and in agreement with the researchers conclusion.

Edited to add 15th April 2016:

What’s not on the bottle? Alcohol labelling in Europe (PDF)

Skar began her talk by providing a brief history of Eurocare. Eurocare was established in 1990 with membership from nine countries, including the UK. Today, there are sixty member organisations, from twenty five countries, and a central secretariat based in Brussels | SHAAP/SARN, UK

Addiction in the Workplace: Recovery is Possible

This is an excellent blog once again from Castle Craig that was published last month.addiction-at-work-poster

  • Do you have employees or colleagues who are habitually late for work, are increasingly absent or functioning at two-thirds of their capacity, and/or with impaired decision making?
  • Do you notice poor team morale and staff relations, as well as damaged customer relations, centered around a particular person?
  • Has your company had a sudden increase in accidents?
  • Has a colleague’s productivity been affected by cancer, liver disease, heart disease or stroke – or even by risky sexual behaviours with adverse outcomes?

If your answer is “yes” to any of the above questions, your solution could be identifying and addressing substance abuse in the workplace. Addressing health issues today is not merely a ‘virtuous circle’ but a hard economic factor with high stakes, as the following UK statistics highlight:

  • £7.3billion a year is lost in productivity due to alcohol (2009/10 costs)
  • Using US figures as a comparator, lost productivity from illicit drugs is a very close second
  • 14-20million working days are lost each year from alcoholism
  • 60% of workplace deaths are linked to alcohol
  • 40% of accidents are linked to alcohol
  • £30,614 is the average cost to recruit a single staff member, according to Oxford Economics.

There is also lost productivity from those around the person with the substance-abuse problem: for example, 14% of employees in one survey said they had to re-do work due to a co-worker’s drinking.

Moreover, upwards of half of working family members of alcoholics report that their own ability to function at work was negatively impacted by their family member’s drinking. There is even a book on this subject by New York Times bestseller Janet Geringer Woititz called Self-Sabotage Syndrome: Adult Children [of alcoholics] in the Workplace.

When organisations need to retain key employees, the returns on investment are inarguable. So why do too many people let these damaging behaviours go on too long?  Reasons include: fear, company culture, no procedures, perceived human rights, lack of knowledge and thus confidence to do anything, discomfort in change, and the misperception that it is easier to do nothing.

Despite denial, 76% of people with drug or alcohol problems are employed – firing them won’t make the problem go away, but addressing the core issues can yield improvements.

“A former star performer who seems to have fallen off the face of the earth will do everything possible to cover up the problem,” says Jeff Jay, co-author of Love First: A New Approach To Intervention for Alcoholism & Drug Addiction. “So first make sure you have all the facts. Review your company’s policy for alcohol or drug abuse. If you’ve decided that the person needs help, talk to other managers, consider calling in a professional then meet with the employee.”

During an intervention like this, you can expect the substance abuser to explain away his or her declining productivity with excuses and rationalisations that come down to one thing: ‘I’m not responsible’. Your job is to help them get back on track.

This is not the first post about alcohol and workplace issues I’ve written and you can see the rest of them here 🙂

Defence against the dark arts

Stealing from Harry Potter and those who taught ‘defence against the dark arts’ I wanted to close this Alcohol Awareness Week with two contrasting views.

defence against the dark artsPresenting the Scottish First Minister opening speech at the the Global Alcohol Policy Conference in Edinburgh in October which was both eloquent and steadfast with the BBC responding with praise for its “political courage” in attempting to introduce a minimum unit price (MUP) for alcohol.  She spoke not just about MUP but other approaches too such as a ban on advertising after the watershed and the creeping presence of alcohol advertising on all media platforms.

It is well worth your time to listen and I continue to support their efforts as both a nurse and public health professional, a parent and member of society and as someone in recovery from alcohol dependence.

And lets face it’s needed as this also appeared in the news the same day:

Strongbow ad banned for suggesting that alcohol is more important than relationships

Heineken, which owns Strongbow, posted the ad on its YouTube channel. It was based around the idea of a spoof awards ceremony in which the winner, Carl, gave a speech after accepting an award called “best Strongbow as my other half”.

A message read out on Carl’s behalf said: “I dedicate this award to my family, to all the lovely creatures out there, and to my other half. I love you. I’ve loved you since the first day I met ya. And I always will do. My dear Strongbow.”

