Monday, November 8, 2010

Massachusetts Tax Repeal taps Drug, Alcohol Abuse Funds

Boston Herald

When Massachusetts voters decided to eliminate the sales tax on alcohol, they also eliminated a main source of funding for the state’s drug and alcohol abuse programs.

Now lawmakers and advocates are scrambling to shore up money for the programs in the face of an ongoing budget crunch.

Lawmakers last year voted to apply the state’s 6.25 percent sales tax rate to liquor sold in stores to bring in an extra $110 million annually to help pay for substance abuse treatment Massachusetts.

Liquor store owners and other opponents of the tax dumped more than $3.7 million into an advertising campaign to persuade voters to repeal the levy.

Supporters of the tax say that it was designed to help shield critically needed detox beds and other detox programs from the ups and downs of the budget cycle.

Wednesday, November 3, 2010

Alcohol is more harmful than Heroin or Crack: Study

NY Daily News

It's sobering news for drinkers.

Alcohol is even worse than heroin and crack on the list of "most harmful" drugs, according to a new study published in the British medical journal, The Lancet.

A variety of social, physical and psychological problems that are caused by drugs were examined by a panel of experts, who concluded that alcohol, heroin and crack were the most harmful to others while heroin, crack cocaine and methamphetamine were the most harmful to individual users, CNN reported.

Dr. Petros Livados, director of the Addiction Institute of New York at St. Luke's-Roosevelt Hospital, agreed with the study findings.

"Both in terms of the medical consequences as well as societal consequences, I agree that alcohol ranks very high in overall harmfulness,"he told the News. "Alcohol has tremendous repercussions in our society in terms of drunk driving and societal consequences.”

Twenty drugs were scored on 16 criteria – nine related to the harms that a particular drug does to an individual and seven to the harms a drug does to others. All the drugs were scored out of 100 points, and overall, alcohol came in the highest, at 72 points, according to The Lancet. Heroin came in second with 55 points and crack cocaine took third place with 54 points.

While cocaine and tobacco were found to be equally harmful, LSD and ecstasy were found to be the least harmful, according to

Funding for the study came from the Centre for Crime and Justice Studies in London.

The report in the Lancet was co-authored by Professor David Nutt, Britain's former chief drug policy advisor, who stirred up controversy last year when he wrote an article that said riding a horse was more dangerous than taking ecstasy, CNN reported.

Almost 17.6 million adults in the United States either are alcoholics or have alcohol problems, according to the National Institutes of Health.

But because alcohol is legal and easy to access, many people don't think it is a problem for them, says addiction expert Dr. Jeffrey Parsons, chair of the psychology department at Hunter College.

"It is legal and socially sanctioned, so it does not carry the same stigma and issues that illegal drugs do,"he says. "But the negative health consequences of alcohol are even greater than with many illegal drugs.”

Drinkers tend to equate "legal"with "safe,"but that's not necessarily the case, says Lebanon Valley College psychology professor Lou Manza. "In the general public's mind, because you can go and buy alcohol in the store, it is okay,"he said.

One major difference between alcohol and other drugs, such as nicotine, is that there is a "safe"level of it for many people, Livados says. It's generally recognized that two drinks a day for men and one for women can be considered safe, with exceptions such as people with depression or anxiety, those with alcohol dependence and pregnant women.

"It's not the same with nicotine,"Livados says. "We have not been able to find a low threshold under which smoking cigarettes is safe. There's no such thing."

Alcohol dependence tends to be masked more often than dependence upon other drugs, Parsons says. "With alcohol, someone can feel like a law abiding citizen despite the fact that they're abusing a drug," he told The News.

Monday, November 1, 2010

Warning over Parent Alcohol Abuse 'Child Effect'

BBC News

Millions of children are at risk of neglect because of a parent's drinking, and yet the problem is being ignored, say charities.

Alcohol Concern and the Children's Society want social workers to have more compulsory training on how to deal with alcohol abuse within families.

Their report estimates 2.6m children live with a parent whose drinking could lead to neglect.

A body representing social workers said alcohol posed more problems than drugs.

Unsurprisingly, a poll carried out by Alcohol Concern in July found an overwhelming majority thought that heavy drinking by parents had a negative impact on children - many thought it was as harmful as drug abuse. However, the two charities say that the scale of the problem is not fully recognised.

The parents of the 2.6 million children are defined as "hazardous" drinkers - either because of the sheer amount or frequency of their drinking, or because their drinking, even at a lesser level, leads to other problems, such as not being able to get up in the morning, or fulfil "expected duties".

Of those 2.6m children, 700,000 are being raised by a parent defined as an alcoholic.

No training

Despite alcohol or substance misuse being suggested as a factor in more than half of social worker cases which progress to the "serious review" stage, there is relatively little emphasis placed on the problem within social worker training.

Recent research suggested that one third of social workers had received no training on alcohol or drugs, and, of the remainder, half had been given three hours or less.

Bob Reitemeier, the chief executive of The Children's Society, said: "I cannot stress strongly enough the harmful impact that substance abuse can have on both children and whole families - it is imperative that everyone understands these risks and we believe that education is the key.

"We are calling on the government to make sure that everyone who needs either training or education to deal with parental substance abuse is given the appropriate assistance."

Mandatory substance abuse training for social workers was recommended in a 2003 report from the government's own drug advisory group.

Alcohol Concern suggested that the system currently "sweeps the problem under the carpet".

Chief executive Don Shenker said: "Millions of children are left to do their best in incredibly difficult circumstances.

"A government inquiry must look into all aspects of parental alcohol misuse so that we can improve outcomes for these children."

Groups representing social workers agreed with the report's recommendations.

Dr Sarah Galvani, who chairs the British Association of Social Workers Special Interest Group in Alcohol and Other Drugs, said training for both newly-qualified and existing social workers was "lacking".

"Problematic alcohol abuse by parents is highlighted by social workers as far more prevalent than drug use.

"Alongside the overlapping experiences of domestic violence and mental ill health, parental alcohol and other drug use are the three factors that repeatedly put children at risk of serious harm.

"We must support social workers to work as best as they can in what are often very complex and challenging situations."

Public health minister Anne Milton said health service reforms would help local communities put in place services tailored to tackle problems such as this.

She said: "This report highlights the harm that millions of children face because their parents drink too much alcohol.

"It paints a shocking picture, which is why we must make sure that we identify early on, children and families that need support."

Thursday, October 28, 2010

Michigan's new 'Super-Drunk' Law goes into Effect on Sunday

Lansing State Journal
Those who drink excessively and get behind the wheel may be in a sobering reality beginning Sunday.

New laws go into effect that double the jail sentences and license suspensions for first-time offenders who are convicted of having higher blood-alcohol levels while driving and expand the use of substance abuse treatment programs.

State officials say the “super-drunk” legislation is designed to target those first-time offenders who apparently have a serious drinking problem.

“When you get super-drunk, it becomes exceptionally dangerous,” said state Sen. Alan Cropsey, R-DeWitt, a sponsor of the legislation.

The new law essentially creates a new class of blood-alcohol content of 0.17 percent or higher for more serious first-time offenders; that’s slightly more than twice the minimum of 0.08 percent now required for a drunken-driving conviction.

Those convicted of the higher blood-alcohol level will get an automatic one-year driver’s license suspension -- twice the current penalty -- and would face 180 days in jail, which is roughly twice the current maximum.

They also face bigger fines and mandatory treatment for substance abuse.

Judge Harvey Hoffman of District 56A Court in Charlotte said substance abuse treatment Michigan for serious first-time offenders is critical to reducing the alcohol dependence and further offenses. Substance abuse treatment now is used more commonly for repeat offenders.

“The average person, if they a blow a 0.20, and you’re up and functioning enough to operate a motor vehicle, it shows you have an elevated tolerance to alcohol,” said Hoffman, who has dealt with drunken drivers for 14 years as a judge. “That’s pretty good proof you are dealing with someone who has a significant alcohol problem.”

Monday, October 25, 2010

Drug, Alcohol Abuse grows among Iraqi Forces

The Seattle Times

A growing number of Iraqi security-force members are becoming dependent on drugs or alcohol, which has led to concerns about a significant addiction problem among the country's armed services as the insurgency remains a potent force and American troops prepare to depart at the end of next year.

In some regions of Iraq, military and police officials say, as many as 50 percent of their colleagues, including high-ranking officers, use drugs or alcohol while on duty.

While there is no way to know the exact number of drug- and alcohol-dependent members among Iraq's 675,000-member security force, interviews with dozens of soldiers, police officers, political leaders, health officials, pharmacists and drug dealers indicate that drug and alcohol use among the police and the military appears to have grown significantly during the past year or so.

Those who admit to using drugs and alcohol say long hours working at checkpoints, constant fear and witnessing the grisly deaths of colleagues make drugs and alcohol less a choice than a necessity.

