Boozers' brain damage time bomb

GARETH ROSE ~ Scotsman.com ~ Fri 29 Jul 2005

BINGE drinkers in Edinburgh are suffering brain damage in their 30s because they have been abusing alcohol since their teens, a drink and drugs chief has warned.

Tom Wood, chairman of the Edinburgh Drugs and Alcohol Action Team (DAAT), said the severely debilitating and potentially fatal Korsakoff's Syndrome is now affecting people 20 years younger than previously.

And he warned the binge-drinking culture among young people in Edinburgh and across Scotland will lead to an increase in cases.

He said the lifestyles of some of the Capital's more excessive party people could be a ticking timebomb leading to brain damage, kidney failure, heart problems, and even death.

Mr Wood, a former deputy chief constable at Lothian and Borders police, said: "What we have is people getting into desperate problems with alcohol early in life. That is leading to an awful lot of people suffering from Korsakoff's Syndrome.

"Twenty years ago it was most commonly found in people over 50, now we are seeing it in people in their late 30s and early 40s. It shows alcohol abuse is getting worse in people at a younger age."

While the number of people suffering from Korsakoff's Syndrome, a form of dementia, is high in Edinburgh and in Scotland as a whole, it is worst in Glasgow. A study two years ago found it had the highest concentration of sufferers in the world.

The £2.3 million Ardencraig Care Home was opened in Castlemilk to treat up to 30 sufferers.

However, Mr Wood said he fears the number of sufferers in Edinburgh will keep rising if youngsters continue to drink heavily.

He added: "Many young teens are becoming heavily involved in alcohol. The undeniable consequence of this is that they will get into desperate medical condition in later life.

"If they start drinking in their early teens, develop an addiction to alcohol, and keep it up through their life at some point there's going to be a price to pay.

"That price could be their job or marriage, but the final payment will be their health."

Binge drinkers are not the only ones paying the price - their deteriorating health is also costing the NHS.

A British Medical Association report estimated that, at peak times, up to 70 per cent of all admissions to accident and emergency units in the UK are related to alcohol consumption.

The total cost of alcohol misuse to the health service is estimated to be in the region of £1.7 billion a year.

And Professor Peter Hayes, of the Edinburgh Royal Infirmary liver unit, said people's drinking habits were showing no signs of easing up.

He said: "The increase in Korsakoff's Syndrome in Edinburgh has run parallel with an increase in liver disease.

"The number of people admitted to our hospital with liver problems has doubled in ten years.

"It has reached epidemic proportions and shows no sign of abating.

"And we are now seeing a lot more younger people. We used to just get men in their 50s, 60s and 70s, these days we're seeing more and more in their 20s.

"I've even heard of people in their teens with liver disease although I haven't come across any."

Prof Hayes said that the two most common forms of drink-related problems are cirrhosis of the liver and alcoholic hepatitis, which can lead to jaundice and liver failure.

"That can be fatal within a month," he said.

Typically people in their 50s and 60s who contract liver disease have histories of heavy drinking.

What is concerning officials is that somehow some younger people have managed to do the same amount of damage to their bodies in a shorter period of time.

PROF HAYES said: "The archetypal patient used to be men who had drunk a bottle of spirits a day for 20 years - that's the equivalent of 200 units a week.

"People are getting that kind of liver damage in their 20s - maybe because they started drinking when they were very young, maybe because they are more susceptible than previous generations, although I don't know why that might be."

The Scottish Executive is taking steps to attempt to reduce binge drinking which is also responsible for a lot of crime and disorder in city centres on weekend nights and puts a strain on police resources.

The Licensing (Scotland) Bill which is the first major overhaul of licensing law since 1976, is aimed at putting a stop to drinks promotions such as happy hours in pubs.

However, last month the Scottish Parliament's Local Government and Transport Committee said the Bill did not do enough to deal with irresponsible promotions from retailers.

And committee members also criticised proposals enabling pubs to open 24 hours a day, saying they were unconvinced the move was justified.

Prof Hayes said: "The fact is that alcohol has never been cheaper in relation to what young people can afford to spend.

"So if we want to reduce binge drinking we must make it socially unacceptable, like smoking has become - I can't see that happening.

"It's actually becoming more sociably acceptable for young women to drink more.

"And women are more susceptible to the effects of alcohol than men."

The shocking revelation comes as Libra, a service aimed at helping alcoholic women, appealed for more funding to reach weekend binge drinkers who are shunning help available to them.

The organisation is seeing more women than ever, but fears those in the greatest need of help are reluctant to come forward or even admit they have a problem.

That is part of the reason why Libra, which was launched 20 years ago to help women in Edinburgh with alcohol problems, is now busier than ever.

Jane Aldous, manager of the group which received funding from the DAAT, said: "We're more in demand than ever.

"We're providing counselling for about 200 women from Edinburgh and the Lothians a year.

"However it is hard to reach young people. We have tried to set up a younger women's group but we need more funding.

"We need to reach them because a lot of damage can be done by long-term binge drinking. The consequences can be life threatening.

"We are starting to see a small amount of women with liver damage, there are certainly some cases of brain damage, and some women have mental health problems because alcohol is a depressive drug."

Supermarkets apply for 24-hour alcohol sales

Manchester Evening News ~ Tuesday, 26th July 2005

Alcohol could be on sale 24-hours-a-day in hundreds of supermarkets across the UK, it emerged today.

Sainsbury's, Tesco and Asda are hoping to take advantage of new drinking laws to sell alcohol round the clock instead of between 8am and 11pm.

Sainsbury's has applied for 24-hour licences for "the majority" of its 727 stores, while Asda is trying to get licences for more than 100 outlets. It is understood Tesco has also applied for a number of the new permits.

But the move, under the Licensing Act 2003, which comes into force in November, has triggered fears of an increase in binge-drinking.

Concerned

Alcohol misuse charity Alcohol Concern warned it could lead to a rise in "problem drinking" and urged the supermarkets to be "responsible".

A charity spokesman said: "We are concerned that increased retail hours might result in a rise in drinking and problem drinking.

"If supermarkets are to sell alcohol round the clock they need to be committed to following responsible retail practices.

"That includes no cheap drink promotions and a no sales to people who are underage or obviously drunk."

The supermarkets today said they supported responsible drinking.

An Asda spokesman said licences would be extended to "match the opening hours of our stores" and added: "Customers tell us they want to be able to buy a bottle of wine or crate of beer when they are buying the rest of their groceries."

Sainsbury's said it would offer "flexibility in the run up to key trading times of the year, such as Christmas".

German tax reduces youth alcopop consumption

Reuters ~ Tue Jul 26, 2005 2:05 PM BST

BERLIN (Reuters) - Consumption of "alcopops" by German young people has almost halved since the imposition of a special tax on the fizzy alcoholic drinks last year, a German government drug commission said on Tuesday.

A report published by the commission showed the percentage of youths aged 12 to 17 who drink alcopops - typically a mixture of sweet soft drinks and spirits - once a month dropped to 16 percent from 28 percent since last August.

One third of the surveyed teenagers who consumed alcopops last year had since quit.

The commission also reported that teenagers cited the tax, which added 80-90 cents to the price of a bottle, as the main reason why they cut back or stopped consumption of alcopops.

The government imposed the special tax in August 2004 to deter youth consumption of alcopops after it determined that the popularity of the drinks was encouraging alcoholism among teenagers.

"What is especially pleasing is that there was no substitution with other alcoholic drinks," said government drug commissioner Marion Caspers-Merk.

"We have reached our goal of better protecting children and teenagers from the dangers of alcoholism."

Journeys of Recovery and Relaxation

By FRED BIERMAN ~ The New York Times ~ July 24, 2005

FROM the ever-present airport bar to après-ski cocktails and tropical drinks at beachside bars, alcohol and traveling have always been closely linked. For recovering alcoholics, such temptations can be frightening. But as the stigma surrounding alcoholism has faded, a growing number of travel companies have found success combining the tenets of 12-step recovery with the relaxed atmosphere of a vacation.

Steve A. often took as many as four or five trips a year, but after he stopped drinking alcohol in 1980 it was six years before he mustered the courage to go on another vacation. Like others who attend meetings of Alcoholics Anonymous, including those mentioned in this article, Steve observes the organization's policy of anonymity.

"It was tricky," he said, referring to the perils travel posed to his recovery. "When you travel, people are always trying to put alcohol in your hand. In those days I hadn't done much of anything socially without a drink and now all of a sudden I'm at a beach resort, sober, and how do I participate? How do I cross that line of inhibition without alcohol?"

Finally, after going on a vacation with family members in 1986, Steve realized that giving up alcohol did not mean giving up traveling, and he began to think about combining the support meetings for which Alcoholics Anonymous is known with vacation and leisure options.

"I had done some Alcoholics Anonymous conventions and I thought they were fun, but it was just like, 'What are you going to do between meetings?' " he said. "At Club Med you go water-skiing or you go scuba diving or you go golfing or you sit on the beach and then you could go to meetings. So those ideas kind of converged, and I called Club Med and they were really interested in doing something with our group."

In 1988, Steve took 180 fellow recovering alcoholics to a resort in Ixtapa, Mexico. That was the beginning of what is now Sober Vacations International, a tour operator based in Sherman Oaks, Calif., that offers all-inclusive vacation packages for people recovering from drug and alcohol addiction. The next year the company was able to fill an entire resort with 350 travelers, and it has taken over a resort for a week every year since.

By 1995, Steve, who was working as a travel agent at the time, was enjoying such success with Sober Vacations that he stopped working with his regular clients altogether. Last year, his company took around 1,100 clients on vacations throughout the Caribbean, Mexico, Europe and Alaska.

"It's a niche that didn't even exist 20 or 30 years ago," said Joan Clark, the director of alumni relations at the Betty Ford Center in Rancho Mirage, Calif. "It's so much more out in the open now."

In the mid-1990's, Laurie P. had recently given up drinking and was working for En Route Travel, an agency in Pacific Palisades, Calif. She accompanied a large group of insurance salesmen on a cruise, who, along with many of the ship's other passengers, frequented the numerous bars on board. She felt she needed support, and sought out an Alcoholics Anonymous meeting on board. Most large cruise lines offer these meetings, but Laurie was disconcerted to find that she was the only one there.

