One in eight worked while under the influence

Around one in eight people in Wales has admitted to being under the influence of drink while at work in recent months, a survey out today shows.

And the poll of 1,500 full-time workers reveals the under-30s are most likely to "pull a sickie" because of a hangover.

Insurance firm Royal & Sun Alliance said its research confirmed there was an "ongoing cultural problem" in Britain of people drinking during the working day.

Somebody dies every day inWales due to alcohol-related accidents or illness, with 419 alcohol-related deaths in 2004.

Yesterday the Rev Eldon Phillips, spokesman for the Church in Wales' Swansea and Brecon diocese said the number of people admitting to being "under the influence" at work was sad.

The Llanelli clergyman said, "I don't blame the individuals, I blame society.

"We live in a 24-hour culture now where booze is available round the clock in supermarkets or clubs and the TV is on right through the early hours.

"It's hardly surprising lots of people arrive at work still drunk.

"But it's so selfish. Presumably many of these people drive to work during the school run while drunk and other people will have to take the workload off them because they just can't perform."

The survey shows that 13% of Welsh people have been under the influence of drink during working hours in the past six months, and 6% have taken a day off in the past six months due to alcohol-related illness.

Companies in Wales attribute up to 10% of absenteeism to alcohol-related illness and up to 10% of under performance in the workplace to alcohol.

Royal & Sun Alliance spokesman Phil Bell said, "The effects of alcohol can be extensive, from an increased number of accidents in the workplace or lateness due to hangovers, through to impaired decision-making and a poor image for customers or clients.

"This can have an impact on everyone, especially sober colleagues who end up carrying the strain.

"Employers can be held liable for accidents in the workplace and research shows that up to 25% of these are caused by alcohol."

While the figures have caused concern, workers in London are twice as likely to be under the influence of drink while working.

The BMA in Wales is calling for tobacco style warnings on all alcoholic drinks to try to cut the harm binge drinking is causing.

And many Welsh doctors favour stark messages such as the "Smoking Kills" stickers which feature on all packs of cigarettes by law.

Welsh BMA secretary Richard Lewis, a former Maesteg GP, said, "The kind of slogans we would like to see are similar to those on cigarette packets.

"But on alcohol they would be adapted to something like 'overindulgence in alcohol can seriously damage kidney and liver function'.

"Alcohol is the most commonly misused drug in Wales. It is associated with other problems including casual, unprotected sex and crime and disorder."

The R&SA research showed that two million working Britons took one or more days off sick due to alcohol-induced illness over the past six months.

But both employers and employees in England and Wales did not think the problem has got worse since the introduction of 24-hour drinking in November.

According to the Health & Safety Executive, between eight million and 14 million working days in the UK are lost due to alcohol-related absenteeism.

Plaid Cymru health spokesman, Dr Dai Lloyd, a city AM and also a Swansea GP, said, "We have to learn to treat alcohol with respect.

"People are drinking to toxic levels and 90% of attendees at A&E departments are there because of alcohol.

"They have either collapsed due to the sheer amount drunk, caused a fight, been attacked by drunks, fallen over or been in an accident.And the long-term damage to hearts, livers and kidneys is starting to show itself in our hospital wards. Another major problem with alcohol is that people forget they are still probably affected the morning after heavy drinking."

Western Mail

'There is life after alcoholism'

It took 30 years of drinking for Tom to realise he was an alcoholic.

What started as a social tipple after work slowly degenerated into a bottle of spirits a night.

He lost his home, his health and his job.

From being a successful BBC and Radio Caroline presenter, his drink and later cocaine abuse left him living on the streets and relying on handouts.

Struggle

Today Tom, aged 61, is celebrating 11 years without a drink, but admits it has been a long and hard fight.

"I started my career on pirate radio and then I joined the BBC in Norwich and then I came down to London.

"It was then that I became aware of alcoholism - everybody seemed to be drinking at that time.

"I used to look down my noses at the people who drank at work and think 'how can they hold a job down?' I was about 22 or 23 at the time."

But without realising it, Tom's alcohol intake was gradually increasing.

"My alcoholism did not happen over-night. It took 30 years to creep up on me. I found that the harder I was working, the more I needed to drink to unwind."

He was drinking a bottle of Gordon's gin each evening, but still managing to hold down his career.

"Where I crossed the invisible line from social drinking to this though I do not know."

George Best

Tom's doctor grew increasingly concerned about his patient's alcohol consumption and he prescribed him an anti-booze drug - Antabuse, also known as disulfiram.

It was the same drug used by George Best, although where the former Manchester United star had his implanted, Tom took his in pill form.

For 18 months Tom stopped drinking, but he acknowledges the drug merely suppressed his habit and did not attempt to deal with the root causes.

So when he was offered the chance of a holiday with friends, Tom ditched his drugs and within days was back on the booze.

"At this stage I was heading for disaster," he said.

He then took a job in California, where he acquired a cocaine habit, which he blames on his "ridiculously punishing" work schedule.

"I was in double trouble then, so I came home and went to stay with my mother in an attempt to clean my act up.

"But I had not seen her for a long time and did not realise that she too was an alcoholic."

His drinking escalated, exacerbated by late nights and early mornings at work.

He was back on a bottle a day and, when his mother died a short time later, Tom was tipped over the edge.

"The only thing that I wanted was total oblivion. I was drinking 24/7."

Tom went on what he describes as "a massive bender" for three or four months, drinking his way through the £11,000 he inherited from his mother, staying in top hotels until he blew all the cash and was thrown out onto the streets.

He lived rough for a while until a former colleague heard of his plight and came to Norwich to scour the streets to find him.

He encouraged Tom to book himself into a rehabilitation clinic, the Ferdowse Clinic at Heckington near Sleaford, Lincolnshire, which has now closed.

"When I crossed the threshold of the clinic I realised that I was sick and tired of being sick and tired!"

He stayed at the clinic for three years until he felt ready to face the world as a sober man.

"I didn't want to stay in there any longer in case I became institutionalised."

But when Tom came out of the clinic he was destitute with just the clothes he stood up in. He had no job and no savings.

Friends and former colleagues rallied round, and celebrity Bob Monkhouse gave him his first job as the voiceover man on his game show Wipe-Out.

Tom settled into the Norfolk village where he had been successfully treated.

Eleven years later he knows he had a lucky escape. Doctors told him that when he was admitted for treatment he had probably less than two weeks to live if he continued drinking.

Now he is keen to warn others of the dangers of alcohol and to cut back before their drinking gets out of control like his did.

"I have had a long struggle, but I have not touched a drop," he said.

"Even recently when it was wrongly suspected that I had cancer I did not go back to drinking, although some people worried that I might.

"Now I can go to the pub and have the 'Red Bull' without the vodka.

"There is life after alcohol, but it is a tough nut to crack.

"You can be booked into clinics like The Priory, but at the end of the day, it has got to be the person themselves who wants to stop.

"I had to reach rock bottom and to be sleeping homeless on the streets before I was ready to give up.

"I approach my 12th year of sobriety in August this year. I am proud but never complacent.

"There is life after alcohol and I am grateful for this second chance at life because I knew deep within there would not be a third!"

BBC News

3,000 in Ulster are treated for alcohol abuse

More than 3,000 Ulster people are being treated for alcohol abuse, it can be revealed today.

And nearly a third of them are also receiving treatment for drugs and drink problems.

The shock new figures emerge just a week after health chiefs unveiled a £4m drive to tackle the worrying rise in binge boozing and drugs abuse among Ulster's young.

Of the 3,074 people being treated for alchohol abuse, 42 are in jail while 108 prisoners are also receiving treatment for drugs problems.

Meanwhile, some 230 drink/drugs abusers are currently in hospitals across Northern Ireland.

The statistics were revealed in reply to a written Parliamentary question from DUP MP, David Simpson.

The Department of Health say alcohol abuse does not constitute addiction - but said there are currently 239 people on the Northern Ireland Addicts Index Database.

No figure was available for drink addicts.

Mr Simpson said it was vital addiction and abuse services were properly resourced.

"There is no doubt that addiction problems are an increasing challenge in Northern Ireland and across the rest of the UK," he said.

"Treatment for addictions is not regarded as an emergency and therefore does not attract the resources that other services do.

"Northern Ireland would benefit from many more hospital beds dedicated to addiction services.

"There are approximately 5,000 hospital admissions and over 200 deaths each year in Northern Ireland as the result of alcohol. Addictions can have a knock-on effect on so many other areas such as crime.

"For example over 12 months from 2004-05, 359 young offenders committed to Hydebank Young Offenders Centre and Prison declared a dependency on alcohol. Some 468 inmates admitted to dependency or misuse of drugs.

"Only 58 inmates did not declare a dependency on either alcohol or drugs."

The Department's Strategic Direction for Alcohol and Drugs (2006-2011) will look at the problems of drink and drugs in the province over the next five years.

The strategy document contains a range of proposals designed to develop a co-ordinated and integrated approach to tackling the twin issues of alcohol and drug misuse in Northern Ireland.

Its main aim is to reduce the level of alcohol and drug-related harm in Northern Ireland through a series of inter-connected short, medium and long term outcomes. These will be delivered through activities and initiatives at both local and regional level.

Binge-drinking among adults continues to be of concern, with 48% of men and 35% of women reported having binged.

Alcohol and drugs misuse costs Northern Ireland society hundreds of millions of pounds each year and causes undoubted misery to many individuals, families and communities.

The new strategy contains a wide range of activities aimed at providing treatment and support to all problem users, as well as targeted education and prevention programmes.

Belfast Telegraph

Clean break

Personal testimonies highlight the sobriety successes of an Alcoholics Anonymous group in Charlottetown that is celebrating 60 years of helping people get their live in order.

Elizabeth wishes that she had joined Alcoholics Anonymous at age 16.

If she had, she believes she could have avoided several hellish, self-destructive years.

Elizabeth (not her real name), 26, of Charlottetown, took her first alcoholic drink at age 13. The introduction to booze was a simple “weekend thing with the friends’’.