"Pills are cheaper than cigarettes and they make you more comfortable and relaxed," said Nazhan al-Jibouri, a police officer in Nineveh province in northern Iraq. "They help us forget that we are hungry, and they make it easier to deal with people. They encourage us during moments when we are facing death."

A spokesman for Iraq's Defense Ministry, Maj. Gen. Mohammed al-Askari, denied that the military had a drug problem. Health officials say it is part of a larger problem of drug abuse in Iraq, where addiction has spread amid three decades of war and economic hardship.

The problem has been exacerbated by the recent proliferation of powerful prescription medications — as well as of smuggled heroin, marijuana and hashish from Iran, Afghanistan and elsewhere. Police and Iraqi army officials in Diyala province, on the Iranian border, say they believe insurgents have moved into drug smuggling to finance their activities.

Illegal drugs in Iraq are readily available in cafes, markets and on the street via dealers.

Among the more popular pills are a potent form of Valium made in Iran and nicknamed "the bloody," because of its red package; a pill called "Abu Hajib" or Father of the Eyebrow — because of its parallel squiggly lines — that packs a heroinlike punch; a pink pill nicknamed the "Lebanani" that produces feelings of bliss; amphetamines; muscle relaxants; and a variety of hallucinogens.

When those drugs are not available, security-force members say they guzzle several bottles of cough syrup at a time or drink spirits.

The United States has spent more than $22 billion training and equipping Iraqi security forces since 2004.

Friday, October 22, 2010

Study: Students who study Abroad may hit the Brewskis Harder

LA Times

With the new school year underway, some college students are spending the year abroad. In addition to hitting the books and taking in the sights, they may also be drinking a lot more, a new study suggests.

University of Washington researchers surveyed 177 study abroad students about their drinking habits before they departed for their new host country, during their stay (an average three to five months), and on their return.

Overall, drinking more than doubled while abroad, but returned to pre-travel levels when the students returned. However, the heaviest drinkers drank more when they got back.

Where the students studied had an effect on how much they drank. Those who were in Europe or Australia and New Zealand drank the most, and those in Latin America drank significantly more when they returned compared with pre-trip levels.

Students under 21 drank less than their older peers before traveling, but once abroad they increased their drinking more--by about 170%. They also drank more when they returned compared with before their trip abroad, and those numbers had no association with turning 21. It should be noted that in some countries the legal drinking age is under 21. Those who intended to drink more while abroad fulfilled those goals.

The researchers mentioned that the study population may be more inclined to drink and want to drink more while abroad. The study also didn't get into details about specific drinking habits, such as risky or binge drinking. But the scientists also noted that there may be serious consequences of excessive drinking in a foreign country, such as supporting negative views of American students, mucking up travel plans and getting caught in a legal morass.

"The study abroad experience presents both unique opportunities and unique risks for students," said study co-author Mary Larimer, director of the Center for the Study of Health & Risk Behaviors, in a news release. "Working with these students pre-departure is a terrific opportunity to help reduce their risks for drinking consequences while abroad, and may also help prevent difficulties when they return home."

The study was published recently in the journal Psychology of Addictive Behaviors.

Monday, October 18, 2010

More Americans Drinking More Alcohol

Bloomberg / BusinessWeek

Among women, whites more likely than Hispanics, blacks to down 5 or more drinks a day, study finds

Alcohol consumption is on the rise in the United States due to a number of factors, including social, economic and ethnic influences and pressures, a new study has found.

Researchers analyzed national alcohol consumption patterns among people who took part in the 1991-1992 National Longitudinal Alcohol Epidemiologic Survey and the 2001-2002 National Epidemiologic Study on Alcohol and Related Conditions. Each survey included about 43,000 people.

Drinkers were defined as people who had consumed at least 12 drinks that contained at least 0.6 ounces of any kind of alcohol within the past year. The number of whites, Hispanics and blacks who reported drinking increased between 1992 and 2002.

Among women, whites were more likely than Hispanics or blacks to consume five or more drinks a day or drink to intoxication, said the UT Southwestern Medical Center researchers.

The study also found an increase in drinking five or more drinks per day among heavier drinkers, which suggests a potential polarization of drinking practices.

Males younger than 60 who did not have a college degree were likely to consume more drinks per month, and being unmarried or unemployed were risk factors for males getting intoxicated more than once a month, according to the report published online and in the October print issue of the journal Alcoholism: Clinical & Experimental Research.

The findings suggest "that a variety of public-health policies such as restrictions on alcohol advertising, regulating high-alcohol-content beverages, increasing taxes on alcohol, as well as treatment and brief interventions may be needed to reduce alcohol-related problems," lead author Dr. Raul Caetano, dean of the UT Southwestern School of Health Professions, said in a medical center news release.

Tuesday, October 12, 2010

Smarter Pricing for Alcohol

Victoria Times Colonist

Alcohol abuse carries a high cost, affecting everything from relationships to health to crime. It is the most destructive drug available in B.C.

With that in mind, the provincial government should ensure that more potent drinks carry a stiffer price.

That move has been recommended by the B.C. Coalition for Action on Alcohol Reform, which says the government needs to stop allowing the alcohol industry to market high-powered cheap drinks to young people and alcoholics.

Housing and Social Development Minister Rich Coleman, who is responsible for the Liquor Control and Licensing Branch, has expressed a reluctance to raise alcohol tax rates, because B.C. already has the highest rates in the country.

Those taxes could be, however, reworked to reflect the alcohol content in the bottles without increasing the overall tax hit. The government already takes in about $890 million from liquor sales; a revision to penalize the more potent drinks would not increase the total if the rates on lighter drinks were cut.

There are many inconsistencies in the pricing structure. A six-pack of eight-per-cent beer is $7.99, while a six-pack of low-strength beer is $11. Hard lemonade brands with a high alcohol content cost less than ones with less alcohol. Low prices are also a concern; a bottle of Vincor's Vex Hard Pink Lemonade, with seven per cent alcohol, costs just $1.59, less than some soft drinks.

The government should be discouraging young people from drinking to excess, yet it is pricing high-alcohol drinks in a way that encourages abuse. B.C.'s minimum retail prices are set without regard for the percentage of alcohol in each drink.

Provincial health officer Perry Kendall urged the government two years ago to introduce a pricing system that reflected the alcohol content. No action has been taken here -- although Saskatchewan has introduced a similar system in an attempt to reduce the availability of cheap drinks to the more vulnerable members of society.

Since Saskatchewan's system was introduced in April, the sales of cheap, high-alcohol products -- those considered to be high risk -- has dropped by 12.6 per cent.

In the 1980s and 1990s, B.C. sold low-alcohol beers at a low price, but they were not as popular as regular beers. Still, it would be worth taking another look at how alcohol is priced. It only makes sense for the prices to match the costs that come with alcohol.

Thursday, October 7, 2010

MTV Exploits Snooki's Alcohol Abuse

LA Times

MTV's got a situation on "Jersey Shore" -- and I'm not talking about Mike Sorrentino's abs.

Snooki, also known as Nicole Polizzi, has a drinking problem. Instead of helping her, the network is exploiting her.

Last Thursday's episode should have featured a very sloshed Snooki being rushed to a local hospital for alcohol poisoning.

Instead, all we saw was a totaled 22-year-old tickling her roommate's feet while the couple smushed (please don't make me explain).

Way to go, MTV. Let's cut the teachable moment out of the show and party on.

According to, Snooki's near-death experience happened in May, three months before she was arrested in Seaside Heights, N.J., on a charge of drunk and disorderly conduct. In that incident, the teeny tanned tart with the sky-high hair and lowbrow lifestyle was drinking heavily the night before and passed out face down on the beach.

Good times.

After a breakfast of champions -- a couple of tequila shots and a Long Island iced tea -- she was busted around noon.

At her court hearing earlier this month, the judge fined her $500 and told her she was rude, profane, obnoxious and self-indulgent. Snooki later told the press she was cutting back on drinking.

That scene made it onto YouTube. I wonder if MTV will leave it on the cutting-room floor?

Clearly, consequences aren't a plot device in the series, otherwise we'd see a lot more trips to the pharmacist (the hot tub alone is ground zero for STDs.)

The allure of "Jersey Shore" is its debauchery. It's a weekly dose of wild behavior featuring a foul-mouthed cast of characters who, when not wasted or busy bedding everybody on the Eastern seaboard, are pulling in tens of thousands of dollars each episode, making the rounds on shows like "Dancing with the Stars" and ringing the opening bell at the New York Stock Exchange.

Why would any of them change their behavior?

And why would MTV make them?

The no-longer-music-video channel's ratings were in the toilet before "Shore." Now, thanks to sex, swearing and swinging fists, it's on top again.