"I certainly could have used a fellow alcoholic on that trip when everyone around me was drinking," she said.

As a result of her experiences and at the behest of her friends in recovery, she decided to organize a cruise specifically for sober travelers. On that first trip in 1995 there were 24 passengers. It was successful enough for her to start Meetings en Route as an offshoot of en Route Travel. Last year Meetings en Route took about 2,200 passengers on cruises to such destinations as the Caribbean, the Mediterranean and Alaska.

"It wasn't something that I necessarily decided I wanted to do," she said. "It just kind of kept growing and growing until it became a full-time thing, and then I stopped managing the travel agency and started doing this full time. It's become quite successful."

Sober Vacations International and Meetings en Route are not the only operators that offer trips like these. Sober Travel Adventures, based in Georgia, offers trips to Africa and India as well as Europe. Spanish Journeys, a company based in Wellfleet, Mass., that offers small-group tours of Catalonia, is offering an alcohol-free trip Oct. 7 to 14. While many spouses or partners of people in recovery come along on these trips to offer companionship and support, most of the travelers on these trips are recovering alcoholics, according to the tour organizers.

Promoting and marketing sober trips can be difficult because Alcoholics Anonymous refuses to endorse any company and people at recovery clinics often refuse to speak about specific operators.

"You can violate the spirit of A.A. by putting your brochures in meetings, by putting your brochures on the windshields of people who go to meetings." said Steve. "I so honor the traditions of A.A., it saved my life and that's way more important than my business. But the bad news is that it's like having both my arms behind my back."

Operators must rely on word of mouth and their own connections among recovering alcoholics and drug addicts.

Sue A. of Maryland has been on 21 trips with Sober Vacations. When asked how people find out about the trips, she said: "It's word of mouth. That's exactly how it works."

There are many travelers like Sue, who go on alcohol-free trips year after year and have made lasting friendships on them.

"We've traveled with them almost exclusively since 1989," Sue said of Sober Vacations. "It was so much fun, the trips were fun, the people were fun. They became our friends. When we travel around the country we go see them, and they come and see us when they travel in our direction. It became our social life."

Fellowship has always been a hallmark of Alcoholics Anonymous, and the need for support can be even stronger while away from home. In 1935, Bill W., the founder of A.A., was on a business trip and found himself at a hotel bar trying to maintain his newfound sobriety. He called up a fellow alcoholic and, through talk about their shared experiences, he managed to avoid drinking. The success that he had staying sober that night helped lead Bill W. to create what is now A.A.

"You can walk into a room full of strangers and reminisce because you all have those same experiences," said Ms. Clark, of the Betty Ford Clinic.

As a result, companies like Meetings en Route and Sober Vacations International have high rates of repeat business. "It's somewhere in the neighborhood of 75 to 80 percent," said Laurie P. "It's phenomenally high."

Steve of Sober Vacations said, "Seventy percent of my people will come on another trip. Fifty percent will come back within a year. This year 200 people signed up for next year's trip before they even knew the price or location."

For Steve, running such trips is immensely satisfying and far outweighs the rewards of running a regular travel agency.

"What I do gives me a nice life and enriches other people's lives," he said, adding that he now gets thank-you notes from clients. When he worked for an ordinary travel agency, he said, "people would only call to complain that the guy next to them paid less than they did."

"We've had over 30 people meet on our trips and get married," he added. "And they become my friends. I feel very loved and very lucky."

Study question effectiveness of alcoholism therapy

Reuters ~ Sat Jul 23, 2005 2:13 AM BST

NEW YORK (Reuters Health) - An alcoholic's desire to quit drinking, rather than the effects of therapy, may be what determines success, according to a new report.

The report, based on a reanalysis of a major study of three approaches to alcoholism, concludes that none of the strategies is particularly effective if the patient is not motivated to quit.

However, the researchers caution, that doesn't mean alcoholism treatment should be abandoned.

"We are not suggesting that alcoholism treatment should be discontinued and even reduced," write Drs. Robert B. Cutler and David A. Fishbain of the department of psychiatry and behavioral sciences at the University of Miami.

"People with alcohol problems clearly need all the help our society can give them."

However, they conclude that the findings suggest that alcoholism research and treatment need to shift the focus away from the components of therapy itself and toward patients' "characteristics and beliefs," which includes finding ways to boost their motivation to quit.

The report was recently published in the online journal BMC Public Health.

Cutler and Fishbain reanalyzed data from a clinical trial known as Project MATCH, which included 1,726 alcohol-dependent volunteers who each received one of three alcoholism approaches.

Treatment included cognitive behavioral therapy, which focused on things like dealing with thoughts about alcohol and urges to drink or motivational enhancement therapy, which aimed to strengthen patients' commitment to change and feelings of personal responsibility. The third approach was a program that introduced the first few "steps" of the Alcoholics Anonymous 12-step approach.

At the time the original study results were reported in the late 1990s, they were hailed as demonstrating the success of all three strategies, because there were no clear differences in patients' outcomes regardless of which therapy they received.

But Culter and Fishbain looked at the data in a different way, comparing the outcomes of participants who immediately dropped out of treatment with those of men and women who completed treatment.

They found that in the months following treatment, study participants who attended no therapy sessions did nearly as well as those who went to all sessions. On average, those who received no treatment were abstinent for 72 percent of the days the original investigators followed them.

Cutler and Fishbain found that patients who stuck with treatment made most of their improvement in the first week, before they had received the bulk of their therapy.

All of this, according to the researchers, suggests that motivated people entered the trial and that's why all the treatment approaches were successful.

Enrolling in a study, they write, "suggests that the alcoholic has crystallized a decision to reduce or abstain from drinking."

Once in a trial, they add, the monitoring and support of healthcare providers can help them further.

"While this study shows that three of the best treatments currently available for addiction were not very effective," Cutler and Fishbain write, "it remains likely than many severely dependent alcoholic individuals benefit from external help."

Still, if patients' motivations and beliefs are the "critical issues," they conclude, it will be important to find ways to measure and influence these factors, and possibly improve the effectiveness of therapy itself.

Medicine May Help Alcoholics

Story from Rednova News ~ 2005/07/22

Alcoholism should be treated with medications, much like depression, a U.S. scientific institute said for the first time, a suggestion that could help prompt a shift in treatment emphasis to doctors from counselors.

Although counseling and abstinence programs such as Alcoholics Anonymous are widely used and considered effective, three approved drugs - disulfiram, or Antabuse; naltrexone; and Campral - can also help patients, said Mark Willenbring, director of the treatment and recovery research division of National Institute of Alcohol Abuse and Alcoholism..

"Treatment for alcohol dependency is about to shift dramatically," Willenbring said. "It's about to become what treatment of depression is now." Depression is treated with a variety of agents, including such drugs as Prozac.

Alcoholism treatments are being studied in at least 16 human trials, according to the National Institutes of Health.

His institute this week sent a revised guide to doctors suggesting for the first time that they "consider adding medications" when treating alcoholics.

Alcoholics are more likely to see an alcoholism counselor than a doctor for treatment, Willenbring said, and most don't receive approved drugs.

"There's usually no physician in sight" when alcoholics seek treatment, Willenbring said. "That's one of the key barriers to drug treatment."

Willenbring spoke with reporters at an American Medical Association-sponsored briefing on alcoholism Thursday in New York. The revised 2005 NIAAA guide contains information about drug treatment of alcoholism for the first time, he said.

The guide is used to advise general practitioners and internists. "Consider adding medications whenever you are treating someone with active alcohol dependence or someone who has stopped drinking in the past few months who is experiencing problems such as cravings or slips," the new guide said.

About 15 percent of people in the U.S. have drinking problems, according to the NIH. Alcohol and drug abuse costs the U.S. economy an estimated $276 billion a year in lost work, health costs, crime, car crashes and other expenses, according to the National Council on Alcoholism and Drug Dependence.

Women with a drinking problem have help at hand

Alcoholics Anonymous will launch their all-women group this Sunday
Aishwarya Mavinkurve ~ Indian Express Newspapers ~ Friday , July 22, 2005

Pune, July 21: ARE you a woman with a drinking problem? There is a solution -find the support and guidance you need to get sober and live happy, joyous and free. That's the Alcoholics Anonymous (AA) announcing their all-women group, Women In Sobriety, ready to take off on Sunday.

The AA has 10 groups in the city with approximately 800 members but only six are women. ''The idea behind the all-women AA is that it will help those who are either unaware of the AA programme to enroll. Also they will probably feel more comfortable sharing their experiences with others similarly placed. The only requirement for membership is a desire to stop drinking. After all, it is known that more than doctors, psychiatrists or a rehabilitation centre, a recovering alcoholic will be able to help most,'' says a member.

The first closed-door meeting will be held at the Parish Hall, opposite St Xavier's Church, St Vincent's Street, near Shivaji Market Camp on Sunday between 4 pm and 5 pm.

''Earlier, social drinking was taboo. Today, it has increased among women in the city. While this does not mean they will turn alcoholic, social drinking could perhaps lead to habitual drinking,'' says the member. Sunday's meeting will start as most AA meetings do - with a serenity prayer. This will be followed by the AA Preamble being read out and the sharing of experiences, strengths and hope.

Spot the problem
* Do you buy liquor at different places so no one will know how much you purchase?
* Do you have 'blackout' periods about which you remember nothing?
* Do you feel wittier or more charming when you are drinking?
* Do you become defensive when someone mentions your drinking?
* Do you drink when under pressure or after an argument?
* Do you invent social occasions for drinking such as inviting friends over for lunch, cocktails or dinner?

Bottle of the sexes

by Dr Thomas Stuttaford ~ Times Newspapers Ltd ~ July 21, 2005
Alcohol often discriminates against women

JULY is the month for summer parties. Celebrating the start of summer on May 1 by listening to choristers welcoming the dawn from the top of Magdalen College in Oxford sounds romantic, but it seems to be almost invariably wet. And even June can't be relied upon. But there is a reasonable chance that the weather in July will be balmy, women will be able to wear their flimsy dresses and the Pimm's or champagne will taste better for being appropriate.

