Wednesday, April 14, 2010

U.K. Reaches Limit on Binge Drinking

The Wall Street Journal

Great Britain's Drinking Problem Gets Political
CARDIFF, Wales—Around midnight on a recent Saturday night, 19-year-old Annelies Hopkins inventoried her evening's revelry: half a bottle of Jack Daniel's and four pints and six bottles of beer.

As she waited in line at Lloyds No. 1 Bar, Ms. Hopkins, a secretary by day, said she had no intention of slowing down. "No, speed up!" she cried. Ms. Hopkins and her sister, dressed in sleeveless tops despite the cold weather, convulsed in giggles.

Such raucous partying routinely turns the weekend streetscape here in the capital of Wales into a scene from "Night of the Living Dead." Drunken young men and women stumble through streets fouled with trash and broken glass, while the police labor to maintain order and tend to those needing help.

The U.K. is struggling with a rise in alcohol consumption that many people contend is fueling public disorder and violence. Alcohol abuse and "antisocial behavior" have become an issue in the run-up to the nation's general election, to be held May 6. Politicians have proposed remedies ranging from minimum alcohol prices to bans on barroom promotions to wider use of shatterproof cups in places where broken pint glasses are frequently used as weapons.



The U.K.'s problem is especially striking because of the contrast to what's been happening in many other industrialized nations. Per-capita consumption of alcohol in the U.K. rose 19% between 1980 and 2007, compared with a 13% decline for all 30 countries in the Organization for Economic Cooperation and Development, according to the most recent data. Average consumption over that period fell by about 17% in the U.S., 24% in Canada, 30% in Germany and 33% in France, according to the OECD.

David Jernigan, an alcohol expert at Johns Hopkins Bloomberg School of Public Health, says higher alcohol taxes and restrictions on marketing have contributed to the declines in many nations. But in the U.K., he says, longer hours for pubs, cheap supermarket booze and the advent of "alcopops"—premixed cocktails favored by young drinkers—have pushed numbers in the other direction.

In Cardiff, the toll on a recent Friday night suggested the scope of the problem. Police and paramedics responded to numerous reports of assault or injury, including drunken revelers tumbling down stairs and a young woman punching two police officers. The city's main drinking streets were littered with trash and empty bottles. Alleys and doorways reeked of urine.

An employee of one pub found a young woman lying on the sidewalk, vomiting and shivering in a red cocktail dress. Chris Williams, a volunteer "street pastor" who helps Cardiff cope with its night-life casualties, wrapped the woman in a foil blanket and helped her to a bench. Using the ill woman's cellphone, she called a number marked "Mum" and waited until her mother came.

The average Briton 15 and older drinks the equivalent of about 11.2 liters (about three gallons) of pure alcohol a year, compared with the OECD average of 9.7 liters, and 8.6 liters in the U.S. Over one-quarter of England's population is "drinking at hazardous levels," according to a recent report by the Royal College of Physicians and the National Health Service Confederation. The report said treating alcohol-related conditions cost the state-run health service about £2.7 billion (about $4 billion) in the fiscal year ended March 31, 2007, almost double the cost in 2001.

Alan Campbell, a minister in charge of crime reduction for the U.K.'s Home Office, says the ministry has taken various steps to combat alcohol-related problems, including cracking down on stores that sell booze to minors, hauling parents of underage drinkers into court, and financing advertisements that mock the sloppy behavior of binge drinkers.

Health experts say the availability of cheap alcohol is a major factor. U.K. supermarkets have long sold alcohol at a steep discount or even a loss to attract customers, and some market researchers say discounting appears to have intensified during the recession. Low prices, in turn, have prompted some pubs and clubs to cut drink prices and offer promotions including "all you can drink" specials.

Last year, Britain's chief medical adviser, Liam Donaldson, said the country should enforce a minimum price for alcohol, warning that "cheap alcohol is killing us as never before."

