As we officially enter this years Alcohol Silly Season I thought it might be good to reflect on the after-effects of all that Christmas & New Year celebration. This was an excellent guest post on Alcohol Policy UK in July earlier this year courtesy of Dr Sally Adams.
In this guest post Dr Sally Adams, Assistant Professor in Health Psychology at the University of Bath, takes a look current knowledge and gaps in our understanding of the impact of hangovers.
Given this recent definition of alcohol hangover from the Alcohol Hangover Research Group, you could be forgiven for thinking that the causes and consequences of alcohol hangover were fully understood by researchers. However, whilst tens of thousands of academic papers have examined the short and long-term effects of alcohol consumption on thought processes and behaviour, only a handful have studied how hangover may impact the way we think and behave.
Hangover is an under-researched, but important area of study, especially given the health, economic and social effects. Hangover is one of the most frequently reported negative consequences of heavy drinking and is often associated with health effects including headache, nausea, vomiting, anxiety, low-mood and irritability. Additionally, hangover and other alcohol-related cause cost the UK an estimated £6.4 billion each year due to absenteeism, whilst the costs due to loss of productivity at work remain unknown. Socially, hangover may lead to isolation, social withdrawal and regret, where research has shown that individuals report increased levels of anxiety and low mood during alcohol hangover.
To determine the impact of alcohol hangover, researchers have begun to explore the effects of hangover on cognitive processes – the mental actions or processes used in everyday activities – such as workplace performance and driving. In these studies, individuals who regularly experience hangovers are asked to either consume a controlled amount of alcohol in a laboratory or to drink “naturalistically” by consuming alcohol in their normal environment e.g. at home, pub etc. Individuals attend a test session the following day to complete computerised tasks designed to assess cognitive processes used in everyday activities, such as attention, memory and psychomotor performance (the combination of cognitive function and physical action).
To date, studies have produced mixed findings on the cognitive effects of alcohol hangover. A review 13 studies indicated that only 5 individual studies showed a detrimental effects of alcohol hangover on cognitive functioning. However, this finding is more likely to reflect the poor methodological quality of the reviewed studies, rather than an absence of hangover effects. This notion is supported by promising findings from more recent, well-designed research studies demonstrating the impairing effects of hangover on cognition and everyday performance. For example, several recent studies have shown that driving behaviour, attention and memory are impaired during alcohol hangover.
These findings have important implications for improving our understanding of hangover, which may be among the causes of increased mistakes, accidents and injury in the workplace and elsewhere. Research exploring the effects of hangover on cognition and behaviour has the potential to inform policy and workplace guidelines on alcohol and hangover. For example, the UK government does not currently have any polices surrounding alcohol hangover in the workplace and most workplaces do not have health and safety legislation on hangover. A greater understanding of alcohol hangover’s effects on cognitive processes used in the workplace is essential to inform government and employers’ alcohol policies, specifically in sectors where hangover may have serious implications (NHS, transport industries, security and finance).
The current picture of alcohol hangover’s impact on cognitive performance and everyday performance is limited by a lack of robust, well-designed research examining the effects of hangover. Further research in this field is essential in determining the true health and economic costs of alcohol hangover.
For those of us who are heading into the foray minus booze – the Sober Advent Calendar starts tomorrow! As always I owe a huge debt of gratitude to the lovely Arthur Cauty of A Royal Hangover for producing the wonderful images and words you will see over the next 25 days 🙂
I came across this photo series “My Anxious Heart” by Katie Crawford a few years ago and this has sat in draft since then, bookmarked as it resonated with how anxiety can feel for me too sometimes. I used to feel like this after a heavy drinking session and I still get the remnants of it if I am very stressed or there is some kind of perceived crisis.
Her words and images are haunting and you can see them all here:
“numb feeling. how oxymoronic. how fitting. can you actually feel numb? or is it the inability to feel? am i so used to being numb that i’ve equated it to an actual feeling?” (accompanying image)
“depression is when you can’t feel at all. anxiety is when you feel too much. having both is a constant war within your own mind. having both means never winning.” (accompanying image)
Over to The Book of Life again:
Anxiety is our fundamental state for well-founded reasons:
– Because we are intensely vulnerable physical beings, a complicated network of fragile organs all biding their time before eventually letting us down catastrophically at a moment of their own choosing.
– Because we have insufficient information upon which to make most major life decisions: we are steering more or less blind.
– Because we can imagine so much more than we have and live in mobile-driven, mediatised societies where envy and restlessness will be a constant.
– Because we are the descendants of the great worriers of the species, the others having been trampled and torn apart by wild animals, and because we still carry in our bones – into the calm of the suburbs – the terrors of the savannah.
– Because visible objects and locations, oak tables and beaches, can only symbolise calm to our eyes rather than instil it in our psyches.
– Because the progress of our careers and of our finances play themselves out within the tough-minded, competitive, destructive, random workings of an uncontained capitalist engine.
– Because we rely for our self-esteem and sense of comfort on the love of people we cannot control and whose needs and hopes will never align seamlessly with our own.
The single most important move is acceptance. There is no need – on top of everything else – to be anxious that we are anxious. The mood is no sign that our lives have gone wrong, merely that we are alive. We should be more careful when pursuing things we imagine will spare us anxiety. We can pursue them by all means, but for other reasons than fantasies of calm – and with a little less vigour and a little more scepticism.
If you are struggling with anxiety while still drinking or because you’ve stopped know that you are not alone.
“Just sit. Notice where you feel hard and sit with that.
In the middle of the hardness, you’ll find anger, sit with that.
Go to the center of the anger and you’ll probably come to sadness.