Within three years, she was hooked on booze and drugs as a means to escape a young life filled with pain and isolation.

“Drugs and alcohol made me feel 10 feet tall,’’ she said.

Eventually, those vices would send her tumbling to the ground.

At age 19, heavily addicted to ecstasy and alcohol, Elizabeth left home, mom and P.E.I. behind for what would turn out to be a miserable existence in Calgary.

There, she did some waitressing and a little bartending. But mostly, she did drugs and drank.

“I basically worked to use — just to support my habit,’’ she said.

It got worse.

Elizabeth, a native Prince Edward Islander, became hooked on crack cocaine. She suspects that the guy who introduced her to the powerful drug was planning to get her into prostitution. He went on to physically, mentally and sexually abuse her.

Elizabeth ended up living on the streets. Her weight plummeted to 85 pounds. She lost contact with family. She was falling fast into a deadly abyss.

“I felt worthless and dead,’’ she said.

Finally, she decided to try to save herself from complete ruin.

Elizabeth entered a detoxification facility and then went into a recovery house for people who are addicted to drugs and alcohol.

She relapsed after three months, then, “tired of it all’’, returned to P.E.I. in May 2004.

After meeting with a counsellor the following month at the Provincial Addiction Centre, Elizabeth made her way to the Queen Street AA. She hasn’t looked back — or slipped back — since.

Elizabeth has been sober and drug-free for two years. She has been able to, for the first time in her life, enjoy a healthy relationship with her mother and to connect with her father, who had not been part of her life for most of her life.

Today, her life is moving forward and upward. She is studying to be a child and youth care worker. She hopes to eventually become an addiction counsellor, just like her inspirational uncle.

“I want to give back,’’ she said.

“Helping others the way that people helped me . . . I really care a lot about people.’’

Elizabeth credits the Queen Street AA group for helping to instill in her a positive outlook. She knows that she can always turn to the members for support.

And the 12-step program itself — stressing honesty, faith, surrendering, soul searching, integrity, acceptance, humility, willingness, forgiveness, maintenance, making contact and service — is rooted in a spirituality that resonates well with Elizabeth.

“I love AA,’’ she said.

“It has given me a new life.’’

The Queen Street AA has been helping people from all walks of life for 60 years now. Elizabeth sees the diversity of members each time she attends a meeting with the longest-running Alcoholics Anonymous group in Charlottetown — the only AA group in P.E.I. that holds a meeting every single day of the year, including Christmas Day.

“Alcohol doesn’t discriminate,’’ she said.

“There’s lawyers and there’s doctors and there’s teachers.’’

Ted (not his real name), 77, of Stratford, is in his 44th year as a member of the Queen Street AA. He has not had a drink since Aug. 22, 1962. Still, he never takes his lengthy run of sobriety for granted.

“The disease of alcoholism is there from the beginning to the end of your life,’’ he said.

“It never ends. If I took a drink today, I would be back where I was 44 years ago.’’

Ted sees AA as the only true vehicle for success in combatting alcoholism for the long term.

He said Alcoholics Anonymous has given him freedom and peace of mind.

The group’s 60th anniversary was celebrated on Thursday night at St. Pius Parish Hall in Charlottetown. Ted said he shares with other members an unbelievable pride in the Queen Street AA’s long history of successes.

“It’s hard to believe that we have stayed together for this length of time,’’ he said.

“Alcoholics Anonymous is the most disorganized organization . . . people come and they go. Not everybody stays.’’

Elmer of Stratford never considered his decades of sobriety an excuse to quit coming to the Queen Street AA. Even advancing years —he’s 92 — haven’t kept Elmer from making at least a handful of annual appearances in recent years.

“I didn’t want to forget what I’d gone through . . . and I didn’t want to have to go back to drinking,’’ he said.

Elmer is so proud of his success in combatting alcoholism over the years that he was eager to be identified in this article, which goes against the anonymity trademark of AA.

One of 18 children, Elmer said his drinking had become so bad in the 1960s, he had to take immediate action if he didn’t want to face dire consequences.

“I know if I didn’t stop that I was going to be put in jail or something,’’ he said.

“So I decided to stop.’’

His long period of sobriety allowed him to enjoy prosperity, improved health and a good life.

“I had good jobs on the account I stopped drinking,’’ he said, breaking into a big smile.

Ted said that AA is not for everybody, just for everybody that wants it.

Elizabeth agrees. She turned to AA for herself, not for others.

“Some people they come in, they’re getting this over for their wife or their husband or their kids or family member or for a job or to get to go to school,’’ she said.

“Sure, that’s great, but if you’re not doing it for yourself, you’re chances (of succeeding) aren’t very good.’’

The Guardian

Europe to crack down on ‘passive drinking’, says leaked report

The campaigns to combat the effects of ‘passive smoking’ are widely credited for Europe’s growing number of smoking bans. Now alcohol is in the sights of the public health lobbyists, and they have invented the concept of ‘passive drinking’ as their killer argument.

I have seen a leaked draft report for the European Commission, which is due to be published some time in June. It makes claims about the high environmental or social toll of alcohol, the ‘harm done by someone else’s drinking’. The report is likely to inform proposals for a European Union alcohol strategy later this year.

Dr Peter Anderson, the report’s lead author, who has a background in the World Health Organisation (WHO) and plays a leading role in Tobacco Free Initiative Europe, tells me that the concept of social harm takes the alcohol debate beyond the traditional limits of individual choice and addiction. ‘You can make the argument that what an individual drinks is up to them, provided they understand what they are doing and bearing in mind that alcohol is a dependency-producing drug…. But when you talk about harm to others then that is a societal concern and justification for doing something about it. I think that is an important argument. If there was not harm to others then the argument gets a little less powerful’ (1).

The draft report doesn’t mince its words when it comes to estimating the social harms of alcohol. ‘The total tangible cost of alcohol to EU society in 2003 was estimated to be €125bn (€79bn-€220bn), equivalent to 1.3 per cent GDP, and which is roughly the same value as that found recently for tobacco.’ (2) The report further highlights the broader social cost of drinking, with the proviso that ‘these estimates are subject to a wide margin of error, [and] they are likely to be an underestimate of the true gross social cost of alcohol’.

‘The intangible costs show the value people place on pain, suffering and lost life that occurs due to the criminal, social and health harms caused by alcohol’, says the report. ‘In 2003 these were estimated to be €270bn, with other ways of valuing the same harms producing estimates between €150bn and €760bn.’

As Anderson indicates, emphasising the alleged social rather than individual consequences of alcohol will be key to the new campaign. The theme of ‘passive drinking’ was flagged up early on. A Commission working group on alcohol health met in Luxembourg on 9 June 2004 to discuss, among other things, early progress on Anderson’s report. Draft minutes note that the participants, EU and national officials and various experts, were on the hunt for ‘main reasons why there is a need to reduce alcohol-related harm’.

‘EU experts agreed that the strategy needed to show more clearly the facts concerning harm on third parties (both social and health), including children and other family members of persons with alcohol-related problems. Experts said that there, for information and pedagogic reasons, was a need for a good phrase to explain what we mean by third-party harm in the alcohol field – reference was made to the phrase “passive smoking”.’ (3)

Just six days later, the Alcohol Policy Network (APN), a Commission-funded Eurocare project where Anderson is a staff member (4), met in Warsaw. Again, minutes show there was a strong consensus on the propaganda, or ‘advocacy’, merits of finding an equivalent term to ‘passive smoking’ for the alcohol debate. ‘The effect of alcohol on non-drinkers could be used more in advocacy. A need for effective terminology for this point was identified (eg. “passive drinking”), and APN members were invited to submit any suggestions they had in this regard’ (5).

By October 2004, the theme was established in a Eurocare submission to the Commission. ‘Alcohol not only harms the user, but those surrounding the user, including the unborn child, children, family members, and the sufferers of crime, violence and drink-driving accidents: this can be termed environmental alcohol damage or “passive drinking”.’ (6)

Dr Peter Anderson now distances himself a little from the term ‘passive drinking’, while remaining true to the core idea. ‘Passive drinking as a term does not really work. Like you have environmental tobacco smoke, I suppose you could [talk about] environmental alcohol damage. I have used that term…but there may be a better way of doing it’, he admits.

In the draft report, the concept is intact. The report claims that as alcohol consumption, or ‘other people’s’ drinking, increases, so too does social harm. ‘Harms done by someone else’s drinking range from social nuisances such as being kept awake at night through more serious consequences such as marital harm, child abuse, crime, violence and homicide. Generally the higher the level of alcohol consumption, the more serious is the crime or injury.’

Passive or environmental, the figures Anderson has pulled together for the EU are pretty scary. Drink is responsible for 2,000 homicides, four out of 10 of Europe’s annual murders. ‘The economic cost of alcohol-attributable crime has been estimated to be €33bn in the EU for 2003….while the intangible cost of the physical and psychological effects of crime has been valued at €9bn - €37bn.’ Children, too, are passive victims of drinking. ‘Many of the harms caused by alcohol are borne by people other than the drinker responsible. This includes 60,000 underweight births, as well as 16 per cent of child abuse and neglect, and five to nine million children in families adversely affected by alcohol’, says the report’s summary.

But while arguments have raged over a causal relationship between alcohol and crime since the nineteenth century, evidence for a connection has remained thin. ‘Questions of how alcohol exerts its criminogenic influence have never been satisfactorily answered… [all that can be concluded is] alcohol does not directly cause crime but that it may be implicated indirectly’, argues a study cited in the Oxford Handbook of Criminology (7).

The link made by campaigners between alcohol and crime today, whether violence or child abuse, follows not from hard facts but from a subjective outlook that sees human characteristics as damaging in general. And if human beings, particularly when under the influence of stimulants, are destructive, then, the argument goes, social intervention must follow. The idea that almost any activity – drinking, eating, speaking, even thinking – can cause harm is often blown out of proportion and used to generate frightening figures and policies.