Some alcoholic-beverage companies and supermarkets oppose the idea. Paul Walsh, chief executive of liquor company Diageo PLC, says the government has "enough to focus on and should not be fiddling around with this." Adds Krishan Rama, spokesman for the British Retail Consortium: "We don't think minimum pricing is the answer. We think education and changing cultural attitudes would make a much bigger difference."

Some pubs say they're fed up with supermarkets' rock-bottom prices and would welcome minimum-price legislation.

"We find a lot of people will go and spend £10 on three bottles of wine before they come out on a Friday and Saturday night, so they're already well on their way to being absolutely plastered before they've even stepped in your door," says Cardiff pub manager Rebecca How. "I think most publicans and licensing bodies as well would probably support setting a minimum price for a unit of alcohol."

Heading into the election, U.K. political parties are moving to clamp down. The ruling Labour Party pushed legislation through Parliament that bans certain drink promotions, including a "dentist's chair" deal in which patrons recline and have alcohol poured into their mouths. Both the Labour and Conservative parties are promising to raise taxes on certain kinds of alcohol.

U.K. towns and regions also are taking action. Blackpool has mandated the use of plastic cups on weekend nights at pubs, to cut down on accidental cuts and "glassings," in which pint glasses are used as weapons. There are 87,000 "glass attacks" in the U.K. each year, according to the Home Office. Police in the city of Hull fine disorderly drinkers, photographing them and collecting their cellphone numbers.

Cardiff has mounted one of the most comprehensive responses, stepping up scrutiny of irresponsible pubs, parking ambulances on the busiest drinking streets and closing them off to traffic, and hiring extra city workers to maintain an orderly taxi line for drinkers trying to get home. Recently, city officials took the unusual step of refusing supermarket giants Tesco PLC and J Sainsbury PLC licenses to sell alcohol at new branches in the city center, telling them there already was too much alcohol sloshing around.

Judith Woodman, deputy leader of the Cardiff Council, says she doesn't think Cardiff's drinking problem is any worse than that of other British cities. "You can go to any big city and you will see binge-drinking problems and alcohol-related antisocial behavior," she says.

About five years ago, Cardiff city leaders decided they needed to do more to blunt the effects of binge drinking on the city center, where bars can attract between 40,000 and 140,000 people on a weekend night, depending on whether there's a sporting event at the stadium. Most weekends, Cardiff draws visitors from the small towns and former coal-mining valleys that lie to the north.

Police and city officials set up a "traffic-light" system for cracking down on pub violence. They tally assaults and other disturbances at each bar and assign points for each incident. If a pub or club accumulates a certain number of points over a six-month period, it enters a "red" zone, and police assign it a plan for improvement, including switching to plastic cups and adding extra closed-circuit television cameras and bouncers.

Pubs that don't comply or that fail to improve could lose their liquor licenses, says Trevor Jones, a police officer who helped create the program. Three clubs have been closed down so far, he says. Anticipating trouble with the police, one club switched to plastic, changed the color of its walls to soothing blues and greens, and started playing softer music toward the end of the evening—steps the police recommend to create a calmer atmosphere.

When Debbie Richards bought the Borough Arms pub seven years ago, it was known as a rough boozer that attracted football hooligans. She started refusing service to anyone who appeared to be a troublemaker. "If they were in a crowd of over eight to 10 men, or they come in chanting [football songs] because they've had a few—you just get a feeling," she says. She hires older bouncers less likely to lose their tempers. "They don't want to be injured in a fight," she says.

Police say better pub management has helped cut alcohol-related crime and disorder inside Cardiff's pubs and clubs, from 2,442 incidents in 2006 to 1,552 in 2008. They acknowledge that violence in the street isn't improving.

On the recent Friday evening, officers were called to one nightclub to detain a young man who had punched a woman in the face, according to police officer Tony Roach. At another bar, one man hit another with a bar stool, breaking two of his fingers.