Pimm's and champagne lose their edge if diluted by the rain that drips off trees sheltering the revellers - they taste quite different when drunk on a sunlit lawn by the side of water.Most women have no problem about drinking champagne, wine or Pimm's but, surprisingly, they drink only 11 per cent of the beer brewed in the UK. Every effort is made to make beer female-friendly while not affecting its macho male image. Women can now buy alcohol-free beer, a drink that has improved in flavour enormously over the past 20 years. However, it accounts for only 1 per cent of beer sales in the UK, and is drunk so rarely by the under-25s that they don't even figure in the statistics.

In an effort to woo women, smaller beer glasses (a third of a pint, rather than a half) with stems, and 2 per cent beer (about half the usual strength) have been introduced. In the US, so-called "light" beers (the term refers to the number of calories, not the amount of alcohol) are popular with women and account for 27 per cent of the market, but these beers have made little impact in the UK or the rest of Europe.

There are few parties that are not improved if both men and women are present. Most people also probably enjoy the occasion more if the women, as well as the men, are drinking. Even so, there is unfortunately some rather depressing news for women to ponder as they knock back the Pimm's or champagne on an Oxford lawn or in the Chelsea Physic Garden. Moderate alcohol consumption hasn't the same protective effect on their cognitive facilities (medical jargon for intellect) in middle age as it has for men.

Women may already know that, while they are in their reproductive years, their livers, hormones and enzyme systems are not as well designed for metabolising alcohol as men's. Women become drunk more quickly and sober up more slowly. Women should also know that the early stages of serious liver damage are less easily reversed by abstinence.

The latest finding on women and alcohol comes from the British 1946 Birth Cohort Study, which analysed alcohol consumption and its effect on changes in cognitive function. Although its findings cause some potential concern, they are not of the magnitude to spoil a party.

The study surveyed 903 men and 860 women born in 1946. The researchers tested memory, speed of thought and concentration. Allowance was made for educational background, occupation, social class and general intellectual ability. Those men who drank in moderation suffered a slower decline in memory between the ages of 43 and 53 than did their teetotal contemporaries. These effects were apparent regardless of health status and of whether they smoked, underexercised, were overweight, had heart disease or were depressed.

However, there was what the researchers, perhaps euphemistically, described as "a negative association between alcohol and psychomotor function in women" and they added that this was "a potential cause for concern". In lay language, this means that those women who were moderate, regular drinkers tended to be less intellectually bright in middle age than their similarly matched non-drinking female contemporaries. (Drinking in moderation is usually defined in women as up to three small drinks a day, and in men, up to four - this is not the same as the modern "unit".)

There was fractionally better news from a US study published in the American Journal of Epidemiology. This showed that in older age groups (65 to 80), a woman's mental state was better if she regularly drank one drink a day than if she was teetotal.

Another recent survey, published in Neuroepidemiology, has confirmed the advantages that moderate, but not heavy, drinking confers on the intellect of men in older age groups. It has made one new finding: the advantage conferred by a moderate alcohol intake on the intellect of those in older age groups is likely to be proportional to the drinker's educational background - the better the education, the more likely it is that a modest drink or two will keep the intellect sharp. The authors suggest that this may well be related to differences in the pattern of drinking, as these vary with education.

The personal cost of alcohol abuse

The Dominion Post ~ 19 July 2005

Think you've got a problem with alcohol? The relief one woman found in seeking help for her spiralling abuse is a salutary lesson for others in the same boat, she tells Cushla Managh.

The three white lines on the road wavered as Joan* drove home from work, blind drunk. She bought a bottle on the way and when that was emptied, she hiffed it over a farmer's hedge. More bottles awaited, stashed inside gumboots and the backs of cupboards; all Joan had to do was get home without killing anyone.

At home, her husband Harry* waited. He'd been trying to keep track of Joan's drinking, searching for the hidden bottles and marking them, but he was sick of it. Joan knew her marriage would end soon if she didn't stop drinking.

Desperate not to lose the children and husband she "adored", Joan downed two or three stiff gins and phoned Alcoholics Anonymous. Help me, she asked, and they did – and 21 years later this articulate professional woman, now in her 70s, is still attending AA meetings and, more importantly, she's still sober.

Like thousands of other New Zealanders, Joan knows what it means to crave alcohol beyond reason. These days when she sees someone drunk in a gutter, she's saddened by the knowledge it could have been her.

"That could be me, a little old bag lady. I would be in a mental institution, or dead, if AA hadn't been there for me," she says with feeling.

As a nation, there's little doubt we like our tipple. According to the Alcohol Advisory Council (ALAC), people aged 15 and over drank a total of 28 million litres of alcohol last year, putting New Zealand 24th out of 50 countries for the amount of alcohol consumed per head of population. On average, each household spent about $20 a week on alcohol. ALAC's research found that most adult drinkers used alcohol to wind down and relax, and 45 per cent said they enjoyed the "buzz" they got when they drank.

But getting drunk comes with a big price tag. Economic research done for ALAC estimates that alcohol-related harm costs New Zealand between $1 billion and $4 billion each year. That money is used to dry out the nation's drunks, treat their physical ailments, tackle alcohol-related crime, and combat the devastating social effects of alcohol on individuals and families. It includes an estimated $1.17 billion lost in workplace productivity.

People who drank too much and who couldn't stop used to be called alcoholics but ALAC's chief executive, Mike MacAvoy, says they're known now as alcohol-dependent, which more accurately describes their condition. He thinks about five per cent of the population falls into that category and he says every alcohol-dependent person affects the lives of at least 10 other people.

Alcohol dependency is characterised by a craving for alcohol, withdrawal symptoms if it's not available, and an increasing tolerance of its effects. Other than that, drinking patterns vary. Some people go on benders, drinking all day and all night for a week or two, while others drink steadily and heavily every day for months or years on end.

Still others turn to a bottle for solace after a relative's death, but eventually manage to stop drinking.

Dr MacAvoy says teenagers often have drinking patterns that appear alcohol-dependent but, inexplicably, they grow out of it.

"It's often a very difficult time for young people to socialise, and they need the alcohol to support them mixing with the opposite sex, but a lot of that disappears when young people get jobs, form relationships, get married, take on a mortgage - and that's one of the real problems with defining alcohol disease. It doesn't fit any of the normal criteria of disease because you can change it by removing the drug or by introducing a mortgage."

Dr MacAvoy says alcohol-dependency is often accompanied by mental disorders such as depression or anxiety, and dependency on other substances like tobacco. Many drunks wind up in court on drink-driving charges, their relationships collapse and they find they're unable to hold down jobs.

Too much alcohol also affects their health. Their liver, stomach, heart, nerves and brain suffer damage, and their day-to-day working memory may also be affected. Dr MacAvoy says women's bodies often show signs of damage before men's.

"While it might take a man 10 years of heavy drinking to damage his liver, it may only take a woman three years."

Following diagnosis, the priority is to get the people to stop drinking so their body can heal. An eclectic mix of treatment regimes is then used - drugs, therapy, support groups - and Dr MacAvoy says they appear equally effective.

He's cautious, though, about defining what constitutes successful treatment.

"I've always avoided that question because for some people success may be total abstinence but they may be absolute bastards. A dry drunk is sometimes worse than when they're on the booze. There are some people (for whom) success is that they're at least holding their job but continuing drinking. Some are continuing to drink but at least they've stopped beating up their wives."

For Joan, however, success is measured by her continuing abstinence after 21 years.

She drank heavily as a university student in England but says it wasn't till her late 40s, when she was married with children, that she started drinking to cope. She was a perfectionist at home and work but says she was exhausted, and drinking helped her get through the days. Before long she was hiding alcohol around the house, lying, and becoming abusive and argumentative.

When she told her GP she was drinking too much, he told her not to be ridiculous and suggested a course of antidepressants. Joan says it was a particularly hard time for her teenage daughter, who was very distressed by her drinking.

"The guilt, the dishonesty, the remorse and the shame...I really wanted to stop - and I found I couldn't."

Her husband Harry, now 88, says he initially denied his wife had a problem, attributing her changed behaviour to work pressures. When he realised the seriousness of the situation, he became depressed and felt he was to blame.

"I felt that if I was offering a good married life this wouldn't have happened. I also got very depressed because it seemed to me that the personality of my wife was deteriorating. She did not have the same regard for truth that she used to have, and all sorts of deceits were taking place."

Contacting AA proved a turning point for Joan. As she listened to others talk about the horrible things they had done to obtain alcohol so they could drink themselves into oblivion, Joan was overwhelmed with relief.

"Relief that I wasn't weak-willed and pathetic and a bad person. All these people had done all the sort of dreadful things I had done, and some of them worse. They'd been to prison and I said 'oh, I haven't been to prison yet' and they said 'yet' ... and they're absolutely right."

She urges people dependent on alcohol to seek help.

"It was pride and denial that kept me so sick for so long. I just didn't want to believe that I had more than a bit of a problem. Help is there, and there's a lot of compassion and a lot of love."

Today, Joan counts herself fortunate to have good health - and, against the odds, to still be with Harry.

Alcohol fuels rise in violent crime

The Sunday Times ~ Will Iredale ~ July 17, 2005

HOME OFFICE figures to be published this week will show that violent crime has continued to rise despite a pledge by Charles Clarke, the home secretary, to make it his “number one priority” to curb it.

The records — the first to be released since the general election — are likely to show a rise in violent crime last year of about 7%, with an increase of more than 50% in some areas.

Figures released to The Sunday Times by 31 of the 43 police forces in England and Wales show that South Yorkshire suffered the biggest rise in offences of violence against the person.

Murders, wounding and assaults in the county rose by 57% from 13,499 in the year ending March 2004 to 21,213 in the year ending March 2005. South Yorkshire police attributed much of the rise to better recording practices.

The figures also showed a fall of 7% in total crime recorded nationally, while robbery dropped 13%. There was a particularly marked fall in crimes against property, with domestic burglary down 24%.

This weekend some senior police officers said the figures for violent crime were inflated by a rise in alcohol-related “thuggery” — resulting in more than half of the forces recording increases in violent crime.

Commander Chris Allison, of the alcohol and licensing group at the Association of Chief Police Officers, said: “All we are ever dealing with is people who have drunk too much. We are having to keep a lid on that symptom, every night of every week in every town and village up and down the country.”