But success comes at a price.

Snooki is seen as a selfish laughingstock instead of someone struggling. And MTV is complicit in her dangerous behavior by not showing the repercussions.

But the real losers are the 5.5 million viewers who tune in for a reality show that fails to air the most important thing: the truth.

Tuesday, October 5, 2010

Is He an Alcoholic?

Daily Mirror

HE says it's under control. YOU know it's not. But a new book reveals how a little love can help him beat the bottle

Your partner staggers home worse for wear after a night out with colleagues several times a week ... but, then, socialising with co-workers and clients is vital to most people’s careers, isn’t it?

He always manages to upset friends, family and you when he’s tipsy ... and you hate the way he never seems to know when to stop when there’s alcohol around. But he’s not got a drink problem, has he?

If you’ve found yourself asking questions like this — and perhaps taken refuge in these same evasive, self-deceiving replies — you’re not alone.

The knock-on effect of the economic ­crisis has been a dramatic increase in drug and alcohol addiction. In fact, according to a recent NHS report, one in three men and one in six women can be classified as ‘hazardous’ drinkers.

Recent statistics suggest that in the UK, one in 13 people could be diagnosed as alcoholic with the knock-on effect that 3.7 million people are affected by parental alcoholism and one million by their ­partner’s alcoholism.

In a new book, Bottled Up, counsellor Lou Lewis (who lived with an alcoholic husband for 20 years, until his death from cancer in 2007) and her partner and co-author Dr John McMahon (himself a recovering alcoholic who gave up drinking in 1984 after a serious health scare) explain how you can pinpoint when a partner, friend or family member’s drinking is becoming a serious problem . . . and how you can tackle it.

Lewis and McMahon say there’s a very simple test to see if you need help. If you’re reading this, hoping the person you’re concerned about doesn’t catch you; if you’ve ever typed ‘Is my partner/friend an alcoholic’ into a search engine; if you can’t trust the person you care about to turn up to anything on time and sober, it’s likely alcohol is starting to take a hold.

For convenience, we’ll stick with calling the person you might be concerned about ‘he’ — but ‘he’ could be anyone. Women are catching men up in the alcohol dependency stakes.

You may be worried that you’re over-reacting. As ‘he’ no doubt keeps pointing out, there are times when he can drink and not get drunk. But you’re always on tenterhooks waiting for the next time he’s had one too many.

According to standard textbooks, someone can be categorised as an alcohol abuser if, in the past 12 months, one or more of the following has occurred:

    * His recurrent alcohol use has resulted in failure to fulfil major obligations at work, school or home.
    * The person has been drunk in physically hazardous situations, such as driving.
    * There’s been alcohol-related trouble with the law.
    * He’s continued his alcohol use despite recurrent social or personal problems (for example, physical fights).

His problem with alcohol is likely to be spiralling into alcohol dependence if three or more of the following criteria have been met in the past 12 months:

    * There’s a need for increased amounts of alcohol to achieve intoxication.
    * The person drinking experiences ­withdrawal symptoms.
    * Alcohol is often taken in larger amounts or over a longer period than was intended.
    * There are unsuccessful efforts to cut down or control alcohol use.
    * A great deal of time is spent in obtaining alcohol, using alcohol or recovering from its effects.
    * Important social, occupational or recreational activities are given up or reduced because of alcohol use.
    * Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the alcohol (for example, drinking despite having a stomach ulcer that has been made worse by alcohol).

So if the person you care about does fit these criteria, what can you do?

Well, remember the last conversation you had about the issue. It probably started because he was drunk again and you had suggested that he might have a problem.

He immediately became hurt and defensive, and denied any problem. He stormed off to nurse his wounded pride and you were left frustrated.

Lewis and McMahon devised their ­Bottled Up approach as a result of years of experience on both sides of alcohol abuse. It suggests that a gentle, positive attitude is always going to work better than bullying or browbeating.

You may feel like shouting, crying, pleading, pouring the booze down the sink — even threatening to walk out. But if you want your circumstances to change for the better (and Lewis and McMahon insist they can), it is time to learn some new behaviours and go against all your instincts.

Monday, September 27, 2010

Pediatricians Want to Restrict Ads for Tobacco, Booze, Viagra

US News & World Report

The American Academy of Pediatrics doesn't want children exposed to tobacco ads at all, and wants to limit their exposure to alcohol marketing and advertisements for erectile dysfunction drugs and other prescription medications.

Those are just a few of the recommendations in its new policy statement, "Children, Adolescents, Substance Abuse, and the Media," published in the October issue of Pediatrics.

"Although parents, schools and the federal government are trying to get children and teenagers to 'just say no' to drugs, more than $25 billion worth of cigarette, alcohol and prescription drug advertising is effectively working to get them to 'just say yes' to smoking, drinking and other drugs," wrote the policy's authors.

Every year, more than 400,000 people in the United States die from smoking-related illness, according to the policy statement. And, more than 100,000 deaths can be attributed to excessive alcohol consumption.

The AAP is targeting advertising because it works. Advertising may be responsible for as much as 30 percent of alcohol and tobacco use, the authors say. When Camel cigarettes started an ad campaign using a cartoon camel as its mascot, its market share went from 0.5 percent of teen smokers to 32 percent. And, exposure to tobacco marketing more than doubles the risk of a teenager starting to smoke, the paper states.

Alcohol ads are getting through to younger kids, too. A study of 9- and 10-year-olds found that as many kids who could identify Bugs Bunny could also identify the Budweiser frogs. In another study, 75 percent of fourth-graders could identify a ferret used in a Budweiser advertisement.

The AAP would like to see a ban on all tobacco ads and an end to smoking in movies. If characters are smoking, they shouldn't be glamorized, the statement advises.

Some other highlights of the statement include:

    * Limit advertising and product placement for alcohol in venues where more than 10 percent of the audience are children. Alcohol use in teens shouldn't be portrayed as normal in movies or TV shows, and no one should be shown as being "funny-drunk."

    * The White House Office on Drug Control Policy should conduct anti-smoking and anti-teen-drinking public service campaigns.

    * Drug companies, public health groups and the medical communities should have an open debate on the necessity of advertising prescription drugs.

    * Ads for erectile dysfunction drugs should only be shown after 10 p.m., and they shouldn't be overly suggestive.

    * Schools should try to incorporate media education into their curricula.

    * Parents should limit unsupervised media use.

"Alcohol remains the greatest public health problem, and it remains the most lethal drug for young people. Parents need to understand this, and protect their children," said Dr. John R. Knight, director of the Center for Adolescent Substance Abuse Research at Children's Hospital of Boston. "Advertising glamorizes alcohol and really primes our kids to think they can't have fun unless there's booze."

Knight said prescription drug ads contribute to the idea that these drugs are safe for anyone to take and lead to greater prescription drug abuse in teens.

Of the new policy statement, Knight said he's "proud of the AAP" for taking a stand.

Lori Evans, a psychologist at the New York University Child Study Center, agreed that the AAP recommendations are important. "We know the impact of advertising. That's why advertisers spend money on it. For kids, the images are so vivid and clear that it's a good thing to limit access."

But, she added, "No matter how much we limit access, we still have to watch with our children because we need to know what they're seeing and hearing." For example, she said, if you're watching a football game with your children, you'll likely see beer ads. She suggested that parents point out that beer isn't necessary to have a good time.

Knight's approach is a bit more radical. "I love the Super Bowl and I think they have the greatest ads, but I would not encourage my kids to watch that game. I don't want them exposed to it. Parents have the ultimate power and can vote with their feet by not watching."

If you just can't give up watching the big game, Knight suggests using technology to your advantage: Record the game, so you can fast-forward through the commercials.

Sunday, September 19, 2010

Opinion: Doctor Ignores 12-Step Success

Lexington Herald

Recognizing that Dr. Bankhole Johnson is a renowned authority in the field of alcoholism and addictions, his Sept. 12 column, "Medicine needed to treat addiction," is the ultimate of intellectual arrogance. There are millions of recovering alcoholics and drug addicts living happy and productive lives who could challenge his assumptions.

He, like many academicians, assumes Alcoholics Anonymous doesn't work because there are no long-term controlled studies on the efficacy of AA. There will never be. These studies cannot be accurately performed because it is anonymous, which is one of the very strong reasons AA works. Also, AA is a recovery program and not a treatment program.

I have no problem with Johnson questioning the efficacy of treatment centers; some are good and some bad. I have observed over 32 years that all the good centers get their patients started on a 12-step recovery program.

It is unrealistic to think all patients are going to quit drinking with any treatment. Alcoholism and drug addiction are chronic diseases, subject to relapse, and need lifelong attention to maintain abstinence and healthful living — if they do the 12 steps. Many never get it and die.