Most violent crimes are committed by men; should males therefore be subject to special restrictive laws? Domestic violence mostly takes place in private homes; should privacy be abolished? Claiming that aspects of everyday life, such as drinking, automatically leads to ‘harm’ takes away from the responsibility of individual lawbreakers for what they have done, and thus makes for bad policy. Should all 85 per cent of Europe’s citizens who drink – that’s at least 387 million of us – face restrictions because of the tiny minority who commit the 2,000 homicides dubiously attributed to alcohol?

In a twist of irony probably lost on po-faced public health types, the expression ‘passive drinking’ seems to have originated as a spoof in two ‘Peter Simple’ columns in the UK Daily Telegraph in 2002 and 2003, written by journalist Michael Wharton (8). Mocking the rise of nonsense research to justify social measures, he wrote about research work being carried out by ‘Dr Ron Hardware’ at ‘Nerdley University’. ‘They were the first to discover the scourge of “passive drinking”, showing by painstaking experiments and finely adjusted statistics that it was just as deadly as “passive smoking” and equally capable of causing cancer and innumerable other ills’ (9).

Also, Soldier, ‘magazine of the British Army’, generated some shock and awe with a prescient April’s Fool story in 2006, about a looming booze ban to counter passive drinking (10). ‘This is another big brother idea taking in the problems of the minority and laying it squarely on the shoulders of the majority’, wrote one outraged serviceman who didn’t spot the joke. Today, it’s no longer a joke – European officials are plotting to make ‘passive drinking’ a reality.

Many of the ideas behind the latest European attempts to demonise drinking have much older, hoary antecedents. Some of the arguments and organisations involved go back to 1853. The Commission tender for the report went to the British Institute of Alcohol Studies (IAS), an organisation with close links to Alliance House, venerable temperance campaigners. This relationship has already raised some eyebrows (11). It epitomises the convergence between public health campaigners and old-style moralistic prohibitionists. Alliance House was founded in 1853 by Quaker cotton manufacturer Nathaniel Card to work for the prohibition of alcohol. Inspired by prohibition in the US, his campaign soon gathered momentum and the Alliance became a political force to be reckoned with. But, thankfully for us today, Card and his friends were critiqued by John Stuart Mill and other progressive humanists.

In 1857 – the year that Mill’s classic essay On Liberty was published – the Alliance was not seeking outright prohibition of alcohol but rather was trying to establish key arguments about the social harm of drinking. Today’s campaigners use strikingly similar tactics (12). Anderson’s arguments on social harm are similar to those used by the Alliance 150 years ago. ‘If anything invades my social rights, certainly the traffic in strong drink does’, wrote the secretary of the Alliance, as quoted by Mill. ‘It destroys my primary right of security by constantly creating and stimulating social disorder…. It impedes my moral and intellectual development, by surrounding my path with dangers.’

Mill took issue with the idea that drinking was a social act rather than simply a trade in alcohol. He did back limited restrictions so long as they didn’t have an intended prohibitive effect on individuals. He classed drinking as an individual act, for right or wrong, along with religion, opinion or conscience and other ‘experiments in living’, which should be ‘outside’ the scope of the law. The individual act of having a drink is not the cause of crime, believed Mill, any more than parenthood is the cause of child abuse or holding an opinion is a breach of someone’s ‘social rights’.

Mill was keenly aware of the dangers of linking spiralling social harms with individual behaviour. ‘So monstrance a principle is far more dangerous than any single interference with liberty’, he wrote (13). ‘There is no violation of liberty which it would not justify; it acknowledges no right to any freedom whatsoever, except perhaps that of holding opinions in secret, without ever disclosing them: for the moment an opinion which I consider noxious passes anyone’s lips, it invades all the “social rights” attributed to me by the Alliance.’ Anderson’s report and a future EU strategy will be relatively light on legislation – but, as Mill argues, the principle is more important than any particular act of law.

If the Anderson report is anything to go by, the EU looks set to propose shorter bar opening hours, days when shops cannot sell alcohol, health warnings, and higher taxes to put off drinkers across Europe. Here, too, Mill would disagree, because the restrictions spring from the above ‘monstrous principle’ with the avowed intent of cutting individual consumption. He backed licensing laws but only as a means of regulating or taxing public sale of alcohol, not as a means of checking individual acts of drinking.

‘The limitation of number, for instance, of beer and spirit houses, for the express purpose of rendering them more difficult of access, and diminishing the occasions of temptation, not only exposes all to an inconvenience because there are some by whom the facility might be abused, but is suited only to a state of society in which the labouring classes are avowedly treated as children or savages, and placed under a education of restraint, to fit them for future admission to freedom…. No person who sets due value on freedom will give his adhesion to being so governed’, Mill argued (14).

Today’s public health campaigners may not specifically target the working classes (instead we’re all in their sights), but they also, like the old prohibitionists, have little faith in the capacity of people to run their own lives without being instructed by propaganda or tutored in scare stories. The European report says: ‘Educational interventions, which show little effectiveness in reducing the harm done by alcohol, are not an alternative to measures that regulate the alcohol market, which have the greatest impact in reducing harm…. Educational programmes should not be implemented in isolation as an alcohol policy measure…but rather as a measure to reinforce awareness of the problems created by alcohol and to prepare the ground for specific interventions and policy changes…. Broad educational programmes, beginning in early childhood, should be implemented to inform young people of the consequences of alcohol consumption on health, family and society and of the effective measures that can be taken to prevent or minimise harm.’ (15)

There is perhaps one key difference between yesterday’s and today’s ‘prohibition campaigners’. Once the temperance movement believed man could be saved. Today, it joins with the public health lobby to treat drinking as a form of social pathology rather than a question of moral redemption. Once, public health had the aim of protecting society against disease. Today, the ‘new public health movement’ seeks to protect society against people themselves.

Today’s public health outlook on drinking dovetails neatly with other powerful contemporary trends that emphasise human vulnerability or undermine trust between individuals. Linking drinking to free-floating risks, independent of the intentions of individuals, is a characteristic of today’s anti-humanist climate. But 200 years after his birth, we can take heart from the works and legacy of Mill. He stood against the tide in his day and won. We owe him a debt and we owe the future of freedom a duty to make our own stand against the new public health alliance of the twenty-first century.

(1) Telephone interview, May 24 2006

(2) Summary of draft commission report on health, social and economic impact of alcohol, obtained by author

(3) Draft minutes of the commission’s working group on alcohol and health, June 9 and 10 2004, Luxembourg. Meeting with representatives of member states, eea countries, accession countries

(4) Eurocare, APN, Staff

(5) First meeting of Alcohol Policy Network, Warsaw, June 15-16 2004, notes of meeting

(6) Comments from Eurocare to the paper ‘Partnership for health in Europe’

(7) The Oxford Handbook of Criminology, second edition, 1997, page 949, Collins, J 1982

(8) Daily Telegraph, November 15 2002

(9) Daily Telegraph, November 14 2003. Also see article on ‘Peter Simple’, Daily Telegraph October 24 2005

(11) See European Voice, May 11 2006, Financial Times and FT Deutschland May 19 2006

(12) Anderson, phone interview May 24: ‘The temperance message does not need to be bundled up with the public health message. I think this is a problem that has surfaced but this report was written by people who are not temperance people but public health people who are independent.’

(13) On Liberty, Oxford University Press 1998, page 99

(14) Ibid, page 112

(15) Draft commission report on health, social and economic impact of alcohol obtained by author, conclusion 13, recommendations VI 1 & 3

Spiked

Anatomy of a binge

Happy feeling is toxic effect of alcohol on brain

Here's what can happen in a ''power hour'' - that first hour of a 21st birthday celebration in which young adults try to consume 21 drinks between midnight and 1 a.m.

Ethanol, the chemical in alcoholic drinks, depresses parts of the brain, one after the other. First go those pesky emotional things like inhibitions that make you cautious and tame. Then it hits your speech centers, making you slur, and the neurons that tell your muscles how to walk, making you stumble.

Finally, when you've drunk enough fast enough, it shuts down the deep part of the brain that controls your lungs and your heart.

''If they didn't vomit, it would probably kill them,'' said James Rothenberger, a professor of epidemiology at the University of Minnesota. ''That's a strange way to celebrate their 21st birthday.''

To members of Alcoholics Anonymous, who first coined the term, a drinking binge is a big chunk of time - like a week or weekend - lost to the state of drunkenness. Researchers define a binge as when someone has five or more drinks at a sitting. It could be an hour, or it could be eight hours, even though someone who has five drinks in eight hours is not likely to be dangerously drunk, Rothenberger said.

By whatever definition, high-risk drinking is a problem. The University of Minnesota recently reported in 2005 about 45 percent of students age 18-24 reported at least one binge-drinking episode in the previous two weeks. That's an increase from 40 percent in 2004.

Rothenberger teaches an online course at the university called ''Freshman Survival Skills,'' which, not surprisingly, has several sections devoted to alcohol and binge drinking.

He said a lot of young adults between 18 and 24 - the peak age for excessive drinking - don't believe alcohol can kill. They've seen too many people pass out from drinking, then wake up with just a bad hangover. Those news stories about young people who died from alcohol poisoning? That happens to other people.

His online course, which is taken by about 10 percent of freshmen, provides a detailed explanation of what alcohol does to the body.

Alcohol works fast. A little is absorbed almost immediately through the small capillaries in the mouth. Twenty percent of the alcohol one drinks is absorbed in the stomach. At the same time, ethanol increases the amount of hydrochloric acid released into the stomach, which might make a drinker feel lousy. Food - especially milk, protein and fatty foods - reduces the rate of absorption by about half.

Drinking too much too fast results in throwing up. That's because an excessive amount of alcohol in the stomach makes the valve that connects to the small intestine get stuck. The irritation and distress gets worse until it's time to kneel before the ''porcelain god.''

The rest of the alcohol gets into the bloodstream through the small intestine. Drinking wine coolers or other fizzy drinks with carbonation results in absorption happening faster and getting drunk faster.

The liver is the body's garbage collector, and it's put to the test when one drinks. It removes 95 percent of the alcohol from the bloodstream, breaking it down into carbon dioxide and water at a rate of about one drink per hour - unless the drinker is female or Asian. Women metabolize alcohol more slowly, and Asians often carry a gene that makes it harder to metabolize alcohol.