Ms. Williams and her fellow Street Pastors, a Christian volunteer group, have been helping manage alcohol-related problems in Cardiff for 18 months or so. The volunteers, clad in blue parkas and baseball caps marked with the Street Pastor logo, walk the main drinking streets in pairs, looking for people to help.

That same Friday, Ms. Williams and her partner saw a young man being kicked out of a club because he was drunk and stumbling. They helped him walk to the nearest cash machine to withdraw money, then gave him water to try to sober him up before putting him in a cab.

Around 2:30 that morning, they came across a common after-hours sight: a woman walking barefoot because she was having trouble walking in her high heels. Ms. Williams handed the woman a free pair of flip-flops. "By that time of night you have urine and glass on the street," she says.

Some police officers say the problem has grown worse since 2005, when a change in the law allowed pubs to stay open past 11 p.m. Cheap drink deals have made it harder for police.

The pubs and clubs are aggressive in their pursuit of customers, paying people to hawk deals in the town center. On the recent Friday evening, a gaggle of women walked through town with "Free shots at Flares!" stickers on their clothing. Lava Lounge handed out fliers offering £1.50 beer, rum and gin before 11 p.m. Bars offer even cheaper deals midweek, often pitching them to students.

Lucy Slade, a 24-year-old hanging out with her friends, said she's often tempted by such deals. "You set out to get merry, but because it's so cheap, you get drunk," she said.

Around the corner, a young man wolfed down a hamburger while two of his friends urinated against a gate. "Binge drinking is the culture of today," he said before dropping his paper bag on the ground and running off with his friends.

Massachusettes Adults Say 'No' to Buying Alcohol for Youth

Boston Globe

 
A series of shoulder tap surveys conducted in Somerville yielded encouraging results about the adult community's willingness to buy alcohol for minors. Of the 56 individuals surveyed, only one person agreed to purchase alcohol for a minor, the city announced on Monday.

The surveys were conducted at random by members of Somerville Positive Forces 100 and Teens Against Drug and Alcohol Abuse, subgroups of Somerville Cares About Prevention. Youth volunteers worked with the Somerville Police Department and local liquor retailers on the campain, which is run annually as part of a citywide effort to raise awareness of the minimum drinking age and encourage alcohol rehab in Massachusettes.

"If we want to reduce underage drinking, one thing we need to do is reduce youth access to alcohol," said SPF youth leader Anthony Soto, 17. "Shoulder taps engage youth in addressing this problem, and we really enjoy getting out there to talk to adults in our community."

In addition to shoulder taps, youth volunteers conduct annual sticker  campaigns and compliance checks at local businesses licensed to sell alcohol. This year's round of compliance checks began in March and will be completed in July.

Although this year's shoulder tap surveys were positive, youth volunteers had some ideas for improving the program in the future. Youth leader Deepika Bhargo suggested asking participants if they were familiar with the repercussions of providing alcoholic beverages to minors. Currently, adults can face arrest, six months to a year in prison, and up to $2,000 in fines, she said.

"I think this will provide insight on how much adults in Somerville already know about the underage drinking laws," she said.

Friday, April 9, 2010

Alcohol and Indigenous Violence Linked

Sidney Morning Herald

 
Indigenous Australians are up to 20 times more likely to commit offences of violence, due overwhelmingly to alcohol abuse, says a new study.

Backing the findings of earlier research, the Australian Institute of Criminology (AIC) paper found the rate of violent offending by indigenous persons was consistently higher than non-indigenous persons, with indigenous males strongly over-represented.

Levels of recidivism were also disproportionately high while time taken to commit further offences was disproportionately low.

The study's author, criminologist Joy Wundersitz, said it was widely recognised there was no single cause of violence in indigenous communities.

But there were a number of theories, including that initial European colonisation and dispossession played a crucial role.

However, repeated studies, by among others indigenous leader Noel Pearson, have pointed to the role of alcohol.