I also would challenge Johnson to produce any long-term studies to show that psychiatry and behavioral medicine approaches have proof they work. It also is expensive; AA alone costs virtually nothing.

Many in AA have failed every form of known treatment and finally accept AA after exhausting all available resources. Johnson wants to treat them with a pill. What pill works over the same long-term follow-up he demands of AA?

While Johnson searches for a pill, he should visit Lexington's Hope Center recovery programs and observe the many restored lives and families for hopeless street alcoholics and drug addicts.

Alcoholics need lifelong attention to their problems, and they get that in AA, if they continue. The No. 1 cause of relapse is failure to continue in their maintenance program. These people are destined for death, prisons or institutions without help.

The Hope Center has 100 percent follow-up in our jail recovery program. Those completing the program are on probation, are required to report frequently and are subject to random drug screens.

With seven years of experience, 61 percent are sober, most are working and the return to jail rate has been cut by 60 percent with up to two years follow-up. It is a win-win program for the patients and society.

Fortunately, the University of Kentucky is more understanding and tolerant and has many research studies going on — some involving the Hope Center, Chrysalis House and other AA recovery programs in Kentucky.

They also have many millions of dollars of research into not only advanced neuropharmacology, which is Johnson's field, but many other behavioral, genetic and neuroscientific studies involving advanced neurobiology. This is facilitated by Dr. Carl Leukefeld, who occupies the Bell Chair in Alcoholism at UK and who supports AA because he has seen it work.

There is a real danger publishing a column like Johnson's; it may delay many in seeking help in 12-step programs. For example, a RAND study in the 1970s advocated controlled drinking, causing many to try it.

A study 10 years later of people following that study showed only one was able to control his drinking; over 90 percent had further severe problems with alcohol and 20 percent had died.

I do support Johnson's efforts to study these illnesses and develop treatment. We need more research and understanding of what goes on in the human brain. It should be remembered that much of Johnson's research is necessarily funded by pharmaceutical firms. But when he writes distorted accounts of AA, there is a conflict of interest.

Hopefully he will finally come to see (as do doctors at UK) that 12-step programs have a real place in the treatment of addiction diseases.

Wednesday, September 15, 2010

Thousands of American Pilots Treated for Alcohol Abuse

Malaysian News

At least 292 American pilots have attempted suicide in the past three years.

Another fifteen U.S. pilots have been diagnosed with, or been treated for, schizophrenia.

The shock figures have been revealed by the Boston Herald, quoting figures from the Federal Aviation Administration.

The news follows a serious incident at Boston's Logan International Airport in May when a distraught JetBlue pilot threatened to “harm himself in spectacular fashion” an hour before takeoff.

The Herald's Jessica Heslam's review of FAA medical records for 2008, 2009 and 2010, found that 2,700 pilots have been treated for alcohol abuse, and that nearly half of these have been diagnosed as alcoholics.

A similar number, 1,377 pilots, were found to be abusing drugs, while another ninety four were diagnosed as being drug-dependent.

23 pilots have been treated or diagnosed with post-traumatic stress disorder, while another eighty have suffered major affective disorders, including bipolar disorder, and another two have been diagnosed with paranoia.

The Boston Herald article said the FAA was unable to confirm what number, if any, of the affected pilots had been grounded.

More than half-a-million pilots are certified medically fit to fly in the United States. “The FAA is committed to making sure our nation’s commercial and general aviation pilots are medically fit to fly,” FAA spokeswoman Laura Brown was quoted by the Boston Herald as saying. “We have rigorous medical standards and will not issue medical certificates if the pilot has a condition that would create an unsafe situation for the pilot or passengers.”

Pilots are required to undergo medical evaluations every year. Once they turn forty they are subjected to bi-annual tests.

If a pilot is determined to be an alocholic, he or she is disqualified from flying, and must go through an “extensive” medical re-certification process and post-rehabilitation follow-up program before they are recertified to fly, according to the FAA.

Wednesday, September 1, 2010

Liquor Initiatives Stir up old Dispute

Seattle Times

People who think the state should get out of the liquor business could push it out with two measures on the November ballot. One initiative goes even further, killing Prohibition-era regulations meant to keep alcohol relatively expensive and hard to get.

The battle is starting to look like it did in the 1930s, with free-market advocates fighting against people who view cheap, easily available alcohol as a precursor to increased abuse and violence.

"Both initiatives would make it more convenient to buy alcohol, and I think that's why consumers are so interested. They move in from California and other states, and they're going, 'Why can't I buy a bottle of liquor after 8 p.m.?' " said Jan Gee, president and chief executive of the Washington Food Industry Association, which represents independent, family-owned grocers. Washington has been among the strictest states in limiting access to alcohol, dating back to the end of Prohibition in the 1930s.

Privatize liquor sales

The two ballot measures — Initiative 1100, backed by Issaquah-based Costco Wholesale and other big retailers, and Initiative 1105, crafted by alcohol distributors — would privatize liquor sales in Washington state.

If either passes, the state would close its stores and distribution center.

Initiative 1100 would remove price regulations, allowing retailers to receive discounts based on the quantities of liquor they sell and buy alcohol on credit from manufacturers, practices that have been banned for more than 75 years.

It also would allow retailers to buy directly from manufacturers rather than going through distributors.

Costco has worked for years to try to make alcohol sales in Washington pencil out more like selling toilet paper, trying unsuccessfully in the Legislature and the courts to change the state liquor-control system.

Initiative 1105, the distributor's initiative, would allow retailers to have volume discounts on liquor, but not wine and beer. Under this measure, retailers would still have to buy alcohol through distributors.

Under both measures, the 5,200-plus stores that sell beer or wine in Washington could apply to sell liquor, dramatically raising the number of stores selling liquor from 315 now.

If both initiatives pass, differences can be resolved in the courts or by a two-thirds vote of the Legislature, said David Ammons, a spokesman in the Secretary of State's Office.

Back to Prohibition

The debate is largely economic, but it also reaches deeply into the roots of the American West, when saloons were a divisive issue, seen as public-safety threats by some and engines of economic growth by others.

"For us, 'saloon' is just an old, classy word for a bar," said Dean Gerstein, vice provost and director of research at Claremont Graduate University in California and co-editor of the book "Alcohol and Public Policy: Beyond the Shadow of Prohibition."

Before Prohibition, he said, "for a lot of people, a saloon was a place where guys went to throw away their money so they could come home and beat up their wives, a place where criminal deals were done and people got knifed, and where prostitution was as much what the house did as drinking."

Washington was among 13 states that rebelled against saloons so strongly that they banned alcohol earlier than the nationwide ban in 1920, in Washington's case, six years earlier.

After Prohibition ended in 1933, Washington became one of 18 so-called control states that tried to squelch the profit motive by putting the government in charge of liquor distribution and sales.

It remains one of the most restricted states for alcohol sales, with liquor available only at state stores, most of which close by 9 p.m. Only one-third are open Sundays.

Washington also has markups, taxes and rules that keep prices high, and it bans advertising.

"The noble intent behind things like state liquor stores is so that people are not promoting alcohol like snake oil," Gerstein said.

Idea to limit access

Indeed, it is the rare liquor-store worker who pushes the latest tequila or touts the best scotch for your dollar.

"The system was set up to limit access," right down to the way liquor-store workers are paid, said Rick Garza, deputy director of the Washington State Liquor Control Board.

"If I give a person the same salary whether they sell one or five bottles, you're going to have what we have, a really high 'no-sale-to-minors' compliance rate," he said.

About 95 percent of the time, minors who try to buy liquor in state stores are turned away, Garza said. At grocery stores that sell beer and wine, stings show that minors are turned away 76 percent of the time.

That will change if one of the voter initiatives passes, said Snohomish County Sheriff John Lovick.

"There will be 10 times as many places to buy hard liquor, and that's going to increase the chances of children buying liquor illegally," he said. "The word's going to get around. With every minimart out there selling liquor, they're going to try it."

He does not speak for the department but personally opposes Initiatives 1100 and 1105 because of problems with underage drinking, drunken driving and alcohol-related domestic violence.

The state has a conflict of interest in selling alcohol while also overseeing alcohol laws, said Ashley Bach, spokesman for the businesses behind Initiative 1100.

Over the past 75 years, "the notion of controlling consumption has been replaced with alcohol as an unlimited source of state revenue," he said, pointing out that only 80 of the liquor board's 1,200 employees work in enforcement.

Washington residents drink alcohol responsibly, Bach said, and "should be allowed reasonable access to it."

Per-capita consumption

It is impossible to know how alcohol consumption might change if liquor were available along with wine or beer.

Under the current system, per-capita consumption is about the same as in California, where there are 359 stores selling liquor for every million residents, compared with 48 stores per million in Washington.