People have different tolerance levels for alcohol, Rothenberger said. The number of drinks needed to reach the legal limit for driving can vary among people of the same size and gender.

That feeling of being drunk is a result of ethanol's depressive effects on the brain. It slows the central nervous system that includes areas of the brain that control heart rate and breathing, as well as motor control.

If a person had between one and two drinks in an hour, he would start to feel relaxed and loosen up. This is when inhibitions go on vacation.

After two to four drinks in an hour, deeper levels of the brain are affected. Speech becomes slurred. Walking becomes difficult. Here is where drinkers start to lose judgment. This is the danger zone for driving. Whether a drinker knows it or not, he could start getting obnoxious.

At five drinks per hour, speech slurs and dancing is out of the question. At 10 drinks in one hour, emotions become erratic, perhaps swinging from happy to an emotional wreck in moments.

Beyond this point, any more alcohol can shut down the part of the brain that controls the lungs and heart. If that happens, you die.

Effects for men

-They have more water in their bodies, which dilutes alcohol.

-They are generally bigger and it takes more alcohol to affect them.

-They have more of the stomach enzyme that neutralizes alcohol before it's absorbed through the small intestine.

Effects for women

-They have more fat and less water in their bodies, which means that alcohol is more concentrated in their bodies. It also sticks with them longer.

-They are generally smaller, which means it takes less alcohol before they feel the effects.

-They have less of the stomach enzyme that neutralizes alcohol before it gets to their digestive tract.

San Angelo Standard-Times

'One in eleven children have alcoholic parents'

One in eleven British children live with parents who misuse alcohol, a shocking report claims.

A leading social care organisation said alcoholism is having a devastating impact on families, yet it is "hidden and ignored."

The charity Turning Point has launched a campaign demanding the Government examines the effects of parental alcohol abuse and give greater support to the youngsters involved.

Their report found youngsters affected often struggle to make friends, take the burden of caring for siblings and are more likely to express anger through anti-social behaviour.

They spoke to young victims of alcohol abuse to highlight the launch. Fourteen-year-old Danny said: "I just had enough one day. I went to town, nicked a few things and got done by the police...part of me did it just to see if my parents would be bothered."

Jessica who is 15 explained: "I worry sometimes that something is going to happen to my mum or dad and I don't know what I'd do. What happens if they are poorly? What happens if they don't come back?"

Turning Point's Chief executive Lord Victor Adebowale said alcohol abuse was a national problem which was being ignored. "The Government has started helping children affected by their parents' drug misuse but we estimate there are five times as many children affected by parental alcohol misuse," he said.

Liberal Democrat health spokesman Steve Webb said: "The support currently provided to the 1.3 million children whose parents misuse alcohol is wholly inadequate. These children are at increased risk of domestic violence, family breakdown, and behavioural problems."

However, a spokesman from the Department of Health defended their record: "We are working hard to get more people into treatment and are already spending an estimated £217million a year on alcohol treatment," they said.

Daily Mail

Children charged with drink-fuelled crime soars

The number of children charged with alcohol-related crimes has rocketed in the Lothian and Borders, new figures reveal today.

And the number of youngsters allegedly caught in possession of illegal drugs jumped by nearly 40 per cent in only two years.

Campaigners today branded the escalating problem "alarming" and called for tougher action to tackle young criminals.

But police say operations targeting underage drinking by its Youth Action Teams and new ways of recording crimes could also be behind the steep rise.

The figures show the number of children under the age of 16 charged for criminal offences while under the influence of alcohol soared by more than 150 per cent in the past year. The kind of crimes being committed range from violence to sexual crimes and theft.

The news comes as figures also revealed that the number of juveniles charged with drug dealing actually fell for 2005/06, with 18 youths aged between 12 and 15 caught by police for supplying.

The figures, obtained by the Evening News under the Freedom of Information Act, represent a drop of almost two-thirds against the previous year when 49 school-age dealers were arrested.

Violent crime cases rose to 153 from 138 last year, but still fell short of the previous year's figure of 215, while sexual-crime charges fell by almost half from last year's total - from 90 to 48.

Campaigners said the statistics on drink and drug crime reflected trends being seen in society.

Tom Wood, chairman of the Edinburgh Drug and Alcohol Action Team, said: "I do not find these figures surprising. They reflect the increased use of drugs and alcohol among young people. It's disturbing but that is what we would expect to see. Most offences will probably be minor, such as breach of the peace, but others will involve violence and assaults while under the influence.

"That is why our priority with the action team is to tackle the problem of children using drink and drugs."

The figures show that 371 cases involving crimes related to alcohol were passed to the Children's Panel between April last year and March 2006. In the same period the previous year, 146 cases were reported and only 61 for the year before.

The number of children between eight and 15 years old allegedly caught with drugs leapt from 106 in 2004 to 145 this year.

SNP justice spokesman Kenny MacAskill said: "These figures are alarming, but also depressing, and show why we need to look at problems in the family backgrounds.

"Their offending relates as much to the environments they are growing up in as it does to any inner drive or malice on their part. But we have to recognise that many of these children come from troubled families."

In March, it was reported that the number of teenagers seeking help for drug problems had fallen to a five-year low in the city - sparking fears more are abusing alcohol instead.

Ewan Aitken, city education leader, said: "I think the reason for the rise can be partly explained by the success of the police in targeting drinking among youngsters.

"But I'm also aware that there is a serious issue over alcohol and children. Part of that has to be dealt with through education, but also through having positive adult role models. We can say what we like in schools, but if adults are spilling out of pubs and committing crimes then that is sending out the message that this behaviour is acceptable."

A police spokeswoman said: "There have been changes in the way we have recorded figures to include drugs and alcohol in reports to the panel where it may not have been mentioned before.

"There has also been proactive approaches by the Youth Actions Teams and others focusing on youth issues which may have led to more arrests. The rise may be due to a combination of these factors because, anecdotally, the number of children involved with drink and drugs remains relatively static."

A 2005 study which questioned 7000 13 and 15-year-olds in Scotland, found that a third of all 15-year-olds and 11 per cent of all 13-year-olds reported that they had used drugs in the last year.

Scotsman

Who has a drinking problem?

Few individuals from every walk of life like to admit they are having trouble with alcohol. Every natural instinct cries out against the idea of personal powerlessness. “Not me,” they say. “That is not what’s the matter with me.” It is their job that is the problem, their family life or their health. There is always a scapegoat.

For most people, to admit that they are alcoholic is a deadly term, conjuring up images of weak willed, vagrant type people or any of a variety of types they are not proud to be. Their picture of the alcoholic is so ugly, so different from how they see themselves, that they have a good excuse to go on drinking.

Every member of Alcoholics Anonymous understands this type of thinking. Why? Because almost every member once entertained the same idea. They have learnt that denial is a symptom of the disease of alcoholism. It is described as a disease by the American Medical Association and the British Medical Association.

Few individuals with a drinking problem, however, care whether they have a disease or not, they just don’t see how they can give up alcohol which they feel has sustained them for so long. Giving up alcohol, they believe, is like giving up something they cherish very much. This too is part of the problem.

People from a wide variety of backgrounds in AA share how they came to groups with their common problem and how fruitful their lives have become since they became members of Alcoholics Anonymous.

The experiences shared illustrate that alcoholism comes in many different forms and in a variety of disguises. There is no such thing as being too young to be an alcoholic, or too old, or too different, or too special.

It is important to bear in mind that alcoholism is not determined by where you drink, when you started to drinking, how long you have been drinking, with whom you drink, what or even how much.

It is what alcohol did to you that counts. If it has affected your relationships with your family, friends, employers; if it has affected your health; if it determines or affects your non-drinking moods on your state of mind; if you are in any way pre-occupied with alcohol then the possibility exists that you have a problem.

The illness called alcoholism can strike a person of any rank, any age, any race, any social or educational background. The blackouts and the shakes, delirium tremens, loneliness and fears are the same. The shared experiences of active alcoholism at AA meetings make up a bond among all members of Alcoholics Anonymous. “I know what you are going through,” everyone of them can say to a newcomer. “I have been there, I remember what it felt like.”

Most AA members are very competent, intelligent and attractive people. They are not bums or losers.

Their only problem is that they have lost the ability to control their drinking. They have learnt to change their lives. They are not merely abstaining from alcohol and staying dry. Through the AA programme of recovery summed up in the Twelve Steps they are learning a new and satisfying way of life and growing as human beings.

Alcoholism is a treatable illness, an illness that Alcoholics Anonymous can treat. One suffering from it can never return to social drinking. The allergy is present for a life time, but with AA there is no fear about it.

One does not have to hide from alcohol or avoid normal drinkers. One need only to be on guard against the first drink always, as long as life lasts. AA’s say cheerfully. “Don’t take the first drink, and you will never take another” the saying goes “One too many, but 20 is not enough.” This is possible one day at a time.

AA’s keep close to the presence of God and through this closeness the many problems that once tore down every department of their lives are finally solved and rebuilding goes on almost effortlessly.

Trinidad and Tobago Newsday

Battling back to give fresh hope to others

It almost ruined his life but Irishman Dick F is determined that by telling his story he will save others from the same fate.

Having overcome a lifetime battling the destructive forces of alcohol Dick F now dedicates his time to helping other people throughout Ireland and Britain beat their addiction.

The Limerick man travels back and forth from Britain to Ireland giving speeches at AA meetings. And he is heavily featured on a special DVD that is shown to alcoholics in detox centres and support groups across the country.

“I just hope that by telling my story, it helps other people realise that they are not beyond hope or help.

“Since my move to Britain in 1955, I faced a perpetual battle to remain sober.

“My entire existence revolved around the pub.

“Booze did something for me that it didn’t do for other people.

“Booze was the answer.

“At my lowest point, I spent time in prison and slept on park benches. I heard myself described as a dosser, tramp, vagrant and parasite.”

Shunned by society and demonised by those he came into contact with he finally sought help from Alcoholics Anonymous (AA). It was the first step on the long road to sobriety.