"Alcohol addiction and misuse is now widely regarded as one of, if not, the main risk factor for indigenous violence," she said.

Institute director Adam Tomison said available data indicated that indigenous people were 15-20 times more likely than non-indigenous people to commit violent offences.

Risk factors included alcohol misuse, illicit drug use, sex, age, childhood experience of violence and abuse, exposure to pornography, education, income, employment, housing, physical and mental health, geographic location and access to services.

"However alcohol, based on existing evidence, stands out as a problem over and above structural factors, such as socio-economic disadvantage or exposure to alcoholics anonymous," Mr Tomison said.

Ms Wundersitz said the need to break the link between access to welfare money and alcohol abuse was a fundamental driver of the Northern Territory intervention, launched by the previous Howard government.

Most indigenous people were not violent even though many lived in communities where violence was endemic and were subjected to violence and systemic social disadvantage without becoming offenders themselves.

Despite the large number of studies, there were gaps in the data and that was limiting development of policies designed to curtail violence.

For example, there is little information to explain why many indigenous people do not commit offences and the only truly national data on indigenous offending is the institute's homicide monitoring program.

"Without a more detailed understanding of what proportion of the indigenous population actually commits acts of violence, the nature and frequency of that violence, and the circumstances within which it occurs, successful intervention strategies and drug rehab programs will be difficult to develop," Ms Wundersitz said.

Sunday, March 28, 2010

Alcohol Intake Associated with Unhealthy Diet

Toronto Sun


People who drink alcohol are more likely to eat less fruit and consume more calories by munching on foods that are high in fat and sugar, a new study says.

Researchers followed more than 15,000 adults in the U.S. and found that increased alcohol consumption is associated with decreased diet quality.

"Heavy drinking and dietary factors have independently been associated with cardiovascular disease, certain cancers, and other chronic health problems," said Kenneth R. Warren, acting director of the National Institute on Alcohol Abuse and Alcoholism. "This finding raises questions about whether the combination of alcohol misuse and poor diet might interact to further increase health risks."

The researchers found men who drink more alcohol consume fewer whole grains and drink less milk.

The study, conducted by the NIAAA, the National Cancer Institute and the U.S.

Department of Agriculture, appears in the April issue of the Journal of the American Dietetic Association.

The researchers analyzed data from participants in the National Health and Nutrition Examination Survey, an ongoing survey of cross-sectional samples of the U.S. population.

Although the study noted a correlation between drinking and poor diet habits, it didn't determine why that's the case.

Wednesday, March 17, 2010

Combination Treatment May Help Depressed Alcoholics

Business Week

Taking antidepressant plus naltrexone improves odds of not drinking, researchers say

Combined treatment with the antidepressant Zoloft (sertraline) and the alcoholism drug naltrexone improves the likelihood that people with both major depression and alcohol dependence will be able to stop drinking, U.S. researchers report.

Their 14-week study of 170 patients found that 54 percent of those who received the combined alcohol treatment were able to stop drinking, compared with 21 to 28 percent for patients who received a placebo, Zoloft only, or naltrexone only.

The patients who received the combined treatment also went for a longer period of time before they started drinking again -- 61 days compared with 15 days for patients in the other groups.

The findings may prove an important advance in the treatment of patients with alcohol dependence and depression, said the University of Pennsylvania researchers, and should be of interest for programs like Alcoholics Anonymous.

"When depression and alcohol dependence occur together, each condition has a negative influence on the outcome of the other, so not only does this pairing of illnesses affect a lot of patients, it also makes the individual disorders worse," study author Helen Pettinati said in a news release. "Combining sertraline and naltrexone could be a practical approach for these patients because both have (U.S. Food and Drug Adminstration) approval."

Thursday, March 11, 2010

Alcoholics' Relapses Better Understood

Business Week
Brain mechanism could be key, and an existing drug might help, scientists say


U.S. scientists say they've learned new details about molecular mechanisms associated with alcohol addiction treatment and relapse. The findings could lead to new treatments for alcoholism.