But the ad drew fire from organisations such as The Youth Alcohol Advertising Council (YAAC) and Alcohol Concern for showing alcohol as indispensable.

I was really pleased to see that the story was picked up by the BBC children’s news programme Newsbeat which widened it’s reporting on the story:

Strongbow’s YouTube spoof and seven other banned alcohol adverts

Now I get that Heineken said this is a spoof and a parody but how does a young person watching on Youtube know this?  And it seems utterly ironic to me that cider, which used to be know as ‘tramp juice’, is now being spoofed in this way.  There are plenty of people homeless and sleeping rough because cider has literally destroyed all their real human relationships because of addiction.  Without wishing to sound all Mary Whitehouse to think that this is funny is beyond a joke and pretty sick ………..

Oh and the drinks industry is also busy trying to rebrand ‘binge drinking’ (seeing as it has such negative connotations these days) as ‘high energy’ drinking.  To quote The Independent:

Britons were also more likely to  binge drink with 15 per cent saying they had at least one “high energy” night of drinking per week.

This quote is lifted from a report in which “6,500 people across the UK, Germany, Australia, America and China were interviewed by Maxus, a media agency for the drinks industry, who found that Britons had the most liberal attitude to alcohol.” (bolding is mine)

Defence against the dark arts indeed ………

Local Nalmefene pathways emerging to ensure prescribing adherence

This excellent post came from Alcohol Policy UK in October regarding Nalmefene (Trade name Selincro) and pathways to prescribing.

selincroFollowing NICE’s technical appraisal authorising Nalmefene (Selincro) last year, local areas have been developing protocols to ensure prescribing adherence – see below for examples.

Nalmefene was authorised as a drug to support a reduced drinking goal amongst mildly dependent drinkers, although has been considered controversial in some respects. To be eligible, drinkers must be assessed as alcohol dependent, but not be physically dependent (i.e needing a detox).

In addition drinkers must be exceeding 5 units in a drinking day if female and 7.5 units in a drinking day if male, described as a high ‘Drinking Risk Level’ (DRL). Once prescribed, the drug is to be taken ‘as needed’, for instance if a person anticipates a drinking occasion. However patients can only be prescribed Nalmefene if they still meet this criteria two weeks after initial assessment and agree to psychosocial interventions for the length of treatment.

Local pathways

As a result, local areas have been developing pathways to ensure that where Nalmefene is prescribed, it is done so in adherence with NICE guidelines. Concerns about Nalmefene being prescribed without psychosocial interventions may be in some part be driven by media reports or coverage neglecting to highlight or emphasise the key requirement for psychosocial intervention.

As highlighted in a detailed guest post by Dylan Kerr, a number of issues need careful consideration, including how ‘dependence’ is assessed, and the role of brief intervention and psychosocial support. The effects of the latter are hard to extrapolate from the effects of the drug, and indeed the research trials showed only relatively small differences between those receiving psychosocial support and a placebo (control group) and those receiving psychosocial support plus Nalmefene.

In addition, Nalmefene can only be prescribed if a patient is still drinking at high ‘DRL’ two weeks after an initial assessment. In the studies, many patients had cut down significantly as a result of the brief intervention alone, and thus no longer drinking at a high DRL.

Local areas may also be carefully considering the cost as austerity continues to bite. At £3.03 a pill it will not be considered a cheap drug by CCGs, although presently Nalmefene represents only a fraction of the spend on alcohol prescriptions – albeit likely to rise. However Lundbeck, producers of the drug and sponsors of a range of alcohol activity in recent years, have announced major restructuring suggesting a change in priorities.

One positive indirect effect of Nalmefene’s availability could be regraded as increasing ‘help-seeking’ amongst a population of mildly dependent drinkers who would otherwise not have sought help. The issue may be ensuring that the role Nalmefene plays is one in which it is always as part of psychosocial support within a robust pathway, with further evaluation of its benefit outside research conditions.

Some examples of local pathways are below.

Anecdotally I have only spoken to one person  at one of my How to Quit workshops who has used Selincro to try to manage their drinking and their experience was that it did not help them cut down.  I’d be interested to hear any other experiences if you’re happy to share either in the comments below or on email to me 🙂

Under pressure

This was a new report on high blood pressure (hypertension) and drinking behaviours that Alcohol Policy UK shared in October.

under pressure‘Under pressure’ [pdf], a new report on alcohol and high blood pressure, makes a series of recommendations to address what are ‘two of the most common preventable health harms in the UK’. The report was developed by an expert group, initiated and supported by Lundbeck pharmaceutical.

