Many Of The Neurocognitive Deficits Associated With Alcoholism Could Be Resolved By Long-term Abstinence

Alcoholism can cause neuropsychological deficits. A new study looks at alcoholics who have been sober for six months to 13 years and the results indicate that long-term abstinent alcoholics can recover many of their neurocognitive deficits, except for spatial-processing abilities.

Alcoholism can cause neuropsychological deficits, that much is clear. There is much less clarity, however, concerning to what degree recovery may occur with abstinence from alcohol. New findings indicate that long-term abstinence from alcohol can resolve many - but not all - neurocognitive deficits.

Results are published in the September issue of Alcoholism: Clinical & Experimental Research.

"Previous research has shown some but not total recovery with abstinence from alcohol," said George Fein, president of and senior scientist at Neurobehavioral Research, as well as the corresponding author for the study. "The continuing presence of deficits is not a trivial issue as it may interfere with day-to-day functioning."

"The nature of alcoholism as a dynamic condition is largely underappreciated by most people, including clinicians," added Edith Sullivan, a professor in the department of psychiatry and behavioral sciences at Stanford University School of Medicine. "Alcoholics may have periods of abstinence, during which time they give their nervous system time for repair. Thus, longitudinal studies of alcoholics are critical for identifying functional areas that are targeted by alcoholism, those that are relatively spared, and those that can recover with sobriety."

Longitudinal studies in alcoholism, however, are very difficult to conduct, Sullivan added. "Tracking active alcoholics is challenging, finding alcoholics in recovery is also difficult - there is still a stigma associated with the condition. Furthermore, those who are in denial of their condition, by definition, will not avail themselves for study."

In this case, researchers performed a number of neuropsychological assessments on 96 participants, divided into two groups: 48 (25 males, 23 females) long-term abstinent alcoholics, and 48 (25 males, 23 females) age-matched "controls" who either drank lightly or not at all. The alcoholics were abstinent from six months to 13 years, for an average of 6.7 years. Performance was measured in nine domains: abstraction/cognitive flexibility, attention, auditory working memory, immediate memory, delayed memory, psychomotor function, reaction time, spatial processing, and verbal skills. Fein said that the only domain they did not examine was gait and balance, regarding it as separate.

"We found that the cognitive and mental abilities of middle-aged alcoholics who had been abstinent for six months to 13 years are indistinguishable from those of age and gender comparable non-alcoholics," said Fein, "with the possible exception of spatial processing abilities. Recovered functions would include short- and long-term memory, planning, learning, comprehension, etc. In other words, they would be able to support a normal home, work and social life; these people should be able to function cognitively normally."

"These findings further indicate the selectivity of alcoholism's untoward effect on visuospatial processes," added Sullivan, "which are important for many daily activities, including driving. We might also predict that these recovering alcoholics would have difficulties in reading a map, assembling things, and performing tasks that require spatial orientation."

Both Fein and Sullivan noted that these findings provide hope for recovering alcoholics, and can be used to encourage abstinence from alcohol.

However, cautioned Sullivan, "it is important to conduct careful investigation of cognitive and motor functions because they are multifaceted and complex, and component processes and functions can be impaired or recover piece by piece," she said. "It may be that only when enough of the pieces recover to at least some minimum level that we can then observe improved function."

In addition, said Fein, "we cannot definitively say that these individuals had deficits when they stopped drinking. We don't have data on this. Furthermore, these people were middle-aged. We're not saying that you will have full recovery if you stop drinking in your 50s or 60s; we are saying that these people stopped drinking earlier, and they appear to have close-to-full recovery function."

Researchers believe that the older brain may be more vulnerable than the younger and middle-aged brain to the damaging effects of alcohol. Fein and his colleagues are now examining recovery of cognitive functioning among abstinent alcoholics 65 to 85 years of age who stopped drinking before the age of 50, between 50 and 60, and after 60 years of age. This data, said Fein, will address the degree to which alcohol abuse is more damaging to the older brain, as well as the extent of recovery of function with long-term abstinence among older alcoholics.