He added: “The government needs to address the culture, because if people want to drink to excess, they will, and that leads to all the crime and disorder problems we have to deal with.”

The failure in the past year to stem the rise in violent offences will embarrass the government as it spans the period when both Clarke and David Blunkett, his predecessor, launched high-profile schemes to combat alcohol-related crime.

Last month Clarke published the Violent Crime Reduction Bill, which will give police powers to designate “alcohol disorder zones” to tackle drink-related crime and shut down troublesome bars.

Northumbria is among the forces introducing special measures to curb yobbery. Although the area saw a 9% fall in violent crime last year, Mike Craik, the chief constable, has introduced a far stricter policy of arresting drunks as part of a summer campaign against binge drinking. In June the number arrested by the force was double that in the previous month.

The continuing fall in domestic burglary and vehicle thefts reflects a 15-year campaign to introduce more security measures into houses and cars.

Criminologists also attribute the reduction in burglary to a rise in prosperity and the falling cost of household items, meaning that the resale price of stolen goods such as audio equipment as has dropped.

How To Stop Your Children Becoming Binge Drinkers

Mirror ~ 12 July 2005

BRITISH teenagers drink more than any other youngsters in Europe, and children as young as 11 are turning up to school hungover after a night boozing with pals.

The statistics are worrying. Almost a quarter of children aged 11-15 admit to drinking alcohol, while 26 per cent of boys and 29 per cent of girls aged 15-16 own up to binge-drinking.

And as a result, these children are storing up physical, sexual and mental-health problems for the future.

Dr Sarah Jarvis, a London GP with a special interest in alcohol abuse, says: "As young people are starting to drink at an earlier age, they are also having sex younger and taking drugs younger. It's a universal problem that needs to be tackled."

So how can you prevent your children from binge-drinking?

Follow our 10-point plan to help keep them safe and alcohol-aware...

1 MY 11-year-old daughter isn't interested in alcohol and she's too young to be drinking. Does that mean I don't have to discuss the issue with her?

EVEN if your daughter is not interested now, it doesn't mean she won't be soon.

Experts agree the most effective way to prevent children binge-drinking is to talk to them before they reach an age when they are likely to experiment.

Dr Jarvis says: "By the age of 10, it's entirely reasonable to talk to your child about alcohol. They are aware of what's going on around them. Avoiding the issue is disastrous."

Let the subject arise naturally. For example, pick up on something on TV or in the newspaper and expand on the issue. Have an open discussion, tailored to the age of your child and let them give their opinion - it's vital not to use scare tactics.

And give a balanced view. Explain how booze can be enjoyable for adults when used in moderation.

2 IS there any harm in letting my 12-year-old son have a beer at home? He says all his friends are allowed to drink.

THERE'S no harm in giving your child a taste of alcohol at home, provided they are over five years old (below that age it's illegal). Some experts believe allowing older children to have a tiny glass of wine occasionally with a meal can demystify alcohol, making them less likely to binge-drink. But opinion is divided.

Sue Baker, director of services at Alcohol Concern says: "My advice would be not to encourage your child to drink. There's no safe drinking level for kids."

3 SHOULD I drink in front of my child?

BY all means have a few drinks at home but make sure you set a good example. You're unlikely to get through to your son or daughter about sensible drinking if you don't do it yourself.

"Make sure you lead by example," says Dr Jarvis. "Drink in moderation in front of your children - not until you're falling over drunk."

4 I'M worried my 13-year-old son is drinking. His behaviour has changed - now he's stroppy and secretive and locks himself away in his room. Is he just being a typical teenager?

DR Jarvis says: "Many signs of alcohol abuse are classic teenage behaviour, such as sleeping-in or moodiness. You don't tend to see the same clues with drinking as you do with drug-taking. It's more difficult to find proof as it's most likely they'll buy it and drink it, so they won't be leaving evidence.

"If you suspect your child is drinking talk about it with them, not at them. Remember to respect their privacy. It's a recipe for disaster if you don't."

5 WHAT if I'm sure he has been drinking?

DON'T have a go at your child while they are drunk. If they are clearly drunk, the best thing to do is give them water and keep a close eye on them.

Sue Baker says: "Safety is the number-one issue. A child's alcohol tolerance is much lower than an adult's, which means they can be fine one minute and then quickly become ill.

"Leave it till the next morning, then talk through the issue highlighting the dangers."

Stay calm and reasonable. Shouting won't improve the situation. Show them you care and explain you're worried about how drinking may affect their health and that they might find themselves in dangerous situations.

6 I KNOW my 15-year-old daughter is drinking regularly. I can't get through to her. What should I do?

MOST teenagers will experiment with drinking. But if your daughter is boozing regularly you may need to look for outside help.

Dr Jarvis says: "Don't be afraid to speak to your GP. They may be cagey about discussing your child because of issues of confidentiality (even if your child is under 16). However, your doctor will be able to give you general advice and information and put you in touch with local self-help groups.

"And talk to the school. Often they will be aware of the problem and will know who your daughter is hanging out with and if they're known trouble-makers."

7 I THOUGHT my 16-year-old daughter was at a friend's house. But in the middle of the night I had a call from A&E after she'd drunk too much. What should I do?

ACCORDING to Dr Jarvis this is a common problem, with young people often needing to have their stomachs pumped after drinking excessively.

"Accidental drug overdoses and self-harm can also occur during drinking binges," says Dr Jarvis.

"It's usually a cry for help - for example, a reaction to splitting up with a boyfriend - but it can have serious consequences." Sue Baker adds: "Try to establish whether it's a complete one-off. It can be a huge wake-up call to a child.

It's terrifying and can put them off drinking. Try not to overreact, talk it through with your daughter when she has recovered."

8 I'M worried my 14-year-old daughter may be having unsafe sex or getting into dangerous situations as a result of drinking. What can you do?

DR Jarvis says: "This is an increasing problem as cases of both sexually transmitted infections (STIs) and unwanted pregnancies are rising. Plus, girls who drink are more likely to be victims of crime.

In this situation, it's important to be brutally honest with your daughter about how she could be putting herself in danger as a result of drinking.

It's often easier said than done as they can be extremely prickly about their privacy.

"But persevere and reassure her you love her and don't want her putting herself at risk."

9 I THOUGHT my 16-year-old son's drinking was bad enough, now I'm worried it'll lead him into drugs - especially with the crowd he hangs out with. What can I do?

"ALCOHOL can act as a gateway to drugs," says Dr Jarvis. "If young people are around others taking drugs, they are more likely to try it."

Remind him that drugs are illegal and of the consequences he faces if he's caught with them. You should also remind him of the impact both alcohol and drugs can have on his physical and mental health.

It's important to let your son know that while you don't approve of what he's doing, he can always talk to you about any worries he has, and that you'll always be there for him.

Try to find out if your son feels pressurised by friends to take drugs. He may need to talk to you about how to say "no".

And if you're worried about who his friends are, encourage him to bring them round to the house, so you can get to know them."

10 MY 15-year-old son is drinking and I'm worried it could influence his younger brother and sister. What should I do?

"DON'T ignore it," says Dr Jarvis. "Children are perceptive and will pick up on the situation. The concern is that younger siblings will want to emulate their elder brother.

"Be honest about what is going on and explain the dangers in language they understand. In this situation it may help to speak to other parents who have been through something similar.'

SIGNS YOUR KIDS ARE HITTING THE BOTTLE

APART from catching kids red-handed or under the influence, it can be hard to tell if they are hitting the bottle. The smell of alcohol on breath or clothes can be an obvious giveaway but, just because you can't smell it, doesn't always mean you're in the clear. If you answer yes to three or more of the following questions, it's possible your child might be a secret drinker...

Has your relationship with your child changed? For example, have you always been able to talk to them and now they are impossible to communicate with?

Is your child moody, irritable and sometimes depressed?

Is your child refusing to get up in the morning but staying awake during the night?

Has alcohol gone missing from your home recently?

Has any money gone missing from your home recently?

Has your child's school work gone downhill?

Do you think your child is hanging around with the wrong crowd?

Are you sure you know where your child is when he or she is out with friends?

Have you ever caught your child under the influence?

Alcoholic Liver Disease Doubles in Seven Years

By Lorraine Fisher ~ Mirror Health Correspondent ~ 18 July 2005

CASES of alcohol-related liver disease have almost doubled in less than a decade.

Doctors are treating twice as many conditions caused by excessive boozing than in 1997.

And sufferers are increasingly younger claim anti-alcohol campaigners, who blame the binge drinking culture.

In 2003-4, when official statistics were last available, consultants saw 20,779 victims - up from 10,903 seven years earlier.

The problem cost the NHS more than £71million last year, with patients in hospital for 164,226 days.

Campaigners fear things will get worse when pubs open for longer from October, and want health warnings put on alcohol.

Lib Dem health spokesman Steve Webb said: "These figures show new licensing laws should be put on ice."

Kate Winstanley of the Portman Group, which promotes sensible drinking, said the largest increases in liver disease were among 25-44 year-olds - a claim backed up by Alcohol Concern.

She added: "It's very worrying when cases in Europe are falling."

The disease can take ten or 20 years to develop.

Liver disease caused by alcohol has doubled

By Celia Hall, Medical Editor ~ The Telegraph ~ 16/07/2005)

Excessive drinking has caused cases of alcoholic liver disease to nearly double in less than 10 years, at a cost to the health service in England of more than £71 million in a year, Government figures show.

Doctors report increasing numbers of people in their 20s and 30s with liver disease, including young women, as the effects of heavy drinking from their teenage years take their toll.

Until recently the type of liver disease being treated commonly in young adults was seen only in patients in their 50s and 60s.

Figures requested by the Liberal Democrats from the Commons library show that in-patient hospital care rose from 10,903 cases in 1996-97 to 20,779 in 2003-04.

In addition, patients now need to be in hospital for more than a fortnight, nearly two days longer than seven years previously.

Liver specialists said that, from their experience in clinics, they were surprised that the increase and the cost was not higher. Liver patients tended to need much more expensive treatment than average.

Steve Webb, the health spokesman for the Liberal Democrats, said yesterday: "Alcohol-related illness is spiralling out of control. Ministers have done nothing to tackle the growing cost of excessive drinking both in terms of personal health and to the taxpayer.