He said: “The great thing about being at the bottom of the ladder is that I couldn’t fall off. I could only start climbing up. They told me I wasn’t a bad person trying to get good but a sick person trying to get better. Alcoholism was a disease and not a disgrace. AA gave me a message of hope. I was told to take big spoonfuls of it. I couldn’t overdose on it and it wouldn’t kill me.”

Today Dick embodies the hope that was conferred on him by his encounters with AA.

He believes he has been given a second chance to help those suffering from the same disease he has spent so much time trying to overcome.

And although he admits that it is a difficult journey, he is resolute in his belief that all alcoholics can get over their addiction.

He said: “Don’t take the first drink, get to a meeting.

“If you think drinking is costing you more than money seek help. If I can be helped anyone can. There are no hopeless cases.”

The Limerick man still faces a lifelong battle with alcohol but with the help of AA he is equipped with the tools for success.

He said: “No matter how long I am sober I am still one drink away from the worst day of my life. The sniper is still on the roof. He is still aiming to get me. So, I put my sobriety before everything else.”

Irish Post

Alcoholism boosts risk of severe pneumonia

People who abuse alcohol are at elevated risk of developing a serious case of pneumonia, new research shows.

In a study of more than 1,300 Spanish adults who were hospitalized for pneumonia, researchers found that those who were alcoholic were more likely to suffer a severe case of the lung infection.

Alcoholic patients were also 10 years younger, on average, than patients with no history of drinking problems - 58 years old, versus 68. Older adults are more likely to develop and die from pneumonia, which is why experts recommend that people age 65 and older receive a pneumococcal vaccine.

The new findings underscore the importance of vaccinating alcoholic adults as well, Dr. Antoni Torres of the University of Barcelona told Reuters Health.

Pneumonia is an inflammation of the lungs that can be caused by various bacteria, viruses or fungi. The pneumococcal vaccine protects against infection with Streptococcus pneumoniae bacteria, which in the U.S. causes an estimated 500,000 cases of pneumonia and 40,000 deaths each year.

In the current study, published in the journal Chest, both current and recovering alcoholics were more likely than other patients to have pneumonia caused by S. pneumoniae infection.

Current alcoholics, though, were both younger and tended to have more severe pneumonia, more often suffering symptoms like chest pain and breathlessness when they were admitted to the hospital.

Alcohol abuse is believed to make people more vulnerable to pneumonia due to its effects on the immune system. The current findings, Torres and his colleagues conclude, "strongly support" giving alcoholics the pneumococcal vaccine and, if they develop pneumonia, admitting them to the intensive care unit sooner.

Reuters

Schuckit Addresses State-of-the-Art Addiction Treatments

Marc Schuckit, M.D., professor of psychiatry at the University of California, San Diego, School of Medicine, examined recent developments in the treatments for alcohol and drug dependence, and examined important changes in DSM-IV's classification of substance use disorder at the 11th Annual U.S. Psychiatric & Mental Health Congress.

Schuckit, who is also director of the Alcohol and Drug Treatment Program at the San Diego Veterans Affairs Medical Center, explained that the DSM-IV defines substance abuse dependence according to the following criteria: 1) tolerance; 2) withdrawal; 3) larger amounts of substance used/longer period of use than intended; 4) inability to or persistent desire to cut down or control use; 5) a great deal of time spent obtaining, using or recovering; 6) important activities given up or reduced; and 7) use despite problems caused or exacerbated by use.

To properly diagnose an alcohol or substance use disorder, Schuckit said the physician should reflect on the following questions: Does the patient have problems in three or more of the criteria listed above? Did these problems cluster together? Did they come together within approximately a year's time? Another means of diagnosis, he noted, is recognizing physical changes, as the bodies of people who have been taking high enough doses of a substance over a long enough period of time develop symptoms that are the opposite of the acute effects of the substance.

Detoxification

The key to any detoxification treatment is still a good physical exam, said Schuckit, since the chances are high that detoxification will be more difficult for anyone who is physically debilitated. After a thorough exam, the physician should have the patient follow up with proper rest and nutrition, a methodology known as social model detoxification without medication.

Medications and detoxification programs, Schuckit said, are only appropriate for the depressants (alcohol, benzodiazepines and barbiturates), the stimulants (amphetamines or cocaine in any of their respective forms) and the opioids (heroin, any other prescription pain pills or methadone). "You don't detox people for cannabinols, you don't detox people for hallucinogens," he said.

After detoxification, rehabilitation is crucial, said Schuckit. It increases a patient's functioning while minimizing the chance of relapse, he explained. It helps people with a chronic disorder rebuild their lives without substance use, and helps them stay focused and motivated. Schuckit pointed out that a similar approach to rehabilitation is used when treating any other type of chronic disease, such as diabetes or hypertension. The physician would try to get the patient's motivation high and help them change their lifestyle. "Alcohol and drug dependence are just other examples of chronic disorders," he noted.

Alcohol Rehabilitation

According to Schuckit, the majority of physicians who work in the alcohol abuse field agree that the best medications for this disease are the depressants, which are considered the safest and most inexpensive among the three classes of drugs. Among the depressants, the safest and the cheapest are the benzodiazepines, he said. "Either a longer-acting or shorter-acting benzodiazepine can be used; there are complementary assets and liabilities."

There is no reason to carry out alcohol detoxification with anything other than a benzodiazepine, Schuckit stressed. Carbamaze-pine (Tegretol), valproic acid (Depakene) or gabapentin (Neurontin) are no better, they cost more and they are more dangerous than the benzodiazepines.

As far as new medications for alcohol abuse, Schuckit considers acamprosate (Campral) an interesting drug because of its strong effects on glutamate and NMDA receptors, and because it has only a mild effect on gamma receptors. "It is not clear which, if any of those effects, is contributing to the outcome in alcohol dependence." He also advised that acamprosate, although not currently marketed in the United States, will most likely be marketed here within the next year or so.

In 12-month trials, a large number of people were given acamprosate at a dose level between 1,300 mg/day and 2,000 mg/day. All trials except one indicated a slight but statistically significant higher proportional decrease in the amount the research participants drank when on acamprosate. Schuckit noted that acamprosate doesn't negatively interact with alcohol if a patient resumes drinking.

Another medication Schuckit recommends for alcohol withdrawal is naltrexone (ReVia), a pure opioid antagonist. Naltrexone, which has been around since 1984, is also used in opioid treatment. Schuckit said that the selective serotonin reuptake inhibitors (SSRIs) still need more data. He is "not quite so sure they're going to show up very well [in studies]."

Project MATCH

Results of Project MATCH (Matching Alcoholism Treatment to Client Heterogeneity) were published in the January 1996 issue of the Journal of Studies in Alcohol (58[1]:7-29). Schuckit noted that Project MATCH investigated an aspect of rehabilitation that most clinicians believe to be true: if the most important characteristics about each patient can be identified, physicians can assign them to the most appropriate treatment option.

By looking at 10 primary matching variables and 16 contrasts of almost 2,000 previously specified alcohol-dependent individuals, investigators formulated a hypothesis of how these characteristics might relate to three different treatment modalities, he said. One emphasis was a 12-step facilitation approach, e.g., Alcoholics Anonymous (AA), in which the patient is responsible for his own actions, has to rebuild his life, get in touch with other people and recognize that he's not in control. The second emphasis was the behavioral or cognitive approach, also known as cognitive behavioral coping skills therapy, in which the patient has to know where his relapse triggers are and how to head them off. The third emphasis was motivational enhancement therapy-a kind of talking, psychological therapy, explained Schuckit.

After one year, with a follow-up that exceeded 90%, Project MATCH found that the proportion of people who were clean and sober a year later was roughly in the 50% to 60% range. "And that is quite good," said Schuckit. "In fact, all the programs did very well. So the good news was that [it demonstrated] there was no essential level of matching that was required."

Stimulant Rehabilitation

"Stimulant withdrawal is just awful, because you feel depressed, you can't concentrate, and you eat and sleep too much. But, when it gets right down to it, there are basically no medications that are helpful," Schuckit said. So what's the state of the art regarding stimulant withdrawal? he asked.

In recent years, there have been studies regarding medications for stimulant abuse that made great sense, Schuckit commented, but what makes great sense isn't always good or correct. "In stimulant intoxication, people are mixing up their dopamine receptors like mad. So [a physician might ask] why not give a patient a dopamine receptor agonist during withdrawal like Ritalin [Methylphenidate], or drugs that affect the autonomic nervous system such as clonidine [Catapres]?" Because, he answered, there just aren't enough convincing data regarding them yet.

Opioid Rehabilitation

"There's nothing much new regarding opioid rehab," said Schuckit. "Methadone is still the state of the art [in treatment]." However, Schuckit explained, most states lock physicians' hands regarding opioid withdrawal because of the special license needed. "So if people come in who are physically dependent on heroin and they're already on methadone, physicians have it made."

Ultimately the optimal treatment for opioid withdrawal is an opioid, said Schuckit, "but it's illegal to prescribe an opioid for opioid withdrawal in California and in most other states." Thus, Schuckit recommends treating the symptoms with symptomatic medication, such as a decongestant for a runny nose, Imodium (loperamide) for diarrhea, or clonidine for nervousness and autonomic dysfunctions, such as skin crawling-type sensations.

Naltrexone has been used for many years for opioid withdrawal but, according to Schuckit, 90% of patients on the street who come in for opioid dependence treatment and are put on naltrexone stop taking it within a month or so. "They just don't like it," he said. "The opioid blockers aren't doing anything for longer-term mild withdrawal symptoms. [In fact,] they may even be making it worse. So I don't find them very useful for the average patient. However, send me someone who is highly motivated to stay off opioids, and naltrexone would be something I would recommend."

As there is a 20% to 30% spontaneous remission rate for all drug dependence, including opioids, it is difficult to properly evaluate the efficacy of treatments, said Schuckit. "Take 100 people, alcohol or drug dependent, turn them loose and follow up 10 years later, about 20% to 30% of them will be clean and sober without treatment. This is also without AA or NA [Narcotics Anonymous], and they will be clean for years," he said. "So with dependency, there's a lot of fluctuation."