The report says improvements in primary care for hypertension and alcohol misuse are required for better integrated screening, brief interventions, and treatment for both conditions, which would reduce the incidence of other cardiovascular diseases. Both alcohol misuse and hypertension affect around a quarter of adults, however four out of ten people with high blood pressure (BP) will be undiagnosed.

A series of recommendations are made including improving brief intervention (IBA) rates for those with both conditions in primary care, and raising awareness of the links. Currently under NICE guidelines, primary care has a responsibility to deliver IBA to those with high blood pressure as part of its QOF. However the report includes results of a survey which suggests low levels of IBA amongst patients with high BP:

“…even in this ‘at risk’ population, screening for alcohol problems is only done on an intermittent basis; the results of the GP survey … indicate that only about 1-in-5 people with hypertension are screened for harmful drinking”

The report also identifies issues relating to pathways for referral of alcohol treatment services and challenges within the new commissioning landscape. Recommendations within the report include a move to ‘joint commissioning for a holistic and integrated alcohol treatment service that reflects the patient pathway from prevention through to specialist services’. The development of networks for trainers and clinical leads to support skills and best practice are also suggested.

See here for an Alcohol Concern factsheet on alcohol and hypertension.

This is an excellent recommendation as checking someone’s blood pressure is part of the easy non-invasive screening process that should be done on all almost irrespective of why you are going to see your GP.  And it is the ‘canary in the coalmine’ indicator with drinking that may give away an issue even if the person is reluctant to share honestly how much they are actually drinking.

Alcohol Marketing & highlights of Alcohol Awareness Week

marketing seesawSometimes an image can convey so much more than words – like this one …….

In November the Global Alcohol Policy Alliance‘s 2015 Conference, co-hosted by Alcohol Focus Scotland, took place in Edinburgh on the theme of ‘Momentum for change: research and advocacy reducing alcohol harm’.  Alcohol Policy UK wrote an excellent summary post which you can read here.

I don’t know why I have such a bee in my bonnet about this subject but I do.  Is it because I have young children?  Probably.  Is it because I have a public health background?  Probably.  Does it really matter why it lights such a fire under my arse?  Probably not.  The use of the word ‘grooming’ in relation to alcohol marketing certainly got my attention and is absolutely appropriate.

The image comes from a presentation given by Gerald Hastings at this conference called:

Alcohol Marketing: The Need for Radical Action, Gerard Hastings.

I’ve tried to upload the full pdf and was unsuccessful but if you want to see the full presentation access and save it before the end of November via the above link.  I would put up more slides as it is so powerful and important and is really worth a read as he encapsulates it so brilliantly!

The second presentation that caught my eye was this one:

Understanding Alcohol Industry Strategies and Tactics in the UK, Prof. Jim McCambridge

And it was this slide in particular that summed it up perfectly:

  • Largest and most successful companies deliberately engineer addiction
  • Addiction is fundamental to business models
  • Applies across companies through R & D
  • Obvious vested interests in opposing policies that better manage addictions

And finally this presentation:

Protecting children’s right to grow up free from alcohol marketing, Melvyn Freeman

There are many many more presentations touching on things such as TTIP and its impact so do take a look 🙂

Plus Lucy and Laura spoke at the Society for the Study of Addictions (SSA) recent annual symposium and you can listen to their presentations here:

From internet revolution to sober revolution with Lucy and Laura leading the charge!

Bring on the changes 😉

PS Some of you may have had a sneak peek of one of my sober advent calendar windows today!  Apologies for trigger happy scheduling error 😀

Drink driving consequences

This is not the first time I’ve written about drink driving and it has increasingly been in the press here because of the changes to the Scottish drink driving laws this year.  You can read all my posts about the issue here.

drink driving consequencesBut then two stories arrived in my email inbox in the same week and so I felt compelled to revisit the subject again.  Drink driving isn’t just about driving under the influence in the daytime or evening it can include being over the limit the next morning too.

A year ago today was like many other days. Corey Mantia woke up and went to work. Parker and I stayed at home and played together all day. Corey later came home played with our sweet baby as we waited to load up for a wrap appointment. That spare cash was much needed for our little family. Well time comes for us to leave. Little did we know in a few short minutes everything would change. We would no longer get to live our future together. Any dreams we had would no longer happen together. We wouldn’t get to purchase our first house together, we wouldn’t get to take Parker for his first hair cut, his first day at school, and our family would never grow. This would be it. Everything we would have ever known would come to an end and not by choice.