"New licensing laws are being introduced too quickly. Labour's longer licensing hours should be put on ice."

Mr Webb said the ministers had paid too much attention to law and order in their alcohol strategy.

"More should be done - for example clear unit labelling on alcohol," he said.

The figures obtained by the Liberal Democrats show that in 2003-04, 164,226 "beds days" were used treating patients with alcoholic liver disease, compared with 97,785 in 1996-97.

The number of days in hospital rose from an average of 12.7 to 14.1 and both the number of cases and the time spent in hospitals shows a steady year on year increase.

On average, a day in a hospital bed cost £434.

The medical profession is concerned that the Government does not take the health consequences of alcohol seriously enough. Last year the Academy of Medical Sciences urged the Government to double the cost of alcohol to bring it in line with 1970s prices.

In that time average annual consumption has risen from seven litres per head to 11.1 litres.

Prof Ian Gilmour, a consultation liver specialist and chairman of the alcohol committee of the Royal College of Physicians, said: "From what I see in my clinic I am surprised the increase is not even higher. My impression is that cases are rising even more rapidly. Alcoholic liver disease is a huge drain on NHS resources.

"These patients often come in bleeding from the gullet, needing transfusion and other treatments. We see retention of fluid in the abdomen because the liver is not working properly and kidney failure needing dialysis.

"I see young women in their 20s and 30 who had no idea they had a drinking problem."

Drinker faces 5 months in jail

Jul 15 2005 ~ By Chris Pragnell ~ South London Press

A Street drinker faces 160 days in prison if he takes another swig in public.

The alcoholic was given a suspended sentence after he admitted breaching an antisocial behaviour order (Asbo) three times.

He was one of four people in Camberwell served with the Asbo two months ago. They were banned from drinking, swearing, urinating or defecating in public in the SE5 postcode area.

But within days one was spotted flouting the civil order and supping strong lager in Camberwell.

Despite impending proceedings for the initial breach, magistrates heard he was seen on two other occasions disregarding the Asbo.

Camberwell magistrates gave him 30 days, 40 days and 90 days in jail for the three breaches - to run consecutively.

The bench suspended the sentence, saying any further breach of the original Asbo would inevitably mean the full tariff would be imposed.

Nick Stanton, Southwark council leader and executive member for community safety, welcomed the result.

He said: "This shows all agencies are continuing to take a tough line on people who breach their Asbos and demonstrates the continued vigilance in tackling street drinking in Camberwell.

"However, an Asbo is just one tool the council uses and other work is being carried out to assist those who are dependent on alcohol."

Southwark has refused to name the drinker. The sentencing on Wednesday last week followed repeated complaints about the behaviour of people boozing in the area.

Many complaints came from residents living near the Marina House drink treatment centre in Denmark Hill.

The facility, run by the South London and Maudsley NHS Trust, has about 600 drinkers on its books.

Neighbours said groups of drinkers would congregate in the area before or after treatment, often causing a nuisance and causing a mess.

Their complaints to police and the council led to the four Asbos being served. These were the first orders on street drinkers in the borough.

Alcoholics Anonymous Sheds Some Anonymity

The Moscow Times ~ Friday, July 15, 2005

Alcoholics Anonymous shed some of its anonymity for a day Thursday at a news conference to celebrate its 70th anniversary and raise awareness of the group and the problem of alcoholism in Russia.

The president of Alcoholics Anonymous World Services Inc. began his speech with an acknowledgement of his addiction. "My name is Greg M., and I am an alcoholic," he said, asking that reporters respect the policy of Alcoholics Anonymous not to reveal last names.

He told of how he lost his marriage and job, and ended up sleeping in a car before he joined the AA.

Founded in 1935 in the United States, AA has chapters in 180 countries around the world and has been in Russia unofficially since the 1950s, when Finnish members started meeting in St. Petersburg. Officially, the first AA group was founded in 1987.

AA groups in Russia have tripled over the past five years to more than 300, but numbers remain low compared with other countries. New York has one group for every 12,000 people, while Moscow has only one for every 400,000.

"I would like us to have more groups," said Ira, a member of Russian AA who said she would not be alive without group. "We have so many alcoholics."

Russian AA has yet to get the full backing of the medical establishment, she said, and often has trouble getting a place to hold meetings.

President Vladimir Putin has made the fight against alcoholism a priority, blaming it and a loosely regulated alcohol industry for contributing to the country's demographic crisis.

Pregnant mums in binge drinking warning

Jul 5 2005 ~ Emma Brady ~ icBirmingham ~ Health Reporter

Experts are meeting in Birmingham today to look at how to educate women about the dangers binge drinking can have on their unborn babies.

One baby a day is born in the West Midlands with learning difficulties or physical deformities linked to Foetal Alcohol Syndrome.

National charity FAS Aware UK - which is backing the conference at Austin Court, in the city centre - claims that more than 1,300 children a year are harmed in the womb due to their mother's drinking.

Despite Government claims that mothers-to-be can drink up to four units a week, FAS Aware UK believes there is no evidence to prove drinking during pregnancy is safe.

Drinking at different stages of a pregnancy can cause further damage as the foetus develops, which can vary depending on the amount drunk, the mother's metabolism, and her diet.

Even drinking a small amount of alcohol can lead to a wide range of effects including flattened facial features, deafness, brain, heart or kidney abnormalities, behaviour problems, and learning difficulties.

Alison McCormick, the charity's social work consultant, believes the problem will get worse if women do not heed warnings over the dangers of binge drinking.

She said: "It didn't used to be the 'done thing' for women to binge drink and to be drunk but now it's seen as acceptable behaviour by society and it's a serious problem in Birmingham.

"But being drunk may lead to a pregnancy which could be affected by the woman's alcohol intake before she's even aware she's pregnant.

"Public awareness about FAS is very low, and not much is known about it in this country as studies aren't kept so there could be a lot more cases because it is often over-looked or misdiagnosed as Asperger's Syndrome, Attention Deficit Disorder and even Tourette's Syndrome.

"There's no evidence anywhere that drinking any alcohol during pregnancy is safe, there's no proof at all of that, so we would urge women not to drink at all - despite the Government's guideline which states it's okay to drink four units a week.

"If we don't address this problem now, I think we will see the number of cases explode in the next 12 months."

When a pregnant woman drinks, the alcohol passes through the placenta to her foetus and it is broken down much more slowly than in an adult' s body.

As a result, the alcohol level of the baby' s blood can be higher and can remain elevated longer than the mother's blood - which can lead to developmental problems.

Mrs McCormick, who has two adopted daughters with FAS - eight-year-old Jade and two-year-old Emily - will address the medical conference today.

She said: "When we adopted Jade she was five-years-old, she'd been put up for adoption then handed back, and it soon became apparent she had problems which is when I started researching the condition. One day I was looking at FAS website, which was covered with pictures of children who have it. Jade walked in and said 'They all look just like me' - that's when I realised what it was, and I just started crying, because she recognised they were the same as her."

After convincing her GP to carry out a number of tests, Mrs McCormick finally got to see a specialist with some expert knowledge of FAS.

She added: "Women across the Midlands need to wake up to the fact that drinking during pregnancy does harm their unborn babies, leading them to develop disabilities that are 100 per cent preventable.

"But for a disorder which experts believe affects one in 500 babies there is still very little being done about it, which is why this conference is so important."

US prescription drug abusers top 15 million- study

Reuters ~ Thu Jul 7, 2005 1:58 PM BST

WASHINGTON (Reuters) - The number of Americans who admit abusing prescription drugs nearly doubled to over 15 million from 1992 to 2003, with abuse among teens tripling, according to a new study released on Thursday.

The report by the National Center on Addiction and Substance Abuse at Columbia University suggested that more Americans were abusing controlled prescription drugs than cocaine, hallucinogens, inhalants and heroin combined.

"Our nation is in the throes of an epidemic of controlled prescription drug abuse and addiction," said former health secretary Joseph Califano, chairman and founder of the Center.

"New abuse of prescription opioids among teens is up an astounding 542 percent," Califano said. "The explosion in the prescription of addictive opioids, depressants and stimulants has, for many children, made the medicine cabinet a greater temptation and threat than the illegal street drug dealer, as some parents have become unwitting and passive pushers."

The report was based on surveys of doctors and pharmacists, personal interviews and focus groups and analysis of national household surveys and census data.

The report said hundreds of Web sites advertised and sold controlled drugs, often without prescription and without regard to age so that teens and children could easily get them.

The substances most likely to be abused were opioids, or pain relievers like OxyContin or Vicodin; central nervous system depressants such as Valium or Xanax; stimulants including Ritalin or Adderall and anabolic-androgenic steroids like Anadrol or Equipoise.

"The problem can be seen in every stage of life: rich and poor, old and young, teens partying or cramming for exams, stressed executives, women juggling the challenges of work and care-giving, seniors struggling with illness and loss, the mentally ill searching for relief, movie stars, rock musicians and athletes," the report said.

It found that between 1992 and 2002, prescriptions written for controlled drugs increased more than 150 percent while the number of people abusing them rose seven times faster than the U.S. population.

In 2003, 2.3 million 12- to 17-year-olds -- almost one in 10 -- abused least one controlled prescription drug. Girls were more likely than boys to be abusers.

Teens who abused drugs were twice as likely to use alcohol, five times as likely to use marijuana, 12 times likelier to use heroin and 21 times likelier to use cocaine than teens who did not abuse such drugs.

The report also found that in 2002, controlled drugs were implicated in almost 30 percent of drug-related emergency room deaths while the number of prescription drug emergency room mentions in hospital logs increased by nearly 80 percent.

Law enforcement officials around the country have been wrestling with an epidemic of prescription drug abuse, especially of powerful pain killers like OxyContin, popularly known as "hillbilly heroin."

The report found a 140 percent rise in self-reported abuse of such pain killers from 1992 to 2003, disproportionately concentrated in the south and west of the country.

Lager Louts Wreak Havoc in Perth A&E

Perth News ~ Jul 5 2005

ALARMED hospital staff say Perth's drinking problem is spiralling out of control as boozed-up revellers flood into the city's casualty wards every weekend.

The Fair City drink culture has got so bad that A&E doctors claim 60% of cases they see from Thursday to Sunday involve alcohol abuse.