That does not mean Washington consumption would remain steady if the number of stores rose, said Jim Cooper, vice president of the Washington Association for Substance Abuse and Violence Prevention.

"If we're selling liquor until 2 a.m., to me there's a natural jump to an increase in crime, violence and automobile deaths, especially in the wee hours of the morning," Cooper said.

He also likes Washington's high prices, which studies show deter alcohol abuse.

The World Health Organization said last year that increasing alcohol prices can reduce alcohol abuse. Even heavy drinkers are sensitive to price changes, it said.

And that is one thing all sides agree on with the new initiatives: They would mean lower prices for consumers, especially on liquor.

As an example, Costco said a 1.75 liter bottle of Maker's Mark Bourbon costs $61.95 at a state liquor store in Issaquah. In Stockton, Calif., Costco charges $33.99 for the same bottle.

A bottle of Absolut Vodka at a state liquor store is $42.95. In Stockton, it's $22.99.

Tuesday, August 31, 2010

Minister Seeks Control of Alcohol Licensing in Wales

BBC News

Wales could gain control over minimum pricing of alcohol, advertising and licensing hours

Ministers in Wales could take charge of rules surrounding alcohol sales, including minimum price, licensing hours and advertising.

The Welsh Assembly Government has confirmed that Health Minister Edwina Hart wants to "take control and take action" over alcohol.

She will ask cabinet colleagues to request that the Licensing Act 2003 is devolved in Wales by the UK government.

The SNP, which wants similar powers in Scotland, has welcomed the move.

Mrs Hart has previously indicated that she would seek powers to act over alcohol if the UK government did not do the same soon.

According to a report by Public Health Wales, alcohol has a "substantial impact on health" in Wales.

The report said there was "particular concern" about drinking among young people and children, with 23% of boys and 20% of girls drinking at least once a week.

It also found that 4.3% of all male deaths in Wales were "alcohol-attributable".

An assembly government spokesperson said: "While we are investing in education and prevention, the main levers to tackle binge drinking and alcohol misuse remain with the UK government through the power to legislate on price, licensing and advertising.

"Health Minister Edwina Hart welcomes the UK government's indication that it is going to take action on these issues, but believes it is now time for Wales to take control and take action in this area.

"She has therefore written to cabinet colleagues seeking their agreement to request the devolution of powers in the Licensing Act 2003 to regulate the sale of alcohol.

"It would be inappropriate to comment further until the cabinet has made a decision."

Earlier this week, Prime Minister David Cameron backed a crackdown on the sale of alcohol at "below-cost" prices, and supported proposals by 10 councils in Greater Manchester for minimum prices, with each unit costing at least 50p.
Low-income families

Both the House of Commons health select committee and the National Institute for Health and Clinical Excellence support minimum pricing.

But UK Health Secretary Andrew Lansley has voiced doubts on the grounds that it punishes low-income families.

The Department of Health said the government was committed to taking tough action over problem drinking but said demand and attitudes were also crucial factors, in addition to supply and price.

In June the Conservatives and Labour joined forces in the Scottish Parliament to back an amendment calling for minimum pricing plans to be struck from the SNP's Alcohol Bill.

Opponents of minimum pricing in Scotland disputed claims there was "overwhelming evidence" in favour, and said the case had not been made.

SNP MSP Michael Matheson, a member of the Scottish Parliament's health committee, said: "The coalition in favour of minimum pricing as an effective approach to tackling the worst damage done by alcohol abuse is growing by the day.

"The Welsh Assembly Government joins a chorus of expert voices in health, public order and the licensed trade who believe that the selling of alcohol at rock-bottom prices is one of the biggest problems facing our society and that we have to take action to stop it now."

Wednesday, August 25, 2010

Sides Disagree on 21-only's Health Effects


University of Iowa student and 21-only opponent Matt Pfaltzgraf admits that binge drinking is a problem in Iowa City.

However, Pfaltzgraf said he thinks supporters of the 21-only ordinance are missing the mark in their belief that kicking underage patrons out of bars will prevent them from binge drinking.

"The whole notion that the first time students have a drink (is) at night when they go to a bar is just insane," Pfaltzgraf said. "What students do is pregame. They preload. They're binge drinking before they even leave their house."

The most dangerous drinking in town doesn't occur in downtown bars, but at house parties, fraternity and sorority houses and tailgates outside of University of Iowa football games, Pfaltzgraf said.

He cites reported incidents to back up his belief, as well. In November, Drake University student Nathan Erickson reportedly ingested a large amount of Everclear as part of a fraternity hazing. His blood-alcohol content at the hospital registered nearly .50, or more than six times the legal limit to operate a vehicle, .08. He was 19 at the time and made a full recovery.

In September 1995, UI student Matthew Garofalo passed out drunk at a fraternity house and was found dead 12 hours later after his lungs filled with his own vomit.

"You have the largest research institution in the state of Iowa and they cannot provide any data these (underage) students are binge drinking downtown, that that's where they're getting their alcohol," Pfaltzgraf said.

Nonetheless, supporters of the 21-only ordinance insist that keeping underage students out of the bars will make it more difficult for them to get booze, which, in turn, will lower their opportunities to engage in risky behavior.

Rick Dobyns, a clinical professor of family medicine at UI and 21 Makes Sense member, said the 21-only ordinance is good public health practice.

"It just makes it harder (to obtain alcohol)," Dobyns said of the ordinance. "Of course, will they go elsewhere to drink? Sure. It just makes it harder."

Dobyns said many people, even those who are 19 or 20, could drink and not have any problems. However, there are no tests to see who will succumb to alcohol-related issues, such as alcoholism, and who won't.

"We apply a rule to everybody to help a few," Dobyns said.

A former Johnson County paramedic sees it differently.

Ryan From, who worked with the Johnson County Ambulance Service for eight years, said the downtown bars are getting a bad rap for behavior that is taking place outside of the pedestrian mall.

"Most intoxicated patients came from unsupervised house parties, apartments and unlicensed venues -- hands down," From said.

"The thing is, a lot of times at house parties, people are afraid to call. That's when people get hurt and people die. It's in the bars' best interest to have that person leave or leave with medical attention."
Health concerns

Regardless of where they are finding it, experts agree dangerous drinking is especially detrimental for young imbibers, especially those younger than 25.

"Their brain is still developing," said Stephanie Beecher, a health educator for UI Student Health Service. "In this critical time of development, the brain is still maturing, still developing judgment skills."

Alcohol abuse for underage drinkers can have both short- and long-term effects, Beecher said. In the short term, alcohol abuse can lead to making poor or risky choices, as indicated by a rise in acts of violence and sexually transmitted infections, Beecher said. As for long-term effects, people can develop alcoholism and other health problems.

Although his office won't advocate one way or another on the 21-only ordinance, Johnson County Public Health Director Doug Beardsley said a law preventing underage patrons from entering bars is sound public policy and will go a long way to address alcohol addiction treatment and public perception of what is acceptable behavior.

Good policy or not, however, Beardsley said the ordinance won't do much on its own and must be part of a greater effort.

"I don't have the expectation this is the be all, end all, but it's an essential part," Beardsley said, noting the importance of offering alcohol-free alternatives. "Without changing the policy of allowing underage persons into drinking establishments, none of those (alternatives) are going to go very far."

Tuesday, August 24, 2010

Binge-Drinking is as British as Rain

Telegraph UK

Ken Jones, president of the Association of Chief Police Officers (ACPO), made headlines with his remarks to John Humphrys this week about the difficulties police face against "binge-drinking culture". Humphrys was looking for answers, but the ACPO chief provided none, only more questions: "Why is it we've got ourselves into the position where lager is sold cheaper than water? Why is it we've got huge entertainments and drinks companies marketing alcohol to children? Why is it we continue to see products developed that are solely targeted at young people?"

Why indeed? Or, on the other hand, why not? It's a free country (or free-ish), even for marketeers, lager manufacturers and off-licensees. If you make it, people will drink it, whether or not you double the price or legislate the purveyors within an inch of prohibition. This is a drinking nation. It's a national "culture", binge-drinking. Not the kind of culture that Andy Burnham wants taught five hours a week in the nation's state schools, ho ho, but a culture of sorts.

No rite of passage can be marked in these islands without bottles. Who can forget Alastair Campbell telling Tony Blair not to fret about Euan being found drunk? (Leicester Square, 2001, after his GCSEs.) "Every parent in the land will sympathise," said Alastair. He was right: Richard Littlejohn's smirking piece was headlined, "We've all been there, son", in the Sun.

Britain copes manfully with the clouds of gloom and dismay about violent drunkenness in the same way it copes with other miserable facts of nature, such as rain, HIPs, bad public transport, an NHS without doctors at night or 16-year-olds leaving school illiterate.