Stay with the sadness until it comes to vulnerability.
Keep sitting with what comes up: the deeper you dig, the more tender you become.
Raw fear can open into the wide expanse of genuineness, compassion, gratitude, and acceptance in the present moment.
A tender heart appears naturally when you are able to stay present. From your heart, you can see the true pigment of the sky.
You can see the vibrant yellow of the sunflower and the deep color of your daughters’s eye.
A tender heart doesn’t block out rain clouds, or tears or dying sunflowers. Allow both beauty and sadness to touch you. This love, not fear.”
(meditation from Colleen Saidman Yee)
High ambitions are noble and important, but there can also come a point when they become the sources of terrible trouble and unnecessary panic.
One way of undercutting our more reckless ideals and perfectionism was pioneered by a British psychoanalyst called Donald Winnicott in the 1950s. The concept of ‘good enough’ was invented as an escape from dangerous ideals. It began in relation to parenthood, but it can be applied across life more generally, especially around work and love.
It takes a good deal of bravery and skill to keep even a very ordinary life going. To persevere through the challenges of love, work and children is quietly heroic. We should perhaps more often sometimes step back in order to acknowledge in a non-starry-eyed but very real way that our lives are good enough – and that this is, in itself, already a very grand achievement.
You Do Enough, You Have Enough, You Are Enough
Happy sober Friday xx
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
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:
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 firstname.lastname@example.org.
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
- Guide to family support services
- Alcohol stats
- Setting up a support group
- Alcohol and parenting
- Parents who drink too much
- Alcohol-related bereavement
- Challenging the stigma around alcohol
- Families affected by harmful drinking (for practitioners)
- How much should I be drinking?
- I think my parent drinks too much
- Local service case study (Orbit)
- Local service case study (SIAS)
- Local service case study (SSSFT)
- Personal case study (Jo)
- Personal case study (Amy-Beth)
And this valuable research was released recently too:
Plus this was published yesterday – more support for MUP when the Scottish decision is finally announced:
And an update from Alcohol Policy UK today (14th Nov):
It’s a big week!
Another great post from Alcohol Policy UK regarding the Govt’s 2017 Drug Strategy released in July.
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!
Another month another book. This time I’m inspired by by Mark Manson and his book (see left). The 2nd chapter of his book looks at the happiness problem – and yes happiness comes from solving problems 😉 I’m going to quote a small section that discusses our favourite subject – addiction.
Over to Mark:
Highs come in many forms. Whether it’s a substance like alcohol, the moral righteousness that comes from blaming others (yep, ouch!), or the thrill of some new risky adventure (ouch again!), highs are shallow and unproductive ways to go about one’s life. Much of the self-help world is predicated on peddling highs to people rather than solving legitimate problems. Many self-help gurus teach you new forms of denial and pump you up with exercises that feel good in the short term, while ignoring the underlying issue. Remember, nobody who is actually happy has to stand in front of a mirror and tell himself he’s happy.
Highs also generate addiction. The more you rely on them to feel better about your underlying problems, the more you will seek them out. In this sense, almost anything can become addictive, depending on the motivation behind using it. We all have our chosen methods to numb the pain of our problems, and in moderate doses there is nothing wrong with this. But the longer we avoid and the longer we numb, the more painful it will be when we finally do confront our issues.
The path to happiness is a path full of shitheaps and shame. You can’t have a pain free life. It can’t all be roses and unicorns all the time. Our problems birth our happiness.
Amen brother, completely agree! It took me till the age of 44 to finally confront the issues and yep it involved a whole lot of pain that might have been avoided if I had only tackled them sooner! That said having resolved the alcohol addiction issue I’m still working on the moral righteousness and thrill of risky adventure addictions …..
How bout you? Does this ring true for you too?
So this infographic came though in an email from Melli over in Australia in July. She is the genius behind The Mindfulness Summit that I attended virtually last year and this Head-Heart-Gut Check is a great tool. I love her work and it felt like a bit of a birthday present to share it here with you when it was my belly-button birthday yesterday! Another year older, another year sober 🙂
Over to Melli:
We make a lot of decisions every day and these decisions are what determine the direction and quality of our lives. Some are little. Some are completely life altering. All of them matter as you steer the course of your life at each little juncture.
Any time you’re at a decision point you can use this mini-meditation to respond (and not react) to what is arising with wisdom and intelligence, making more mindful choices leading to a fuller happier more authentic life.
Step 1: Take three deep slow conscious breaths as a way of gathering your awareness to the present moment.
Step 2: Bring your awareness to your head
With your awareness in the head acknowledge what kind of thoughts are present in relation to the current situation.
Step 3: Drop awareness down to the heart
Place a hand over the heart and take a moment to attend to what values you have in this situation, what you care about and what your deepest intention is.
Step 4: Drop awareness down to the gut
Place a hand over the abdomen. Tune into any hunches, intuitions or emotions that are present in relation to the current situation.
Step 5: Collect all this information
Take one deep slow conscious breath in and out as you have a sense of collecting all this information from the body and mind. Then mentally ask yourself this question “what shall I do now?” Listen for the answer.
The Head-Heart-Gut Check meditation can be done in as little as 30 seconds when you need to make a quick decision or you can do a longer version that takes up to five minutes when you have more time. This simple powerful mini meditation will help you make more mindful decisions and will be an ally in times when you need mindfulness the most. May it serve you well
The ‘Head-Heart-Gut’ Check In Meditation
You may also listen to the head-heart-gut check in meditation by clicking on the video below:
You can also listen on SoundCloud
Thanks Melli! 🙂