The news comes days after Chief Superintendent Matt Hamilton claimed that alcohol played a part in four out of five serious assaults in the city.

The top cop in Perthshire blamed the figures on a spate of new happy-hour type promotions in pubs and clubs which have seen the extension of the weekend to Thursday nights.

One fed-up senior medic even claimed his colleagues now have problems assessing the condition of potential stroke victims because of the possibility they could be fuelled-up on booze.

Dr Neil Nichol has worked as a consultant at Perth Royal Infirmary's casualty department for six years and says his staff face verbal and physical assault on a weekly basis as the culture of "drink-till-you-drop" spirals out of control.

He said: "On a Friday and Saturday night you'll see that 60 per cent of people coming to A&E have alcohol on board and undoubtedly that can lead to the situation where our staff are assaulted.

"These people can be extremely difficult to manage and often you also have to deal with hangers-on who may also be drunk.

"They don't sit down, they wander about the department and can at times be daringly aggressive.

"If someone is allowed to behave in an inappropriate way it can lead to a chain reaction with other drunks in the room.

"And all the time you're trying to see to a heart attack victim but the drunk with the head wound is also demanding your time, less deservedly so."

Dr Nichol also suggested that the rise in binge drinking effects the ability of health workers to diagnose patients.

"Our ambulance crews often have trouble differentiating between really sick people and someone who is just drunk," he added.

"There are a number of conditions where you may look drunk but in fact you're seriously ill.

"That includes things like head injuries and some varieties of stroke."

But there may be respite ahead for the Fair City's embattled doctors, nurses and cops.

New licensing laws have put the dampers on cheap drink promotions and Chief Superintendent Hamilton revealed his officers have already found success by banning repeat offenders from the city's boozers.

He warned other would-be drunkards that the force would have no qualms about slapping curfew orders on those who get out of hand after one too many.

He said: "If we have someone who is consistently drunk, causing trouble and getting arrested at night then we'd go to the procurator fiscal and seek a curfew order.

"That could also mean that the person stays away from pubs or off-licenses.

"This is a successful tool for dealing with binge drinking."

Addiction experts helping kids

Hornsey & Crouch End Journal ~ 06 July 2005

KIDS as young as 16 are turning to Alcoholics Anonymous in Haringey for help to battle the booze.

The plight of the young drinker has been revealed as the self-help group celebrates its 70th anniversary.

In Haringey, there are 22 meetings a week scattered around the borough - from Muswell Hill to Wood Green and north Tottenham.

And while alcohol addiction has historically taken hold of people from of all backgrounds and social status, it has emerged that those afflicted with a booze problem - and turning to AA - are getting younger and younger.

A spokesman for Alcoholics Anonymous, said: "Everyone has their own version of what rock bottom is and I would say that the drug culture has helped many people get there a lot quicker and at a younger age.

"The younger generation may also be more willing to ask for help."

One regular at Alcoholics Anonymous in Haringey is 31-year-old Charlotte, who like many started drinking too much in her teens and went on to develop a habit which could see her consume two-and-half litres of vodka a day.

Charlotte said: "I would say the youngest AA member I have seen is 16, and the oldest 87. People are coming to AA younger and younger. The awareness is there, and people in general are much more able to talk of their problems these days."

Charlotte said she turned to AA because she would have "done anything" to be free from her horrific habit.

She added: "My drinking became so horrendous that I couldn't hold down a job, my family didn't want to know me. I was at my rock bottom

I drank because I just wanted to change the way I felt. When I was happy I drank to be sad. When I was sad I drank to be happy. I just couldn't fit into myself and be comfortable

"With me, I went into these blackouts where I couldn't remember what I had done for long periods of time."

Charlotte described the move she made to seek help being driven by "the gift of desperation".

She said: "What that means is that you are so desperate that you will do anything to change and that you are ready to change.

"If someone had said to me you have to run around with your knickers on your head at an AA meeting, I would have done it.

"There is such a mixture of people at an AA meeting, from really high-level professionals to people straight off the street. But everyone had the same thing in common - an alcohol problem - and the honesty of everyone there is astounding. It blew my mind how open everyone was. There is sometimes a lot of tears."

Alcoholics Anonymous doing good work for 70 years

Patrick Evans ~ The London Free Press ~ 2005-07-05 01:57:58

TORONTO -- At 14, Mary W. started drinking. By 19 she was divorced, with two kids. She worked in a restaurant because she liked being near the booze. And for years she drank at least a gallon of wine a day.

That was in the 1940s.

Last weekend, Mary came to Toronto from her home in Palo Alto, Calif., for the 2005 International Alcoholics Anonymous Convention.

Organizers said more than 40,000 people from around the world attended the conference, which celebrated the 70th birthday of AA. The conventions for the two million recovering alcoholics worldwide are held every five years.

All weekend they held giant AA meetings in the Rogers Centre. At Saturday night's meeting, Mary and her kind -- alcoholics who have been sober for more than 40 years -- were the guests of honour.

The crowd filled the stands in horseshoe formation around the stage.

The guests of honour took up the front rows, a wash of grey hair you could see from the bleachers. The audience called them "old-timers" and applauded them adoringly.

Old-timers?

Stand-up comedians would be more like it. Twelve were chosen at random to talk about AA. From the first speaker to the last, they had thousands of sober men and women doubled over with laughter.

Lou P. from Pittsburgh, sober since 1964, told the audience he'd never been to an AA international conference before, but the organizers had put an irresistible package together.

"It was cheaper to come here than it was to stay at home," he said.

Ray K., also sober since 1964, told about trying to buy a bottle in a Calgary liquor store in 1962. The guy at the counter asked him what nationality he was. "Oh, I'm Indian," Ray told him.

The guy said natives can't buy alcohol in Calgary.

Ray skipped a beat, making the audience wait for the punch line and then delivered it with a perfect deadpan: "That's the day I became Croatian."

Mary told the crowd that when she first arrived at AA in 1960, she couldn't believe how funny everybody was. "When I was drinking, nothing was funny."

Mary wanted to turn her life around, but she never dreamed laughter would be a weapon in her fight against alcohol.

Today she's doing her part to keep the laughter going. She delivers her best lines with a prim, grandmotherly restraint. "I haven't had a fist fight in 40 years," she said.

Mary divorced her first husband before she turned 20 and did something she'd always wanted to do: She got a job. "I became the gay divorcee," she said.

But those weren't gay years for Mary. She'd been a heavy drinker since her early teens. "I drank after work . . . I'd drive home with one hand over my eye to see the white line," she said.

She married again and had two more kids.

"He was an alcoholic, too. We had a fist fight every weekend."

Mary saw her drinking as a personal flaw that was destroying her.

"I thought it was a moral issue. I was so afraid they were going to put me in . . . the mental hospital."

That's when a friend introduced her to AA.

"I found out I was sick, I wasn't crazy," she said.

Mary now regards alcoholism as a genetic disease. "I have hardly known any alcoholic who didn't have it in their family."

In 1960, she took her last drink.

She's had some good years since. "It's just been wonderful. I've never had it so good."

She's retired from her phone company job, but still works as a drug and alcohol counsellor.

Mary spent 40 minutes after the meeting talking to admirers before leaving. Her legs shook a little as she tucked them into the back seat of a cab. She suddenly looked like a 78-year-old woman and not a rock star.

"I'm not humble," she had told the crowd. "I'm just trying to become the kind of woman my cat thinks I am."

Campaigners oppose beer with caffeine and ginseng

Simon Bowers ~ Monday July 4, 2005 ~ The Guardian

US brewer Anheuser-Busch is to launch the first energy beer in Britain, despite an industry code prohibiting the promotion of alcohol as enhancing physical or mental capabilities.

The product, B-to-the-E, contains caffeine, guarana and ginseng, and is "for contemporary adults who are looking for the latest beverage to keep up with their highly social and fast-paced lifestyles", according to Anheuser's website. It is to be targeted mainly at the nightclub market.

The Portman Group, the industry watchdog, has ruled against a number of alcoholic energy drinks. In some cases companies have been forced to withdraw claims made on packaging or in some cases to scrap products altogether.

Anheuser insists the E does not stand for "energy" but means "extra", a reference to additional ingredients in the beer.

The Portman Group code says packaging and promotional material should not "in any direct or indirect way suggest that the product can enhance mental or physical capabilities".

Products that have been changed or ditched after Portman Group rulings include Cannabis vodka; VK Vodka and Energy; and Red, an alcopop that claimed to "invigorate" drinkers.

A number of spirit-based alcopops with added stimulants nevertheless remain on the market competing alongside cocktails containing caffeine-rich mixers such as Red Bull.

Anheuser's UK marketing director Jim Gorczyca denied that B-to-the-E is to be marketed as an energy drink. He said the added stimulants instead provided "a fresh new taste that is unique and fun".

Anheuser said the Portman Group had been consulted on the drink. Portman refused to comment on any advice given but said it never gave clearance to products before launch. Its code was established by the drinks industry in 1996 in response to public concern at the way alcopops were being marketed.

Several Portman Group members privately recognise the conservative standards set out in the code on packaging and promotion are widely ignored by the time drinks reach the bar - and are flouted by members through their TV and billboard ad campaigns.

Most members ignore Portman Group principles that prohibit linking alcohol to sexual success. TV advertising, however, is expected to be marginally toned down this autumn following a move by Ofcom to tighten its regulations on alcohol promotions.

Campaigners were also concerned about the drink's arrival. Andrew McNeill, director of the Institute of Alcohol Studies, said, "These drinks are clearly aimed at young, heavy drinkers. And young heavy drinkers drink too much as it is."

Victoria Manning, research psychologist for Action on Addiction, said: "This concerns us because the combination of caffeine and beer will enable people to drink more because the caffeine will keep them awake longer. Some people may believe the effects of the alcohol are being neutralised by the caffeine."

Alcoholics Anonymous ended his bad trips, convention delegate says

By Joe Friesen ~ The Globe and Mail ~ Saturday, July 2, 2005

Before he joined Alcoholics Anonymous, Murray dreamed of travelling. In his drinking days, he says jokingly, his longest trips involved falling from the bar stool to the floor.