The slot about teenage binge-drinkers was not one of Humphrys's vintage Today inquisitions. He couldn't run an inquisition, mostly because not one spokesman from any of the various government departments with a brief on binge-drinking would come on the programme to be quizzed. Not Health, not Children 'n' Schools, not Home Office, not even young Andy from Culture, Media and Sport.

So all Humphrys could do was more or less bristle with why-oh-whys and something-must-be-dones. Under-age drunkenness is part of the national conversation. We have one every day, even down here in Bucolicshire. I'm forever giving the national response to my interlocutors' shocked remarks about yet another blameless father of four being kicked to death by drunken yobs: Oh, I know, tragic, awful - but what's to be done?

The answers come: "I blame the parents; I blame the Government's 24-hour drinking laws; I blame the telly ads that make drinking seem cool; I blame the publicans; I blame the supermarkets for selling lager cheaper than water (cheaper than milk, too, by the way); I blame the off-licences; I blame the iconification of George Best, Gazza." But what's to be done? Actually, I don't blame the publicans, but various ministers who have found themselves skewered on Humphrys's Fork at 8.10am have done.

Drunks in the street were always men; now women have equal opportunities, thanks to me and my sisters-in-arms on the feminist barricades. Drunks in the street used to be people who could pass for 18, or 16 at a pinch; now they're rolling out of primary schools. And drunks were always rude, rough people - what my mother called "dragged up in Rowmarsh Road", though I can't remember now where Rowmarsh Road was - but now they're nicely bred girls stumbling out of nicely appointed wine bars on hen nights.

As we were stringing up Christmas cards around the fireplace, I noticed an unfamiliar signatory who wrote her seasonal message thus: "Hope you have a really great Christmas and a fantastic TOTALLY BLADDERED New Year!!!!" Who on Earth? Oh, it's my friend, said the daughter, sniggering. Really? From school? The one with the MSc in rocket science? "Marine hydrography, and no it's not her. She doesn't drink a lot, actually."

It used not to be acceptable for young women to be seen sprawled and stumbling through the streets, held up by a yelling coven in disarray, busy filming everything on their mobiles. Now it's the genial duty of your daughter and mine at a hen night (I say "night"; it's more often a week) to encourage the bride-to-be into a state of falling-down inebriety.

"Everybody binges at hen nights. Except the ones who are pregnant. Pregnant girls don't drink. Not. At. All. But they sneak off to the bar to get their own drinks, like ­apple juice with a lot of water in it, so it looks like white wine - because people moan when you say you're not drinking, oh, this isn't going to be any fun, blah, blah."

There is, I reckon, nothing simple or Draconian to be done that can be imposed from above or enforced by government, judiciary and police to stop people drinking of their own accord. Maybe it's a millennial bug; maybe it's because there's a war on; maybe it's because drinking cheers people up. It's not just us, Rennes council has closed bars in the city to stop students binge-drinking. (How, pray? They'll go somewhere else.)

In the meantime, we'll continue to have national conversations about mayhem in the streets, while ministers and good, well-meaning people (not necessarily the same) try to think of things that will alter the national predilection for binge-drinking for ever.

Here's one. After much lobbying from (among others) the National Union of Teachers, the names of alcohol companies are now banned from children's replica football shirts.

So Everton can't sell shirts saying Chang Beer, Liverpool can't sell shirts saying Carlsberg and Hibernian can't sell shirts saying Whyte & Mackay. (Or perhaps they still can? Who knows? No one in England knows anything about what goes on in Scotland any more, what with them being a Nation Once Again and all.)

Brilliant, eh? That'll help a lot. In England, anyway. That's a start.

Hang on, though; the legislation that came into force on New Year's day only bans new sponsorship deals made after January 1, 2008. Not current ones. And Budweiser can still sponsor the Premier League and Carling the FA Cup. And for that matter Blackburn Rovers can merrily go on selling shirts saying Bet24 because that's not alcohol-related, but tut, tut, it's an online gambling site, isn't it? Don't they know it's addictive? Won't someone think of the children?

Monday, August 23, 2010

New Zealand Acts to Limit Alcohol Access

BBC News

New Zealand's government has proposed several changes to alcohol laws in a bid to curb youth drinking.

Only those over 20 - up from 18 - will be allowed to buy alcohol from shops.

The sale of pre-mixed drinks with more than 5% alcoholic content will be banned, as will be other products deemed geared to the youth market.

Justice Minister Simon Power said New Zealand had to tackle serious alcohol-related issues; critics say the measures are half-hearted.

Mr Power said that alcohol was estimated to contribute to 1,000 deaths a year in New Zealand and was implicated in 30% of all offences recorded by police.

"What the government has heard from the New Zealand public is that the pendulum has swung too far towards relaxation of alcohol laws," he said.

"But there is a balance to be struck between not unfairly affecting responsible drinkers and dealing with the considerable harm alcohol causes."

But the government package has been attacked as half-hearted by some observers, who said more dramatic action was needed to shock participants in the so-called drinking culture into change.

The director of Christchurch's National Addiction Centre, Professor Doug Sellman, said the government was wrong to see alcohol abuse as essentially a youth problem.

Research found that 92% of New Zealand's heavy drinkers were 20 years and over, and 70% were 25 and over, Alcohol Action NZ said.

The government had avoided the big policy decisions, such as increasing prices and restricting advertising, and ended up with a package that was "like treating cancer with a couple of aspirin", Prof Sellman said.

Members of parliament will vote on the proposals according to individual conscience, not party lines, so the reforms' passage is not guaranteed.

Wednesday, August 11, 2010

One in Five Australians Experience Drinking Problems

Sidney Morning Herald

Australians rank among the world's worst abusers of alcohol, with few seeking help to curb its impact on their health, research shows.

A study by the National Drug and Alcohol Research Centre (NDARC) has found 18 per cent of Australians will experience periods of problematic drinking within their lifetime, while four per cent become alcoholic.

Problematic drinking includes being unable to perform duties at home or work, or having alcohol-related arguments with a spouse or run-ins with the law.

Professor Maree Teesson said it totalled 22 per cent of the population - or about 3.5 million Australians - whose lives would be seriously and negatively affected by alcohol.

The majority, she said, were young men while less than one in five of those affected would receive any form of professional help.

"One reason for the lack of treatment is that alcohol problems still have a terrible stigma about them," Prof Teesson said.

"People are much less likely to want to own up to having a problem with alcohol than they are about other physical or mental illness yet their abuse of alcohol has serious consequences.

"(They) include getting into fights, drink driving (licence suspensions), taking time off work, child neglect, getting into trouble with the police and driving while drunk."

Prof Teesson and fellow researchers analysed data collected from almost 9000 Australians aged 16 to 85 years for the National Survey of Mental Health and Wellbeing in 2007.

The snapshot of alcohol disorder and dependence showed one third of Australian men will have a drinking problem at some point in their lives - about double the rate of alcohol abuse among women.

Married people and those from a non-English speaking background were less likely to have a problem with alcohol.

Men born during the 10 years to 1987 were 1.7 times more likely to drink at risky levels compared to men born in the decade prior.

More than 40 per cent of those with alcohol problems also report a mental illness, while comparison with a similar study done 10 years ago showed no improvement.

"Alcohol problems are most common in young men, so we need better interventions and prevention strategies for young Australians," Prof Teesson also said.

Looking globally, Australia was found to have rates of problematic drinking on par with New Zealand and the United States, and well above other developed countries including France, Germany and Spain.

The paper concluded "prevalence rates for alcohol use disorders in Australia are some of the highest ... worldwide". Meanwhile, "treatment rates were unacceptably low".

Russia and Ireland were also thought to have a high prevalence of alcohol-related problems, Prof Teesson said, though there was a lack of comparable research.

The NDARC is based at the University of NSW, and the study is to be published this week in the journal Addiction.

Thursday, July 29, 2010

Giving Kids Booze, Medicines Can Be Child Abuse

US News & World Report

The malicious use of alcohol and medicines is an under-recognized form of child abuse, according to a new report.

The U.S. study reviewed cases of pharmaceutical-related child abuse reported to the National Poison Data System between 2000 and 2008. The cases included the use of alcohol, painkillers, cough and cold medicines, sedatives, sleeping pills and antipsychotic medicines.

The findings are scheduled to be published in an upcoming issue of the Journal of Pediatrics.

The review included over 1,400 cases, and nearly 14 percent led to moderate or major consequences for children, including death. In about half of the cases, children were given at least one sedative. On average, 160 cases of pharmaceutical abuse, including two deaths, were reported each year.

Motives for this type of child abuse included punishment, amusement, or a desire for a break from childcare responsibilities, the researcher pointed out in a news release from the journal's publisher.

The findings highlight a serious problem, according to study author Dr. Shan Yin, of the University of Colorado and the Rocky Mountain Poison and Drug Center at Denver Health.