On our way to this wrap appointment my amazing husband whom was driving, my precious baby whom I still nursed and kept rear facing watching Mickey Mouse Club house, and I were struck nearly head on at an excessive speed by a drunk driver. This is a date and time that will forever be embedded in my head. The action of this one selfish person who thought they were “ok” to drive instantly took the life of my sweet innocent 15 month old son in the back seat. She would cause my husband and I to be air lifted from the scene where my husband would loose his fight 24 hours later. She would cause a family to be devastated and emergency personnel to need counseling.

One selfish decision to drink and drive caused me to be a widow and a mom to an angel at the age of 21. She has caused many nightmares with the news of various reports being released such as an autopsy of my baby being sent to me or many reconstruction pictures. Many things a 21 year old should never have to see or imagine. She ended any dreams that we may have had together and caused pain I never knew existed.

That day the Destiny that was a mom and wife died as well. I’ve sense had to find myself. I never knew the strength I could pull out that I never knew I had. I think I was able to find this strength through the prayers and support of many friends and family and also an amazing widows group who kept me knowing I was normal for feeling how I felt.

This hurt, pain and our future could of all been prevented if someone would have stepped up and stopped this selfish woman from drinking and driving. You can save someone’s life too! Don’t allow your friends and family drink and drive. Don’t share DUI checkpoints. Be an advocate! Stand up with me! Let’s stop this. One is too many. DONT DRINK AND DRIVE!

Read full story here.

And then this news coverage:

A first responder with 20 years of experience says Sunday’s crash in Vaughan, Ont., that killed three children and their grandfather has left his colleagues heartbroken.

“It’s one of the most horrific things I’ve seen,” Vaughan Fire and Rescue Deputy Chief Andy Zvanitajs told CBC Radio’s Metro Morning on Tuesday. “From the collision and the damage to the vehicles, it’s one of the worst ones I’ve seen in 20-plus years of being a paramedic and a firefighter. These first responders, these firefighters, are heartbroken.” 

More than 30 first responders attended to Sunday’s crash, which involved an SUV slamming into a minivan carrying six family members. At one point, firefighters and paramedics were working to resuscitate four people at once.

The Neville-Lake family’s van was T-boned at the intersection of Kirby Road and Kipling Avenue, north of Kleinburg.

Three siblings – Daniel 9, Harrison 5, and Milly 2 – were killed along with their 65-year-old grandfather, Gary Neville. The children’s grandmother and great-grandmother are in stable condition in hospital.

Jennifer Neville-Lake said she first heard about the crash while watching TV. She also posted on Facebook Monday morning that “all of my children have gone home to God with my dad. My mother and grandmother are still in the hospital.”

In the post to the Today’s Mom Facebook group, she also thanks people for their support.

“Your kind words and messages mean so much to my husband and I as we sit in our son’s empty room surrounded by our children’s things,” she writes. “Please keep us in your prayers. God bless.”

Marco Muzzo, 29, of King Township, who was driving the SUV involved in the crash, faces 18 charges:

  • Four counts of impaired driving causing death.
  • Four counts of driving over the legal limit.
  • Four counts of dangerous driving causing death.
  • Two counts of impaired driving causing bodily harm.
  • Two counts of driving above the legal limit causing bodily harm. 
  • Two counts of dangerous driving causing bodily harm.

The consequences of getting behind the wheel of a car while under the influence of alcohol can be fatal both to you and others.

And then a couple of weeks later Alcohol Policy UK sent out this news piece:

10 million UK drink drivers survey claims

Nearly a third (31%) of drivers that drink admit to driving when over the legal alcohol limit – equivalent to 10 million UK adults – according to a recent survey. The survey was commissioned by insurance company RIAS, who warn many people are still prepared to risk drink driving despite a huge decline in drink driving.

Read their full report here

‘Crewe is UK’s drink-driving capital’

Moneysupermarket analysis of car insurance quotes puts Cheshire town’s drivers at top of the list for driving under the influence, with Wales following closely | Guardian, UK

And then this story hit the headlines too:

Oklahoma car crash: ‘Drunk driver’ kills four people including toddler in high-speed accident
44 injured as horror crash sends spectators flying “like rag dolls”​ 🙁