Now, as Alcoholics Anonymous celebrates its 70th anniversary in Toronto, Murray, who has travelled through Europe, Asia and South America on behalf of AA, has the pleasure of welcoming the first delegates from Mongolia to attend a world convention.

Last year, Murray, who lives in Thunder Bay, Ont., brought the only Mongolian translations of AA's Big Book, the 12-step liturgy, to the former Soviet satellite.

He said that as the books were being passed out in the large canvas tent where the AA meeting was held, shouts of joy erupted when the assembled alcoholics saw the Mongolian script.

"That's how hungry they were for some literature," Murray said.

Before the collapse of the Soviet Union, alcohol was cheap and widely available in Mongolia, he said.

As the country liberalized in the 1990s, vodka and other popular drinks became more expensive, and those who had grown dependent on them turned to crime to feed their addiction.

"There was no stigma attached to alcoholism there. They were seen as poor Mongolians who had fallen victim to the Russian sickness, so once a way out was presented [in the form of AA], they looked into it."

The Mongolian government sent a group of doctors to the United States in 1997 to study their addiction-treatment programs, and then imported AA to Mongolia. There are now 42 groups in Mongolia, even though the size of the country and the nomadic life of its animal herders make it difficult to get to meetings.

The groups range in size from gatherings of two or three in the desert of the mountain steppe, to full meetings of 20 in the capital, Ulaanbaatar.

Murray remembers one meeting in the old Mongolian capital of Kharakorum. Everyone sat in rows inside a large tent, and although he couldn't speak the language, it wasn't long before he understood what they were saying.

"They were telling story after story about what it was like when they were drunk," Murray said.

"I didn't need to know the words to know what they were saying."

It's that kind of instant understanding that creates such a feeling of goodwill in AA.

Murray explains it as the joy that comes with being given one's life back. At 57, he's been sober for 23 years. But until he was 34, he was a drunk.

He worked as a teacher at a community college and every day at 3 p.m., he would head to the local bar. He could rarely remember what happened after that, and developed a habit of checking his pockets every morning for matchbooks taken from hotel bars to help piece together his movements.

As more than 40,000 people, according to conference estimates, stream through the Metro Convention Centre, there's an overwhelming sense of fellowship among strangers. Men and women dressed in red shirts shake hands with everyone in sight, welcoming them to Toronto and greeting them by their first name. Delegates wear their names on cards hung around their necks, and in AA everyone goes by their first name to protect their anonymity.

The crowd is mostly white, middle-class and populated mainly with American delegates. But there are a few far-off countries represented. China and Cuba, like Mongolia, are making their first appearances at a world conference. The conferences are held every five years and offer discussion groups such as: Pain: The Touchstone of Growth; Carrying The Message into Correctional Facilities; and Young People in AA: We Hit Bottom Too.

The Miracle Worker

By Jennifer Bails ~ Tribune-Review ~ Sunday, July 3, 2005

It's the unlikeliest of hugs.

One set of arms extends from an elderly Hasidic rabbi with a sugar-spun beard, clad in a frock coat and velvet yarmulke. His appearance is more reminiscent of prewar Eastern Europe than modern-day Western Pennsylvania.

Completing the embrace is a young addict, with pained, tired eyes that belie his age. We don't know his name or his demon of choice.

It could be alcohol or heroin or pain-killers or something else. The particular substance doesn't matter. Not really, anyway.

What matters is that like the hundreds of patients here at Gateway Rehabilitation Center in Center Township, Beaver County, the man has been given another chance at sobriety, another chance at life.

"That was the first time I heard you speak," the man tells the rabbi, tugging on his baggy jeans and subconsciously checking to make sure his stubbed-out cigarette is still tucked behind his ear. "Thank you so much," he says, softly but without shame.

Hugs for Dr. Abraham Twerski come by the dozens here during his monthly visits to the nonprofit drug and alcohol treatment center he founded in 1972.

They come in the security line at the airport and in the aisles of the grocery store. They come from strangers in the streets of countries as far away as Japan, Finland and Brazil. They come from recovered addicts in all walks of life -- surgeons, politicians, journalists and construction workers.

Even women have found a way to hug Twerski without violating the religious principle that forbids him from having co-ed physical contact with anyone other than his wife and daughters.

"Abe!" shouts a heavyset black woman dressed in pink hospital scrubs in the Gateway lobby, where a portrait of Twerski hangs in the corner he refers to sarcastically as "the shrine." She clasps her arms across her chest and sways side-to-side as Twerski does the same, standing a few feet away.

"You never have to worry about me getting in trouble because I don't have any anonymity," Twerski says.

He wouldn't have it any other way.

More than 30 years after entering the wrenching field of chemical dependency, it's the human contact that sustains Twerski, and in turn, has improved the lives of thousands of people on the brink of self-destruction.

By now, it's a familiar, but no less remarkable story. No matter how many times you hear it, though, it still sounds more like a fable than reality.

It's the story of a rabbi -- descended from the 18th-century Baal Shem Tov, Master of the Good Name, the mystic founder of the Hasidic movement -- who became a psychiatrist specializing in drug and alcohol addiction.

Twerski, 74, is a world-renowned expert on substance abuse, religious scholar and beloved spiritual guru.

In addition to establishing Gateway, which has been named as one of the 12 best treatment centers in the country by Forbes magazine, he served for 20 years as the clinical head of psychiatry at St. Francis Hospital.

"Dr. Twerski is the person you would go to talk to in tough situations," says Dr. Ben Taitelbaum, 66, of Squirrel Hill, Twerski's childhood friend who worked alongside him at the now-defunct Lawrenceville hospital. "Not only was there medical and psychiatric expertise, but there was a certain wisdom there that made him a great resource."

Twerski has recorded this wisdom in 50 books, some translated into several languages, with titles like "Getting up when you're down," "Living each day," and "When do good things start?" a collaborative effort with Peanuts comic strip creator and friend Charles Schulz. His latest book -- "From pulpit ... to couch ..." -- will be released this month.

His lectures on stress, self-esteem and faith still draw standing-room-only crowds. He appears in eight videotapes and publishes a weekly advice column called "Dear Rabbi" in a Jewish newspaper.

But Twerski's real accomplishment is the nearly 45,000 people he estimates that he has helped to usher from the dark, desperate depths of addiction to sobriety. To illustrate this point, he pulls out a file folder stuffed with thank-you letters, some yellow and creased, others more recent, from former patients.

"It's been over seven months since my last drink and you know I feel great," one woman writes.

Card after card bears the same basic message of recovery and overwhelming gratitude.

Twerski closes the folder and removes his lunch from the refrigerator.

Because he follows strict kosher dietary laws, he prepared the cholent -- a Jewish stew of meat, beans and potatoes -- at home in New York and carried it with him on the airplane for his brief stay in Pittsburgh. He heats his meal in the microwave, pours himself a cup of water from his Thermos and reclines in his desk chair.

Focus on Twerski's deeply etched face and the ancient aroma of his meal and you could be in a rabbi's study in turn-of-the-century Poland.

Indeed, Twerski set out to model himself after his father, a Hasidic rabbi who immigrated from Russia to escape persecution in the 1920s and landed in Milwaukee. Hasidism is one of the most staunchly traditional, insular sects of Orthodox Judaism that stresses the mercy of God and encourages joyous religious expression through music and dance.

The middle child of five boys, Twerski watched people flow in and out of his father's study for counseling at all hours of the day.

"Our house became Grand Central Station for people with problems," he says, pulling at his wispy sidelocks and pushing his yarmulke back on his balding head. "Even judges would sometimes tell their litigants, 'Take the case to Twerski.' That's what I was modeling myself after."

Twerski was chosen by his father to take over the pulpit. But the meteoric rise of clinical psychiatry and psychology after World War II meant fewer people were turning to their clergymen for counseling.

"I spent my first three years as a rabbi presiding over weddings, bar mitzvahs and funerals," Twerski says. "That's not what I wanted to do. I did not want to go through life being a performer of rituals. It seemed nobody wanted what I had to offer."

So the natural-born counselor opted to attend medical school at Marquette University School of Medicine and became a psychiatrist to do what he had wanted to do as a rabbi.

A 1959 Time article described how Twerski juggled his religious obligations in the secular world of medicine. For example, he had to wear a "snood-like surgical mask" to cover his beard, which posed "a sanitary problem" and wore a cotton prayer shawl instead of the customary wool to avoid setting off a static spark that could ignite the anesthetic in the operating room, the magazine recounts.

While completing his residency at University of Pittsburgh Medical Center's Western Psychiatric Institute, he met a woman named Isabelle who piqued his interest in alcoholism. The daughter of an Episcopal priest, Isabelle was an alcoholic who had been rejected by her family and turned to prostitution. She had been through detoxification more than 90 times before committing herself to a state hospital for a year.

"I wondered what would motivate this woman to make this drastic change," Twerski says. "I had never heard anything about alcoholism. They didn't teach it in medical school or psychiatry."

Isabelle came out of the hospital sober and stayed that way with the help of Alcoholics Anonymous and its 12-step process of recovery, which emphasizes taking a moral inventory, admitting wrongs, accepting the will of God.

Her story intrigued Twerski so much he decided to attend an AA meeting. He was amazed by the sense of parity and interdependence among recovering alcoholics he couldn't find anywhere else, even in religion.

"Once you walk through the doors, who you are and what you have doesn't make a difference," Twerski says. "For the first time, I saw a place with real equality, and I was impressed."

Twerski's only experience with chemical dependence was the narcotic Demerol he took for a few days 20 years ago while recovering from an intestinal infection, yet he continues to go to Alcoholics and Narcotics Anonymous meetings. The 12 steps can do more than help people beat addiction -- they provide the tools for character and spiritual development that we all could benefit from, he says.

"Everybody has character defects, but only people in AA and NA have to face those defects and make amends," Twerski says.

Twerski finishes his lunch with a cup of coffee with kosher milk powder and a few pieces of rugelach. He slips on his black hat, recites the grace after meals in Hebrew and then sets out across the Gateway campus to talk to a group of men -- most of them in their 20s and 30s -- from the Tom Rutter House, one of the center's residential halfway houses.

With his almost otherworldly presence, Twerski commands the attention of the room, finding a way to relate to these recovering addicts.