"The malicious administration of pharmaceuticals should be considered an important form of child abuse," Yin stated in the news release.

Pediatricians and emergency medical personnel should be on alert for this type of child abuse, and comprehensive drug screening should be used for children who are suspected victims of abuse, Yin added.

Thursday, July 22, 2010

The Science Behind Drinking: Testing for Alcohol Consumption and Abuse

Health News Digest

As actress Lindsay Lohan now knows, there are a variety of ways to test a person’s bodily fluids for alcohol consumption, both before and after an arrest for driving under the influence and to monitor adherence during rehabilitation. During her recent probation for DUI, Ms. Lohan found herself in a special ankle bracelet that uses Breathalyzer technology to sample the sweat on the skin every half hour to determine if an individual violates probation by drinking alcohol. In Ms. Lohan’s case, the device was triggered several times, prompting the judge to consider these violations when sentencing her to 90 days in jail.

In most cases where individuals are suspected of driving under the influence, breath analyzers are used to determine blood alcohol concentration, but according to Dr. Amitava Dasgupta, Director of Clinical Chemistry, Toxicology and Point-of-Care Services at Memorial-Hermann Hospital, Texas Medical Center in Houston, not all breath analyzers are created equal. ”Most people don’t know that there are two types of blood alcohol breath analyzers and the results from only evidentiary breath analyzers can be used to prosecute people accused of driving under the influence,” he said. Additionally, interferents such as mouthwash, hand sanitizers and energy drinks can skew the results of a breath analyzer, and test administrators must take these factors into consideration.

Measuring alcohol use and abuse goes far beyond just testing DUI suspects, and during a morning presentation titled “Role of the Laboratory in the Science of Drinking: From Blood Alcohol Levels and Markers of Alcohol Abuse to Pharmacogenomics,” on Monday, July 26, both Dr. Dasgupta and Dr. Loralie Langman, Associate Professor of Pathology and Laboratory Medicine at the Mayo Clinic in Rochester, will outline the complex and changing role labs are playing not only in measuring and interpreting blood alcohol levels, but also in measuring biomarkers of alcohol abuse and researching genetic variations that can provide insight into why individuals metabolize alcohol in different ways. These presentations will be offered during AACC’s 2010 Annual Meeting, which is being held at the Anaheim Convention Center.

Both Dasgupta and Langman point out that monitoring alcohol consumption and alcohol abuse long-term is much more complicated than taking snapshots of blood alcohol concentrations. In such a scenario, clinicians need to continue measuring traditional biomarkers for alcohol consumption and abuse, such as liver enzymes, mean corpuscular volume (MCV) and carbohydrate-deficient transferrin, mainly because these markers stay elevated for a longer period of time and have the potential to help determine recent alcohol intake versus chronic alcohol consumption, as well as alcohol abuse versus moderate drinking.

Genetic researchers have discovered that there are some genetic factors that cause alcohol sensitivity in people of certain ethnic origins. “Certain populations are genetically predisposed to be more sensitive to alcohol than others,” explains Langman. “Individuals who are sensitive to alcohol can be drunk with a blood alcohol level of .03, and these are the people who should probably not drink.” However, testing individuals for certain genetic polymorphisms related to alcohol abuse or addiction is complicated and there is still much research that must be done before such tests can be offered clinically.

Tuesday, July 20, 2010

Protein Regulator Shows Promise Against Addiction

US News & World Report

Little things can make a big difference in the brain. Case in point: A tiny snippet of RNA may help guard cocaine-using rats against addiction to the drug, a new study shows.

The minuscule molecular guard is a hairpin-shaped piece of RNA known as a microRNA. Raising levels of a microRNA called miR-212 in the brains of cocaine-using rats led the animals to take less of the drug than rats with normal microRNA levels, researchers report in the July 8 Nature. Similarly, blocking the microRNA’s action increased the rats’ cocaine use.

If the results hold true in people, researchers may be able to develop new therapies for treating addiction to cocaine and other drugs of abuse. “Once you get out of whack, this is something that might help bring you back,” says Yale neuroscientist Marina Picciotto, who was not involved in the study.

It’s unlikely that the research will lead to gene therapy to raise levels of microRNAs in people’s brains. But small-molecule drugs that mimic the microRNA’s action might be helpful.

Just 21 to 23 RNA units long, microRNAs are major regulatory molecules that govern part of the process by which instructions contained in DNA are transformed into proteins. The molecules generally block protein production. So it was a surprise to find levels of a protein called CREB increase with rising levels of miR-212, says Paul Kenny, a neuroscientist at the Scripps Research Institute in Jupiter, Fla.

CREB has been found to help fight addiction by decreasing the rewarding experience of taking cocaine, sometimes to the point that rats actually develop an aversion to the drug. It took Kenny and his colleagues years to work out exactly how cocaine use boosts miR-212 production and how the microRNA, in turn, increases production of CREB protein. The process involves several steps and intermediate proteins, including a protein called Raf1 that had never before been shown to be involved in the response to drugs.

The miR-212 microRNA blocks an inhibitor of Raf1 in the striatum, a part of the brain involved in learning habits like driving a car and learning to avoid making the same mistake twice. With its inhibitor in check, Raf1 is free to stimulate CREB production, Kenny and his colleagues show in the new study.

Protecting against cocaine addiction may be a side benefit of mir-212’s normal job of regulating CREB production and other biochemical processes in the brain, Kenny says. The microRNA helps set the correct level of CREB production to keep it from getting too low, which leads to addiction and anxiety, or too high, which leads to depression.

Any therapy targeting CREB would have to strike this delicate balance as well, he says. “Obviously there could be some very profound side effects,” Kenny says.

The researchers are investigating how mir-212 is regulated and whether it is protective against other drugs, such as nicotine and alcohol addiction.

Wednesday, July 7, 2010

Pat O'Brien to Address Alcoholism and "Unfortunate Scandal" in Memoir

Seattle Post

Former Access Hollywood and The Insider anchor Pat O'Brien intends to write a tell-all detailing his struggle with alcohol addiction and his "unfortunate scandal," in which he left slurred sexually graphic voicemail messages on a woman's phone, he tells the New York Post.

O'Brien, who will co-write the memoir — tentatively titled I Love Your Work — with biographer Andrew Morton, will also address his 2004 divorce from his wife, Linda, which occurred a year before his voicemails leaked.

In the voicemails, O'Brien asked an unidentified woman to join him for drugs and sex. He subsequently entered drug rehab before returning to The Insider. He did another stint in rehab in March 2008 and six months later was fired from The Insider after writing e-mails to co-workers that insulted co-host Lara Spencer.

"I was not in total recovery or in alcoholics anonymous at the time. I was still messed up," O'Brien, 62, told the Post's Page Six.

O'Brien, who says he's been sober for more than 600 days, is considering a multiyear radio deal.

I Love Your Work is scheduled to hit shelves from St. Martin's Press in fall 2011.

Thursday, July 1, 2010

San Francisco Eyes Alcohol Tax to Recover Health Costs

San Francisco Chronicle

San Francisco would be the first local government in the state to impose a booze fee intended to recover health care costs associated with alcohol addiction treatment now covered by taxpayers.

The fee, expected to generate more than $15 million a year, would cover such expenses as ambulance transport to the emergency room for public inebriates, unreimbursed hospital and clinic services for alcohol-related accidents and diseases, and Department of Public Health-funded programs aimed at preventing and treating alcoholism.

The idea, said Supervisor John Avalos, who proposed the fee legislation Tuesday, is to make the targeted businesses pay "for the harm of alcohol consumption on the people of San Francisco and the city and county of San Francisco."

The fee is focused on wholesalers. The rate would be 0.076 cents per ounce of alcohol sold. Avalos estimated that the added cost to a standard drink would be a little less than a nickel.

A similar statewide bill was killed this year in the Legislature amid opposition from the alcoholic beverage industry.

Eric Potashner, a spokesman for California Beer and Beverage Distributors, said the Avalos legislation was still being analyzed by the trade group, "but it would be safe to say they're opposed to it."

Mayor Gavin Newsom has not taken a position on the proposal, said his spokesman, Tony Winnicker. But, he noted, "It's the kind of fee that would impact every hotel, restaurant, retailer and hundreds of thousands of people and would require careful scrutiny and public outreach" to uncover any potential unintended consequences.

The mayor's health director, however, backs the proposal.

"We support it," said Dr. Mitch Katz, director of the Department of Public Health. "Alcohol rehab and abuse has a tremendous cost on the health care system. It seems to me that a fee should be added to the cost of alcohol."

On Avalos' behalf, the city controller's office commissioned an independent study that looked at how much money the cash-strapped city spends on unreimbursed alcohol-related expenses. Among those identified: The Fire Department spends nearly $4 million for emergency medical response; San Francisco General Hospital spends $1.8 million caring for patients; and the city's community substance abuse treatment program spends another $10 million.