DSM Criteria Progress

Careful reading of DSM-III-R and DSM-IV, said Schuckit, is likely to reveal that the approach to substance-induced disorders has not changed remarkably. However, DSM-IV is much more explicit about how to apply these criteria in clinical situations. In addition, the revision of the structure of DSM-IV facilitated the incorporation of warnings regarding the need to be certain that the clinical syndromes of anxiety, confusion, depression and so on are not substance-induced.

"There has been progress in substance abuse criteria," said Schuckit. "DSM-IV split off abuse [and dependence] into [separate] criteria that…can now be studied." In addition, Schuckit noted, DSM-IV took a major step in acknowledging the potential importance of dependence in tolerance or withdrawal.

"DSM-IV simplified the approach to criteria for substance use disorders by basically incorporating the diagnostic criteria for dependence already existing in DSM-III-R," said Schuckit. "As a result, the criteria for dependence are now similar in both the International Classification and the DSM systems. However, since the criteria for abuse in DSM-III-R and harmful use in the International Classification DSM approach were found to be unreliable in a field, new, reliable criteria for abuse are presented in DSM-IV," he noted. "Future research will be required in order to establish the predictive validity of these diagnostic items."

Psychiatric Times

Last orders for the lunchtime pint

Is the lunchtime pint facing extinction? Only a minority of companies now allow staff to drink during the working day.

It's a sunny Friday lunchtime, the kind of weather that brings on a thirst for a long, cold drink.

After a week spent hunched over a computer monitor, it's easy to feel like the dust-encrusted, thirst-crazed soldier who's driven across the desert in the classic film Ice Cold in Alex.

You can almost see the condensation running down the curves of a pint, the sun glinting on a wine glass...

But hold on. Re-wind the tape, because that lunchtime pint - a cultural tradition in its own right - is disappearing. A survey from law firm, Browne Jacobson, says that 57% of businesses now ban drinking during the working day.

There have always been drinking restrictions on safety-sensitive jobs, such as anyone driving or operating machinery, but now the booze ban is being extended much more widely.

In many parts of the country, particularly outside London, an even higher proportion of companies don't allow staff to drink. In the West Midlands, the survey says that 75% of businesses don't allow drinking during the working day.

Liquid lunch

"If you'd carried out such a survey 10 years ago or more, it would have been a much lower figure," says employment lawyer at Browne Jacobson, Peter Jones. The trend has been driven by a combination of changing attitudes to alcohol - and a fear of litigation among employers.

"If you went out for a business lunch, it would once have been unusual if you didn't have a drink. Now it's more likely to be a round of fizzy water and fruit juice," says Mr Jones.

Drinking no longer seems to fit with a professional image.

"Would you want to pay good money to speak to a lawyer who is reeking of ale?"

And companies have also become increasingly concerned about the risk of litigation if their staff have been drinking.

Booze blues

Among the employers that has switched to a non-drinking policy is Brighton and Hove Council.

"It was quite simple really - the council didn't want front-line staff smelling of alcohol when they met the public," says council spokesperson, Alan Stone.

And within council departments, they didn't want managers to deal with staff after they had been drinking.

The ban, which extends to staff attending council functions in the evenings, has not met with opposition, he says, as few staff would have wanted to drink during working time.

But isn't this too Big Brother-ish - with an employer intruding onto the private life of staff? Not really, says the council, because the effects of drinking alcohol will spill over into work time.

And employees cannot refuse to comply with contracts which include such a ban, says Mr Jones. "There is no human right to alcohol." And in future, smokers could face employers who will make clear that there is no "right" to a cigarette break.

"It's not about a draconian measure. It's just that society is changing - and it creates different pressures at work and it changes people's behaviour."

'I'm in a meeting'

But there are signs of a more interventionist approach towards how employees behave outside work; the survey shows that 28% of employers use contracts requiring staff to take drug tests if requested.

Those wanting to stop daytime drinking can point to the health and economic costs. The Medical Council on Alcohol says that alcohol misuse costs industry £3bn a year through accidents, impaired productivity and absenteeism.

But lunchtime drinking isn't just about consuming alcohol, it's about the social side of working together, says the Campaign for Real Ale.

"There should be nothing to stop colleagues from being able to go to a pub and enjoy a meal out of the office, particularly as in many cases this is the only opportunity staff from different departments get to chat," says Camra spokesman, Owen Morris.

And he rejects the implication that a lunchtime swifty is somehow the same thing as drinking at work. "There is a distinct difference between visiting the pub at lunchtime and drinking during working hours."

Crumbs on the keyboard

But adding to the pressure on the long, lugubrious lunchtime drink is the threat to lunchtime itself.

The traditional 60-minute break has shrunk to an average of 19 minutes, according to a survey in January, so that lunchtime is more likely to be the grim prospect of sandwich crumbs on a keyboard than a relaxed glass of wine.

The TUC says that employees in the UK have the longest working hours in Europe - and have warned of the high levels of ill-health and stress from this long-hours culture. Binge working as well as binge drinking can be bad for your health.

But what about the other losses from the disappearing lunchtime drink? All that creative thinking, team bonding and backstabbing? There must be more to work than working.

There are below-the-radar indications that not all office workers are impressed by the alcohol equivalent of the hosepipe ban.

There's an internet page doing the rounds which lists the benefits of workplace drinking, including "more honest communication", "making colleagues look more attractive" and "giving you a reason to show up at work".

Long hours, corporate claptrap, stuck at a computer screen all day, it's enough to drive you to ...

BBC News Magazine

On saying a firm ‘no’ to alcoholism

Visakhapatam: Are you a tippler and want to give up? The right place may be ‘Alcoholics Anonymous’.

Alcoholics Anonymous is a voluntary body formed by two former alcoholics in the United States of America in 1935, to gather drinkers and reform them.

The motto of the organisation spread to Mumbai in 1957 from where it branched out to all parts of the country.

Three habitual drinkers started it at S Kota in Vizianagaram district in 1991 and since then the outfit has spread to Visakhapatnam, Viziangaram and Srikakulam.

The Alcoholics Anonymous group helped many abandon drinking and lead a ‘sober’ life after 1998 when the outfit was formed.

In the clandestine meetings conducted by Alcoholics Anonymous, the tipplers assemble at a place and vow to desist themselves from drinking.

The alcoholics also discuss the troubles being faced by them in their professions, families and social circles, financial concerns and health-related activities.

Alcoholics, who quit drinking on oath, embrace the habit again after a few days and inconvenience the family as usual.

All such persons can become the members of Alcoholics Anonymous.

Another group of Alcoholics Anonymous, Punarjanama AA group, was started at Dandu Bazaar last year. This group will celebrate its first anniversary and also the golden jubilee of Alcoholics Anonymous (India) on May 13.

Newindpress

Alcohol Concern Manifesto 2006

Alcohol Concern's Manifesto sets out 10 Actions Local Authorities can take to reduce the harm caused by alcohol within their local communities. We want to ask Candidates and Councillors of all political parties to sign up to implementing these to help move us towards a society where problem drinking is effectively tackled at an individual and community level.

Why should alcohol misuse be a priority? Because it is a priority for local people is the simple answer

Alcohol misuse costs the lives of around 22 000 people each year, up to 1.3 million children live with parents who are problem drinkers and around half of violent crime is alcohol fuelled. Yet the most recent figures suggest that only 1 in 18 people who need alcohol treatment are able to access it.

Alcohol misuse doesn’t just affect those who drink it also affects the way local communities feel about the place they live in a very real way. 1 in 4 people say that drunk and rowdy behaviour is a problem in their neighbourhood whilst 52% think that alcohol related crime is on the increase.

We believe that Local Authorities can help to reduce the human cost of alcohol misuse and the burden it poses to public services and we have drawn up a list of ways in which they can use their powers and resources to tackle the wide range of harms caused by alcohol misuse.

Please sign up to implementing our manifesto for action and play your part in reducing the harm caused to individuals, families and the whole community in your local area.

10 steps to reduce alcohol related harm

1 Identify the support needs of local populations, including vulnerable groups (for example homeless populations and those with mental ill health)

2 Work with colleagues in Health and Criminal Justice to draw up a local alcohol strategy

3 Set stretching targets for reducing alcohol related harm suffered locally

4 Review local alcohol services which are provided after the publication of Models of Care for Alcohol Misuse (a framework against which to commission effective, quality services)

5 Provide a full and diverse range of services for those who need them

6 Supply better information for problem drinkers so that those who need help know how and where to get it

7 Involve service users and their families in shaping services

8 Use Health Scrutiny Powers to ensure that local Primary Care Trusts are giving sufficient priority to alcohol

9 Crack down on unscrupulous traders to reduce underage sales

10 Work with local licensees to develop agreements on good practice

Alcohol Concern

Alcoholics Anonymous to hold programme

Margao, May 10: Though alcoholism, termed as a progressive disease, is said to have no cure medically speaking, Alcoholics Anonymous or AA is working full throttle towards helping thousands bid good bye to the bottle that has kept them hooked.

The Alcoholics Anonymous Inter Group, Goa, having 59 groups across the state and over 20,000 recovering or sober alcoholics is celebrating its golden jubilee in India and the 29th anniversary of its Cansaulim group by organising a special commemorative programme on May 14.

Alcoholics Anonymous, a worldwide fellowship of men and women from various walks of life having very little other than alcoholism in common was started in Ohio in 1935 and has over 22 lakh members in India alone.

According to AA members, the organisation is spread across 180 countries and portrays a remarkable unity of people who are bonded together by a set of traditional principles having no legal force at all.

It is another great occasion of AA in Goa as the Cansaulim group affiliated to the South Goa intergroup and one of the oldest group in the state that was started by the late Walfredo A from Arrosim-Cansaulim, who was instrumental in spreading the message of AA. The celebrations will be graced by former minister and Cortalim MLA, Mr Mathany Saldanha, Verna police inspector, Mr Nolasco Raposo along with Dr K R Kamath. A few AA birthdays will also be celebrated on the occasion.