"Whatever I do, I do it one day at time," he begins his lecture, reciting the basic tenet of the 12-step program.

The topic today, like most days, is self-esteem.

Twerski talks for about 45 minutes without the help of notes and almost without pause. He segues effortlessly from anecdote to affirmation to inside joke. He peppers his talk with surprising colloquialisms like "ain't" and "damn." He shares advice with the men about how to beat their addictions and tells them, above all, to believe in themselves.

"Do you know what a raw, uncut diamond looks like when it comes out of a mine?" Twerski asks.

Several men lean forward. Others nod their heads.

"It looks like a piece of dirty glass," he says, answering his own question.

Inside everybody is a diamond, Twerski says.

"You may be telling yourself: 'I don't look like a diamond. I don't feel like a diamond," he tells his audience. "But you know what this place is? It's a diamond-polishing center. If you stay with us, we'll show you how to work the 12 steps to find the beauty inside the rock."

After his talk, he is surrounded by men eager to introduce themselves. Every handshake becomes a hug.

Twerski considers Gateway to be a monument to Isabelle -- a lasting testimony to the basic good he sees inside of everyone.

He opened the center in the quiet woods of Beaver County almost 35 years ago to fill the void he saw in the region for substance abuse treatment. St. Francis had a program for detoxification and in-hospital AA meetings, but no facility existed to provide alcoholics with the guidance they needed to stay sober.

"It was pretty revolutionary in this area to start a rehabilitation center when he did," said Sharon Eakes, former vice president of treatment at Gateway, who worked at the center for 25 years.

Eakes describes Twerski as tough, but not judgmental; brilliant, but unfailingly human.

"Abe has touched a lot of lives," Eakes said. "He is both deeply spiritual and deeply in this world, and that's a rare mix."

Gateway weathered the financial storm created by the onset of managed care and now has a network of 20 program locations spread across Allegheny, Beaver, Erie and Westmoreland counties, as well as eastern Ohio. The center's reach even has extended overseas to Jerusalem, where Twerski helped to establish a rehab center for drug-related convicts.

Gateway offers detoxification, inpatient and outpatient services for teenagers and adults. On any given day, the center is in contact with about 1,800 in need of help.

Clearly, not every patient can be a success story. Some relapse and return before they become sober. Others fail altogether.

The center's latest study found that 42 percent of 249 randomly selected patients reported being continuously abstinent for three years after treatment.

"The hardest part of my job is when you lose someone," Twerski says, rubbing his heavy-lidded eyes. "To me, it's like somehow or other I wasn't good enough, that I let him down."

Twerski now lives in Monsey, N.Y., with his second wife, Dr. Gail Bessler-Twerski, whom he met at a convention of Orthodox Jewish psychotherapists. They also have a home in Efrat, Israel. His first wife of 43 years, Goldie, died of breast cancer in 1995, making sure to leave behind notes in their house that encouraged her husband to remarry.

Their daughter, Sarah, is a transplant nurse at UPMC Presbyterian Hospital in Oakland. All three sons live in Brooklyn, N.Y. Isaac is a metallurgic engineer; Ben is a psychologist; and Shlomo is a tax attorney.

Although he no longer makes his home in Pittsburgh, Twerski still returns to Gateway a couple days every month to lecture and encourage patients, staying at a hotel near the airport when he visits.

"This is a place you can't run away from," Twerski says.

Retirement is just a figure of speech for the rabbi-cum-psychiatrist who spends his days answering e-mail requests for help -- typing methodically with two fingers at a time -- and drafting his newspaper column and books. His "Sober Thought For The Day" appears daily on the Gateway Web site. He still lectures about five times a year and travels extensively.

Every morning, Twerski attends religious services and studies the Talmud, the collection of ancient rabbinic writings on Jewish law and tradition.

When he isn't learning or writing, he enjoys cooking, watching an inning or two of baseball and spending time with his grandchildren and great-grandchildren. If you ask him how many children there are, he will answer "not enough" to put the kibosh on the evil eye.

But aside from family, religion and the occasional leisure distraction, Twerski remains wholly dedicated to his role as a healer -- although some may call him a miracle worker.

Indeed, Twerski says miracles happen every day at Gateway.

"There's just a limit to how many things can be coincidence," he says, although to him, it is God's hand, not his own, that is creating the miracles.

Twerski may not see himself as blessed with extraordinary powers, but he understands the magnitude and nature of his legacy.

"I want to be remembered like the guy who discovered the diamonds in the uncut stones," he says. "That's what makes it all worthwhile."

Blueprint for living

Toronto Star ~ Jun. 30, 2005. 12:34 PM

Drawing on many spiritual sources, Bill W. summed up the essence of what brought him to sobriety Challenge was to codify basic principles of fledgling Alcoholics Anonymous, writes Andrea Gordon

It took William Griffith Wilson 17 years of blackouts, broken promises and wrenching despair before he took his last drink of alcohol in 1934.

Four years later, it took him only 30 minutes to scribble the essence of his spiritual journey to sobriety on a yellow scratch pad so it could be used to help other alcoholics.

The result was the first draft of the 12 Steps, the heart of the Alcoholics Anonymous program of recovery and a path described as nothing short of a miracle by the many who have followed it.

"Two hundred years from now, the 20th century won't be remembered for penicillin or landing on the moon, but for the 12 Steps," says Graeme Cunningham, director of addiction with Homewood Health Centre in Guelph and associate professor of psychiatry at Hamilton's McMaster University.

Cunningham's words are typical of the praise heaped on the fellowship.

British author Aldous Huxley, one of Wilson's contemporaries, called him "the greatest social architect of our century."

In 1999, Time magazine put Wilson in the company of such giants as Albert Einstein, Gandhi and Sigmund Freud as one of the 100 most influential people of the century.

To Wayne Skinner, deputy clinical director of the addictions program at the Centre for Addiction and Mental Health (CAMH) in Toronto, it's hard to think of anything that has had more impact than the 12 Steps of AA throughout the history of addiction.

You wouldn't get much argument from many of the 50,000 people gathering in Toronto this weekend for the annual international AA convention. This year celebrates the 70th anniversary of the day that Wilson — known in AA circles as "Bill W.," in keeping with the organization's principle of anonymity — met another alcoholic, physician Robert Smith, or "Dr. Bob", in Akron, Ohio, and discovered the healing power that emerges when people fighting the same demons share their stories.

Half an hour may have been all Wilson needed to jot down his draft a few years later. But the roots of the 12 Steps go back much further and can be traced to an unlikely array of sources.

"AAs are always asking: `Where did the Twelve Steps come from?'" he wrote in the July, 1953, edition of the AA journal Grapevine. "In the last analysis, perhaps nobody knows."

He always described himself as a synthesizer, according to author Susan Cheever in her 2004 biography My Name is Bill. He cited three main influences: the Oxford Group, an evangelical Christian fellowship that flourished in the 1920s and '30s; New York physician Dr. William Silkworth, who pioneered the revolutionary idea that alcoholism is a progressive and fatal disease, describing it "as an allergy of the body and an obsession of the mind"; and William James, a Harvard professor and founding father of American psychology who, years earlier, had researched the validity of religious or conversion experiences.

But the series of crossed paths and coincidences that led to the creation of AA and the 12 Steps also included a diverse assortment of other figures. There was Swiss psychoanalyst Carl Jung, who, unable to help an alcoholic patient, told the man his only hope was a spiritual conversion. The patient turned to the Oxford Group, which opened its arms to those with drinking problems, and had a conversion experience that led to a period of sobriety.

There was philanthropist John D. Rockefeller, Jr., who planted the seeds for the AA model as a self-supporting organization.

And, most important, there was a handful of alcoholics with no qualifications beyond their desire to stop drinking. Seeking a life of sobriety above all else, they managed to combine their faith and the wisdom gleaned from others into a package that many in AA today still describe as "divine intervention."

By the time Wilson — a Vermont native who worked as a stockbroker on Wall Street — met Smith in 1935, he had been sober for five months. During a business trip to Akron, finding himself increasingly anxious and fearing he might reach for a bottle, he set out to find someone like him who would understand. He was soon put in touch with Smith.

As Cheever recounts it, the day they met, Smith was surly and barely sober. But he was able to listen. Several weeks after meeting Wilson, he, too, took his last drink.

Wilson wrote of the encounter in AA Comes of Age. "I had stopped preaching. I knew that I needed this alcoholic as much as he needed me. This was it."

Over the next few years, the two men were instrumental in building a network of people in Akron and New York who were helping each other stay sober.

In 1938, hoping to avoid distortion of their message and wanting to extend it to others in distant places, Wilson, Smith and the other pioneers of AA set out to put their program and personal stories into a book. Called Alcoholics Anonymous, it is referred to by AA members as "the Big Book."

It was a monumental task. Spreading the word face to face was one thing. In print, it had to be done right the first time. Chapter 5, titled "How It Works" and aimed at laying out the basic principles, was Wilson's job. As he put it, "there must not be a single loophole through which the rationalizing alcoholic could wiggle out."

Until then, the budding network had described its course of action as six steps. But during his inspired burst of writing, Wilson turned those six into 12 and surprised himself by moving the notion of a higher power almost to the top, in Step 2.

Though the steps are inextricably woven together, building on each other, they are commonly looked at in groups.

In the first three, the bedrock, the alcoholic admits the problem, sees a glimmer of hope that there might be a solution and becomes willing to try it.

Steps 4 through 9 are the "action" steps.

They are the route to growing up, where alcoholics, so long immersed in self-pity, resentment, rage and fear, start to take responsibility for their actions and themselves. They do this by taking a good, hard look at their lives and shortcomings, taking steps to get rid of those character flaws and making amends to those harmed as a result of their drinking and destructive behaviour.

The work is onerous and requires guidance from other members, notes Cunningham, who has been sober for 20 years.

It is also a lifelong process that can lead to great rewards.

By practising Steps 10 through 12 — which some members call the "maintenance steps" and others call "growth and development steps" — alcoholics can keep a clean slate, attend to their spiritual needs and carry the message to other alcoholics who are suffering, which AA founders stressed is a critical part of staying sober.

In laying out the steps in the Big Book, the authors presented fellow alcoholics with both tremendous hope and challenge.

"Rarely have we seen