The money also would be used to cover the costs of fee collection, investigation and enforcement.

Fees, which unlike taxes do not have to go before voters for approval, are tied to cost recovery.

Avalos hopes the fee would be enacted effective in January. Litigation is expected if it is adopted.

Sunday, June 27, 2010

Wisconsin Adds more Weapons to Battle with Drunken Drivers

The Northwestern

Officer Mike Weinberger patrols the streets Wednesday night in the Town of Menasha. A new law imposing tougher consequences for drunken driving goes into effect Thursday. (Post-Crescent photo by Dan Powers)
It's a gamble taken all too frequently by Wisconsin residents: Getting behind the wheel of car while drunk.

To combat the problem, the state has raised the ante with the most ambitious package of drunken-driving reforms in decades. One of the primary aims of the law, which takes effect Thursday, is to persuade impaired motorists to stay off the roads.

But there is considerable debate about whether the target audience will get the message.

"Many people simply think that they won't get caught," Neenah Police Chief Kevin Wilkinson said. "Until we can intrude in the psychology of that, that portion won't change."Many police officials, lawmakers, researchers and safety advocates are taking a wait-and-see approach on whether the stiffer drinking-and-driving penalties will make a significant impact.

Even with the changes, Wisconsin's law is not among the nation's toughest.

Still, state Rep. Tom Nelson, D-Kaukauna, said, the law marks the first major upgrade in how Wisconsin treats drunken driving in 20 years. It incorporates ideas that were subject to debate for years before Gov. Jim Doyle signed the law in December.

In striving for meaningful reform, lawmakers worked to incorporate provisions on punishment, prevention and treatment, Nelson said.

"It's not just a criminal justice issue or a prevention issue," he said. "We chose to take a different approach: Let's bring everything to the table. Let's bring all these approaches into this law."
Bad habit

Meanwhile, police and experts say Wisconsin's alcohol-driven culture puts it in a uniquely difficult position when it comes to improving roadway safety.

Nina Emerson, director of the University of Wisconsin-Madison's Resource Center on Impaired Driving, said drunken driving carries a certain degree of social acceptance in the Badger State.

A 2008 federal survey placed Wisconsin highest in the nation for driving while intoxicated. More than 26 percent of those questioned acknowledged having done so in the previous year.

Emerson said potential consequences don't often sway drunken drivers when the party winds down or the bartender makes the last call.

"They're not thinking, and they're definitely not thinking they're impaired," Emerson said. "Time after time, they'll say, 'I didn't think I was that bad.' They've also done it so many times without repercussions that it reinforces that behavior. That behavior becomes more entrenched."

Beginning Thursday, a fourth-offense drunken-driving conviction will be a felony if it occurs within five years of the previous offense. Currently, drunken drivers are treated as felons after a fifth conviction.

A first offense will be a misdemeanor if someone younger than 16 is in the car. Today, it's a traffic ticket.

Repeat offenders and first-timers with high blood-alcohol concentrations will have to get ignition interlocks on all vehicles they drive.

In addition, judges will have the power to place more drunken drivers on probation.

State Rep. Dean Kaufert, R-Neenah, said he is confident Wisconsin drivers will take notice once they start encountering others who have been stung by the tougher penalties.

"It was a compromise and we've taken another step forward," said Kaufert, who owns a bar. "In some people's eyes we didn't go far enough, and in other people's eyes, we went too far. The bottom line is that we coalesced on something that could pass."
More felonies

History provides a sense of the new law's potential impact on prosecutors' caseloads.

Last year, Outagamie County registered 57 convictions for fourth-offense drunken driving and 26 convictions for fifth or subsequent offenses, which were felonies. Another 16 felony drunken-driving cases from 2009 remain open.

In Winnebago County, 73 drivers were convicted on a fourth offense and 44 were convicted for fifth or subsequent offenses. Six cases from 2009 cases remain open.

Bottom line: More felony cases would mean more time spent per case.

Felonies require a preliminary hearing, to determine if there is sufficient cause to send the case to trial, which misdemeanors don't carry. And defendants are more apt to fight a felony charge because they stand to lose more, including the potential of going to prison and the right to own firearms.

Despite possibly larger caseloads and related expenses, adopting the tougher threshold made sense particularly when comparing Wisconsin to other states, UW's Emerson said. In 21 states, a third offense is considered a felony. In Indiana and New York, drunken driving is a felony on the second offense if it occurs within five years of the previous conviction. Oklahoma considers a second offense a felony if it occurs within 10 years of a previous conviction.

Only seven states have laws weaker than Wisconsin's fourth-offense standard.

"I don't think it's by any stretch unreasonable," Emerson said of Wisconsin's new law.
Focus on treatment

Some police wonder whether any degree of punishment is enough to break the behavior of those who've reached or exceeded the felony threshold.

"I think punishment has very little to do with it, frankly," Outagamie County Sheriff Brad Gehring said. "At that stage, they've demonstrated they have incredibly strong addictions."

That's where another portion of the law shows promise, he said.

"Legislatively, I understand the need to get tough, but with more alcohol addiction treatment we're hoping to have more positive results."

The new law offers counties the option to use a treatment-based program now available only in Winnebago County. Outagamie County will open its version of the Safe Streets Treatment Options Program to drunken drivers arrested after the law takes effect.

The program is available to those charged with second and third offenses. Participants who complete the Wisconsin alcohol rehab program receive less jail time than they would have under traditional sentencing. They would be placed on probation with alcohol treatment and community service among the conditions.

Annie Levknecht, alternative treatment coordinator for Outagamie County, said the initial benefit of the program is urgency.

Offenders don't have time to consider whether they're ready or willing to undergo treatment because they have just three days to get an alcohol assessment.

Those who complete the program similar to alcoholics anonymous will have two-thirds of their sentence stayed.

"There's incentive," Levknecht said. "Another key benefit is they get to stay with their families."

Winnebago County Judge Scott Woldt, who instituted the program with Judge Barbara Key in 2006, said it has benefited taxpayers by saving on jail costs and it is giving offenders the tools they need to avoid further offenses.

Winnebago's program has produced 266 graduates. Of them, 26 have re-offended.

Woldt said measuring success goes beyond facts and figures.

"I get letters from time to time saying, 'I didn't want to get into it, my lawyer talked me into it, but it was the best thing I ever did,'" Woldt said. "I don't typically get letters from people I've sentenced to prison. People are turning their lives around."

Woldt said he's given about a half-dozen presentations on the program since it was included in the state's new drunken-driving law. In addition to Outagamie, Waukesha County plans to incorporate the program into its alcohol treatment court, he said.

"It's going to be a slow process, but it'll slowly build," Woldt said.

Counties that decline to use Safe Streets still have better opportunities to keep closer watch on offenders.

The new law will make probation an option for those convicted of second and third offenses. Currently, probation is only available to judges for four-time offenders.

Winnebago County Dist. Atty. Christian Gossett said allowing probation earlier in the process is a laudable step, because it's vital to reach drunken drivers early and address the behavior before it worsens.

However, Wisconsin's probation agents are already overburdened, and it's likely drunken drivers wouldn't get the attention that would make it worthwhile, Gossett said, due to any given agent's higher-priority clientele.

"Make it a meaningful probation," he said. "If you can't, it's feel-good legislation only."
Mandatory interlocks

If stricter penalties can't stop drunken drivers from repeat offenses, there's hope that technology will.

Judges now have the discretion to order use of ignition interlock devices for repeat offenders. Beginning Thursday, the devices will be mandatory for repeat drunken drivers and for first-timers arrested with a blood-alcohol level of 0.15 percent or higher. The state's legal limit is 0.08 percent.

The interlock devices require drivers to take a breath test before they can start their vehicles.

Kaufert was among the lead Assembly proponents for toughening the interlock requirement. He said it was crafted to better assure that those ordered to use the devices follow through.

"People are always going to try to find a way to circumvent it," he said, "but I think it's a pretty good law."

Currently, the clock starts when a judge orders a driver to have the device in place for a certain length of time. The offender can ignore the order and drive illegally until the time expires, then get a new license.

Under the new law, a driver won't be able to get a license without proof that the interlock was installed. The clock on an order won't start ticking until an offender applies for a license and officials see the paperwork.

Wisconsin's interlock provision places it in the top half of the country in terms of the strength of the law.

Judges in 12 states are required to order interlock use for any drunken driving offense. Wisconsin will join eight states that require the devices with a 0.15 percent blood-alcohol content. Another six states have mandatory interlocks only for repeat offenses.

New Mexico has had success with provisions to assure drivers follow through with the interlock orders, Kaufert said.

"The compliance is way up, and the recidivism has gone way down," he said.