The University of California, San Francisco researchers gave lab rats free access to alcohol or sugar for nearly two months, followed by a few weeks of abstinence. The rats who had consumed alcohol, but not those that had consumed sugar, showed increased electrical activity in a part of the brain called the nucleus accumbens (NAcb) core, which plays a role in motivation and goal-directed behaviors.

This increased activity in the NAcb core after abstinence resulted from the inhibition of small-conductance calcium-activated potassium channels (SK). These findings can help explain why alcoholics often relapse, even after treatment programs such as alcoholics anonymous have helped them quit.

Futher tests showed that drug-induced activation of SK channels resulted in greater inhibition of NAcb activity in the alcohol-abstinent rats and significantly reduced their desire for alcohol. This type of effect did not occur with sugar-abstinent rats.

The results indicate that decreased SK currents and increased activity in the NAcb core play a critical role in alcoholics' relapse after quitting drinking, said the researchers.

The study appears in the March issue of the journal Neuron.

"Our findings are particularly exciting because the FDA-approved drug chlorzoxazone, which has been used for more than 30 years as a muscle relaxant, can activate SK channels," senior author Dr. Antonello Bonci said in a UCSF news release. "Although SK channels are not the only target of this drug and it can present a variety of clinical side effects, it provides an unexpected and very exciting opportunity to design human clinical trials to examine whether chlorzoxazone, or other SK activators, reduce excessive or pathological alcohol drinking."

Wednesday, March 3, 2010

Tigers' Cabrera 'Comfortable' in His Recovery

The Detroit News


Lakeland, Fla. -- One word, "serenity," is irresistible when you observe Miguel Cabrera at work during these early days of camp, or more tellingly, hear him speak.

"Serenity" is a word Cabrera would view as accurate.

"I'm comfortable with what I do right now," he said this morning, a few minutes before joining his teammates for a 9:30 workout.

Today's Cabrera is vastly different than the one who could sometimes be uncomfortably aloof during earlier years. He smiles easily now. When he converses, he is engaged with the other party. He listens.

He clearly is at peace six months after his life was beginning to careen dangerously. Immediately after a trouble end to his 2009 season, Cabrera confronted alcohol abuse and a general recklessness that had created even deeper concern for him than it had for the Tigers and their baseball community.

"I don't want to hide what I do," he said of his decision to spend much of the offseason in the company of his doctor as they addressed problems that appear to have involved various layers of physical and psychological challenges. "I want to be a man and say I make a mistake.

"It's a part of life to be a man. I don't try to hide."

Cabrera, of course, had an 0.26 blood-alcohol level when police took him into custody the morning of Oct. 3 following a domestic incident at his Birmingham home. The trouble occurred on the final weekend of the regular season, a critical juncture for a team that missed the playoffs by one game.

Although details were not revealed until Cabrera spoke in January, he decided immediately to consult a doctor with whom he worked rigorously during an offseason that appears to have been transformative.

"I don't think he's different, I think he's matured," Tigers manager Jim Leyland said this morning. "He looks absolutely tremendous."

Cabrera has not had a drink since last October. He says he does not miss it, not at all, and that when he is at dinner or with friends he drinks water, or perhaps apple juice or orange juice.

"I knew what I was doing was bad, and I had to say this is not right for my life, for my work, for my family," he said. "The first thing you've got to think about is yourself.

"When you've got a problem, you need some help. You can't find the problem by yourself. You find the problem and fix it."

Cabrera insisted his difficulties were not a clinical case of alcoholism. He has not required any recent attention from his doctor. He does not go to Alcoholics Anonymous meetings.

"It's not that bad," he said, smiling, as if to reinforce thoughts that everything was under control.

And anyone observing him at Tigertown during spring training's first week would be persuaded to agree.