Members referred to by special code names like ‘Roque D’ say that after visiting the doctor (the last possible thing that they do) alcoholics are warned against drinking. The de-addiction through medication normally depends on withdrawal medicines to help alcoholics recover from their drinking problem. However there is no guarantee and this leads the patient back to drinking.

“It is here that AA comes in handy. Using our group therapy we sensitise alcoholics leading him away from the bottle,” said an AA member. Attending these AA sessions, where real life experiences are shared, are a real help in leading to a sober and meaningful life.

AA then adopts its renowned 12-step method of recovery supported by regular group meetings and peer support. The programme is free of cost and supports itself through contribution from members. AA also does not accept contributions from non-members, though within the fellowship it does accept a limited membership fee.

A convention includes speaker meetings, a marathon session, new-comers workshop and Al-Anon participation. AA also has special groups for the children and wives of alcoholics.

In South Goa AA members on every Wednesday visit the detoxification centre atop Monte Hill in the T B Sanatorium premises to conduct a fellowship programme.

Also a look at the list of inter-groups indicates that an overwhelming majority of these groups operate from chapels or churches, although only the decided programme would be followed without any religious preaching.

“We are one here not bound by religion,” said an AA member adding that members simply say no to a drink one day at a time, sobriety is maintained through sharing experience, strength and hope at group meetings.

NT News Service

What wrecks the liver? Double Scotches and doctored herbs

Liver disease is on the rise and alcohol is the villain. But there can be other causes. A visit to an old-fashioned bar late in the evening often reveals lonely drinkers with only a glass for company. Neither obviously drunk nor obviously sober, they knock back their drinks twice as quickly as the average customer.

When such a drinker lifts his glass, his hand is likely to have an alcoholic shake — a rapid tremor. Furthermore, his nails will no longer be a healthy pink but slate grey. Often the fingers beneath the base of the nails will be swollen so that in profile they look like a parrot’s bill.

The palms of the hands will be as red as raw liver, their colour emphasised by a clear line between the red palm and the relative pallor of the back of the hand.

The arms will be red and so, too, will the face, the latter as a result of swollen veins; dominant red blobs with spidery legs protruding from them. And the face may be puffed out like a child’s caricature of a chipmunk, for heavy drinkers develop swelling of the parotid glands under and around the ear (these are the glands that swell up with mumps).

If he has been overdoing alcohol for too long he may be losing weight even though his girth is enlarged, with a loose collar but a waistband to rival that of John Bull.

Mercifully, while the drinker is at the bar his chest and abdomen will remain covered — but if they weren’t, an observer might notice his wasted arms and legs and the absence of hair in his armpits. Likewise, the drinker’s other primary and secondary sexual characteristics would have shrivelled — though, paradoxically, whether male or female, the breasts would be enlarged.

Our imagined heavy drinker is showing the obvious signs of advanced liver disease. The incidence of liver failure has risen sevenfold in the 40 years from the beginning of the 1960s to the end of the 1990s, with a 34 per cent rise since 1997. In February this year The Lancet revealed that UK figures for liver failure showed the steepest rise in Western Europe. In the UK and Ireland the worst statistics came from Scotland, followed by Ireland, then Wales and England.

Professor Roger Williams, director of the Institute of Hepatology at University College London, says: “The rise in death rates from cirrhosis of the liver continues. In the UK these statistics show a close relationship to the increase in alcohol consumption and contrast badly with those of other Western European countries.”

There are many causes of cirrhosis but, as Professor Williams emphasises, the most important in this country is excessive alcohol intake. He estimates that of the patients with liver failure whom he sees, more than 70 per cent have the condition for alcohol-related reasons.

Other common causes of cirrhosis are Hepatitis C and B, the metabolic syndrome and obesity (sometimes associated with diabetes) and various autoimmune diseases.

There are other, rarer, causes of liver failure. Few people realise that it can be a feature of anorexia nervosa, as was explained at a recent conference of European liver disease experts in Vienna.

The conference also heard about another occasional cause of the disease. In some parts of the world herbal remedies proffered as treatment for a variety of symptoms are contaminated. Anxious to get a speedy response, herbalists (not usually those working in the UK) may pollute natural remedies with mercury, other drugs and, above all, steroids.

Although any amateur medical sleuth can detect the signs of advanced liver disease in a heavy drinker at the bar, in the earlier stages of the condition — whatever its cause — there may be no symptoms for many years. Its presence and insidious progress is not always revealed by routine blood tests.

The first signs that a patient is likely to notice are an inexplicable weakness and weariness, loss of appetite, weight loss and a general feeling of being unwell.

The signs visible in the bar drinker are the result of changes in the testosterone/oestrogen balance. It is this that gives rise to the red palms, loss of sexual characteristics and female distribution of fat with loss of muscle.

The more dangerous changes are hidden from view. Varicose veins may be forming in the gullet and can cause a torrential bleed at any time. Liver failure may result in kidney and pancreatic malfunction, too — and eventually, because of the liver’s inability to act as the body’s detoxifying centre, unmodified chemicals may cause brain damage.

Times

U.K. Has Worst Anti-Social Behavior Problem in Europe

The U.K. has the worst problem with anti-social behavior in Europe, fuelled by alcohol and a lack of discipline in homes and schools, according to a study by the Jill Dando Institute of Crime Science at University College London.

The survey of 7,000 people in European countries including France and Germany found 76 percent thought Britain had more of a problem with anti-social behavior than any other country in the region and 83 percent of Britons thought the problem was growing.

Prime Minister Tony Blair's government pledged before last year's election to curb the crime, vandalism and drunkenness it blames for reducing ``respect'' on British streets. At the same time, ministers also relaxed pub rules, allowing bars to apply for round-the-clock licenses to serve alcohol.

``This research is a wake-up call,'' Gloria Laycock, an expert on crime at the Jill Dando Institute, said in a statement today. ``Increasing our access to alcohol cannot be the answer, and it is time that the government addressed perceptions of this problem.''

The government has taken steps to clean up the reputation of Britons abroad. In April, the Foreign Office said it would begin charging fees to aid citizens who get in trouble overseas.

Binge Drinking, Minors

The government and the Association of Chief Police Officers started its fourth Alcohol Misuse Enforcement Campaign yesterday to curb excessive drinking during the summer months. Police will be given greater powers to close bars and clubs that promote binge drinking or stores that sell alcohol to minors.

``This campaign is the next chapter in our drive to crack down on alcohol-fuelled crime and disorder,'' U.K. Culture Secretary Tessa Jowell said in a statement. ``The police now have tougher powers than ever to deal with the minority of drunken revelers and rogue licensees that act irresponsibly.''

British police are also appealing for good behavior from English soccer fans ahead of this summer's World Cup tournament in Germany. Assistant Constable Chief Steve Thomas of Greater Manchester Police will deploy 83 British officers to Germany this summer to help keep a lid on hooligans.

``The reputation should have been put to bed, but it takes a long time for a reputation like that to go away,'' Thomas told the British Broadcasting Corp. ``After Germany, people will finally realize it has gone away and start treating them as they should be, which is on the way they behave.''

Tougher Sentences

The survey also found that half of the respondents thought tougher sentences and punishment would help to cut anti-social behavior in the U.K.

The survey was conducted by TNS, a marketing consultant, in January among people between the ages of 16 and 64. No margin of error was given.

The Jill Dando Institute, which helped devise the study, was opened in 2001 on the second anniversary of the murder of Jill Dando, a BBC television presenter who was shot outside her home. The center aims to help reduce crime and boost detection by researching crime patterns.

Bloomberg

£4M drugs and alcohol strategy announced

The government has outlined its plans to tackle the problem of alcohol and drug abuse among young people in Northern Ireland.

The publication, which has been named the New Strategic Direction for Alcohol and Drugs (2006-2011) was launched today and a total of £4 million will be used to fund the first year of the five year strategy.

Commenting at the launch, a spokesperson for the Department of Health Social Sevices and Public Safety said: “This strategy will ensure that tackling the worrying growth in alcohol and drug misuse is made a priority. Research shows that 13% of young drinkers (11-16) have been drunk more than 10 times and 12% have tried cannabis.

“Through a wide range of programmes and activities designed to educate, treat and support young people, I am determined to combat the growth in the use of alcohol and drugs among this section of the community."

“Binge-drinking among adults also continues to be an on-going concern, with 48% of men and 35% of women reported having binged. In addition, alcohol and drugs misuse costs Northern Ireland society hundreds of millions of pounds each year and causes undoubted misery to many individuals, families and communities."

The new strategy contains a wide range of activities aimed at providing treatment and support to all problem users, as well as targeted education and prevention programmes.

4NI

Billy: I fell off wagon with bubbly

Billy Connolly has confessed that he almost hit the bottle again by celebrating an alcohol-free year with a bottle of champagne.

The comedian talked of his struggle with drink during a radio interview ahead of a series of shows due to open in New York tomorrow.

Connolly told how he nearly plunged back into the drunkenness that had plagued his early life by celebrating a year on the wagon with a gift from his wife Pamela Stevenson.

"I stopped for a year and she gave me a bottle of champagne and I was one glass into it and thought: this is a mistake, I was enjoying not drinking," he said.

"So I stopped again a month later and that was it, that was 21 years ago."

Speaking on the US National Public Radio (NPR) network, he also revealed it would take him days to recall the things that he did while he was drunk.

"I had two memories. I would get drunk and have blackouts, then I would remember the stuff from the blackout after a few days," he said.

"Then I reached the stage when I didn't remember, it didn't come back until I was drunk again. So I had this drunk memory and a sober memory.

"I was two people and that became very scary. I told my wife Pamela about it and she had a name for the drunk guy.

"When I came home as the drunk guy she could tell instantly. It would be one drink, two drinks and I would change completely."

Connolly, who is better known in the US for his performance in the sitcom Head Of The Class and for his big screen roles than his stand-up shows, said he was rarely sober before meeting his second wife, the psychologist and comedian, Ms Stevenson.

He said it was only at her urging that he decided to stop drinking.

Stevenson has since written two bestsellers about the former shipyard worker's complex mind and troubled upbringing.

In her 2001 book, Billy, she described how he would ask for alcohol at breakfast.

She also described how he once danced drunkenly with the chat show host Michael Parkinson in the middle of traffic in London's King's Cross.

But Connolly added that, despite his obvious drink problem, he never saw himself as an alcoholic.

"I'm a drunk but sometimes I feel strange because I didn't have all those hallmarks of the alcoholic. I didn't go to alcoholics anonymous and never had DTs, I never drank at home very much and didn't steal money to buy booze - I was just drunk all the time.

"I didn't need to steal, I had a lot of money and a lot of time, so I spent most of it drunk. I'm like the guy whose wife didn't know he drank until he came home sober one day.

"But I was such a fraud because I would say to myself that I had never been drunk on a stage in my life, which I thought was true but I must have been from the previous night.

"I've been to one therapy session when I went with a pal to some church hall. They were doing immense good but I would have felt a fraud if I had gone alone. I would have had to invent some stories to be as amazing as those guys and what they had come through."

Scotsman

I Tried to Blame Everyone and Everything

Hello, my name is Jean and I am a recovering alcoholic. I am one of the fortunate alcoholics who has lived to tell my story. But for the grace of God and the program of AA, I would have died.

I started drinking at a very early age and was very popular with my high school crowd as "the life of the party". I could always outdrink everyone who I was with. What started out as fun ended in living hell. My drinking continued through high school and into business college and then into the first law office in which I worked.

At that time, my drinking was fairly well under control; I was young, I had the stamina to get drunk every night and work every day and the vicious cycle went on and on. I really don't like "drunkalogs", so I will try to be brief and say: I was married several times, held very prestigious jobs, i.e.,working in various law firms, for a state Senator and a Probate Judge and the Lt. Governor's office. I had a beautiful home and a husband who I thought I loved at the time; and most of all, my beautiful children.

Well, this husband didn't love me as much as I thought; he did the right thing; he took my children, he booted me out of my beautiful home, and he divorced me. I STILL had not bottomed out. I could still outdrink anyone around; and by then, of course the blackouts had started.

Believe me, I tried to blame everyone and everything I knew for my drinking; the death of my child, the ex-husbands, etc. Everyone was responsible for my drinking except me. The blackouts were, in a way, a blessing. I don't want to remember some of those times.

Finally of course, the time came when I could no longer work; I had to have my daily fix of alcohol every few hours or so. My life was a total living hell. There were so many days when all I could do was look out my window to see if it was daylight or dark.

That, my friends, is something that no living human being would ever want to go through. Of course, eventually the time came when there was no money for apartment rent, or for anything, except the few dollars I kept back for my booze. Thank God for the final blackout -- I came to in a room with a quarter on the dresser in the room.

Thank God my family practiced "TOUGH LOVE". None of my family would allow me in their homes; this was bottom out time. I looked in the yellow pages of the phone book and found the number for AA.

Within minutes, a lady and gentleman from AA were there. Neither of them seemed shocked by the few things I told them. I was so sure my story was unique from anyone else's story. I was so sure I was unique. Little did I know but I was simply an alcoholic, one who was ready to do anything in the world to change my life.

These people took me in, carried me to my first AA meeting, and lots of other people started working with me and detoxing me. I have never been so sick, mentally and physically. But I learned after that, that even my worst day sober was better than my best day drunk. The liquor had stopped working for me. There was no more "high," or good feeling.

I would like to tell you that I stopped there, but after one year of sobriety, I decided I possibly could still be a social drinker. God, what a disaster. What I was always told in the AA program was that this disease is so very progressive, even when you are sober, and sure enough I lived to find that out. After my first or second drink, I went straight into a blackout. So my insane bout of drinking had started all over again.

I am so grateful to my Higher Power and to those that still believed in me, that I was one of the lucky ones who "made it back". It was so hard to walk back into that door of AA and start over and pick up a new chip.

But I did. To hell with false pride - I was ready to quit drinking. Otherwise, I was doomed for an insane asylum or death. I am happy to tell you that I have just picked up my 17 year sobriety chip. Never could I have made it alone. I have to have all of you, my brothers and sisters, to remind me of who I am, and that is, Jean, a recovering alcoholic who must take life one day at a time in order to stay sober.

There have been many setbacks in my life, but thank God I have not had to take a drink. Seems that this past year has been my hardest; I broke my back, lost a husband I truly loved, and had a complete nervous breakdown. But I STILL DID NOT DRINK.

Every day is like a new day to me now; sometimes I feel as if I don't quite know which direction I am going, but I know as long as I stay sober, the direction will sooner or later become clear. I have the privilege of being able to do some work in a detox unit, and its such a great feeling to share my experience, strength, and hope with another suffering human being.

I hope, in doing so that somewhere down the line, I may help just one person to find their way to the only program in the world that has worked for me; the program for the living, Alcoholics Anonymous. Thank God for Bill W. and Dr. Bob, our co-founders. Whatever would we have done had their paths not crossed.

I don't have everything in the world I want right now, but I do have everything that I need, and it has been proven to me by my Higher Power and the Steps and Traditions of this program and all the great people in this program, that this thing does work. There are many things I would like to change in my life, but I feel if it is meant for them to change, it will happen.

I do have my children back, with the exception of one child who is out there, and is a practicing "addict". There is nothing I can do for him, except pray. I have carried him to many meetings with me, so he has been exposed, and it is up to him as to whether he chooses to live or die. It is that simple. There is no in between.

I want to end by telling each of you, those of you who I don't know, that I love you. We share the same disease and we know what we have to do in life. We have a choice today. And isn't that wonderful? Some people with diseases don't have a choice. I have been given the gift of sobriety; I love life without alcohol; I enjoy so much drinking my coffee on my back steps and watching the birds in the morning; simple things that nobody else would think is that important.

I find that I can make clear decisions, even though they don't always have the outcome I would like. What more can I say? I am a grateful alcoholic whose name is Jean L. and every day is a new awakening, because I have been given another chance; and I must not let alcohol destroy my life.

That is the reason I have to stay active in this program and always remind myself of who I am, where I have been, and where I never want and don't have to,go again. There you for allowing me to share my story with you.

About Alcoholism

Teenage Kicks

Ian Cheveau looks at how children as young as 10 across the North West are turning to beer, spirits, cannabis, cocaine and even heroin

More than 900 children in Merseyside and Cheshire received treatment for drug and alcohol addictions last year.

The astonishing statistic includes a 14-year-old girl with a heroin habit and a 10-year-old schoolboy drinking alcohol and smoking cannabis.

One 12-year-old binge drinker is currently being treated after having her stomach pumped six times, to the point where her liver has been damaged.

Youth workers have broken the silence by saying substance misuse is becoming an increasing problem among the young across Cheshire.

And they revealed many of those affected are from well-off families, attending some of the region's best schools.

Drug and Alcohol Action Teams (DAATs) say they are continually reaching out to more and more youngsters.

Jason Grugan, of one of the DAATs, said: 'Cannabis and alcohol are the biggest problems - to see a young person using heroin and cocaine is, thank-fully, still rare.

'The numbers of young people being treated is increasing but that is mainly down to the fact services targeting them are successful.'

Figures from the NHS's National Treatment Agency (NTA) show that between April last year and February this year, 907 under-18s accessed drug treatment services across Cheshire and Merseyside.

One service for young people has treated 300 since July of young addaction, the UK's leading drugs and alcohol treatment agency, said: 'It's not just young people from deprived areas that are coming through, we are seeing more and more young people from wealthy backgrounds.'

Halton's DAAT saw 65 young people last year for drug and alcohol abuse, with neighbouring Warrington treating 117, while 220 under-18s accessed services in St Helens.

Nine young drug users in Knowsley, 120 in Sefton and 52 in Cheshire received help from trained advisers.

Many young people who turn to drugs are often involved in crime to feed their habits. However, as reported in the Weekly News, last week a Young People's Arrest Referral Service was established by Cheshire Constabulary.

The FRESH referral service will operate from the county's three custody suites at Run-corn, Chester and Middlewich.

Garry Shewan, assistant chief constable of Cheshire Constabulary, said: 'Young people represent 20% of our population but 100% of our future.

'What the criminal justice system has always wanted and needed is motivated, passionate people prepared to ask the question: 'Is there anything I can say or do to stop this young person offending again?'

'Court appearances may be the catalyst to get young people to ask for help and give them the right direction.'

ic Cheshire Online

Study Says Many Options for Alcoholics

Alcoholics who were motivated were able to dramatically cut back on drinking over four months no matter what type of treatment they stuck with, including taking dummy pills, a rigorous short-term study found.

The findings suggest a variety of options can help if drinkers are determined to quit and if they regularly meet with a doctor or nurse for guidance, researchers said. They said the study also indicates drinkers can make strides without going to a costly alcohol treatment center.

That could vastly expand access to care for a problem that affects some 8 million Americans _ most of whom never seek help.

The 1,383 alcoholics studied were assigned to get 16 weeks of treatment _ either counseling, medication or fake pills _ most with the help of a doctor or nurse. All badly wanted to quit, a factor that led some outside experts to question whether the results apply to the real world.

And one critic said getting alcoholics to drink less over just four months doesn't prove they've kicked the habit.

But the researchers argued that cutting back is an important step and said the results should help convince skeptics that alcoholism isn't hopeless.

The study "really does open up the possibility of people having more choice and it could significantly expand access," said Dr. Mark Willenbring, director of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism, which funded the research. The findings appear in Wednesday's Journal of the American Medical Association.

The most effective treatments were naltrexone, a drug that reduces alcohol craving, and specialized counseling. When each was combined with medical management, abstinence days increased from about 25 percent to about 80 percent. Combining fake pills was almost as effective.

Unexpectedly, a newer alcoholism drug called Campral, used more often in Europe than in the United States, was no more effective than dummy pills. The researchers aren't sure why and said more study is needed.

A 58-year-ol