"Whatever their nature," said Sullivan, "follow-up and/or longitudinal studies are of the utmost importance because of the vast number of factors that can contribute to cognitive and motor abilities, such as pre-existing family history and genetic factors, education, gender differences, age at onset of drinking, drinking pattern, age of drinking, nutrition, non-alcohol substance abuse comorbidity, and psychiatric comorbidity, such as anxiety or depressive disorders."

Alcoholism: Clinical & Experimental Research

He Took It One Day At A Time

William Griffith Wilson spent his first 39 years squandering everything he had.

He spent the next 36 proving that it's never too late for redemption.

Wilson, better known as "Bill W." to the countless number of people he inspired, gave up the drinking that had plastered his life, and vowed to help others do the same.

He fulfilled that vow in a big way. He created Alcoholics Anonymous, which has grown into one of the biggest and most successful addiction-recovery programs in the world.

Today, the group claims more than 2 million members in over 150 countries. It has changed the way people think about alcoholism — not as a moral failing, but rather an ailment.

Wilson (1895-1971) grew up in a troubled home in Vermont, to a family of granite quarry workers and mine bosses. Though financially secure, the family was unstable. Wilson's alcoholic father left the family in 1905. His mother remarried and moved to Boston, leaving the children in the care of her parents.

This scarred young Wilson deeply. As Ernest Kurtz recounts in "Not God: A History of Alcoholics Anonymous," the 10-year-old blamed himself for the breakup.

"Deep within young Bill Wilson ached a feeling of rejection," Kurtz wrote. "The more painful because, in his mind, it was deserved."

He took his first drink at 22, during a dinner party held for soldiers about to be shipped out to Europe to fight in World War II. Soon, he found drinking an easy comfort for the loneliness of his overseas assignment, an Army desk job.

For years, Wilson's sharp mind and natural talent masked his growing dependence on alcohol — and the havoc it wreaked.

At the end of the war, Wilson entered law school. Showing up drunk at one of his finals, he nearly flunked out. His wife, Lois, grew alarmed at the frequency of his drinking binges.

Wilson lost interest in law school and grew fascinated with Wall Street.

So he honed his stock-picking skills. He became one of the first to sense the value of corporate research. He believed that many people lost money playing the stock market because they didn't have enough good data about the companies they invested in.

Unable to persuade his broker friends to finance a fact-finding mission, Wilson quit his job, packed a motorcycle and took Lois for a yearlong trek along the East Coast.

With little more than a tent, blankets, a change of clothes and three thick financial reference books, the pair visited companies and took meticulous notes to send to investors.

His efforts landed him a top job as a stockbroker on Wall Street and a generous expense account. He made a very good living.

Drinking And Sinking

But his public success belied a crumbling soul. Caught up in the excesses of the jazz age, Wilson drank day and night.

The party ended Oct. 24, 1929. Black Thursday's stock market crash wiped out Wilson's paper wealth as well as that of many others. Soon he was out of a job.

Wilson and his wife moved in with her parents. By this time, he was almost constantly drunk.

"The market would recover," he wrote in his autobiography, "Bill's Story." "But I wouldn't."

Any money he made went to pay off bar tabs. Soon he needed "a tumbler full of gin followed by half a dozen bottles of beer" just to make it to breakfast.

Things got worse. His mother-in-law died, and his father-in-law grew ill. They lost their house. Wilson resorted to sneaking money from his wife's purse.

After blowing yet another chance at a job in 1932, Wilson finally realized he had a problem. Yet he was powerless to stop. Even when family members paid for his stay at a treatment center, he began drinking again after his release. Doctors told his wife that Wilson would die in a year if he kept drinking. Everyone, it seemed, had given up on him.

"No words can tell of the loneliness and despair I found in that bitter morass of self-pity," he wrote. "Quicksand stretched around me in all directions. I had met my match. I had been overwhelmed. Alcohol was my master."

Salvation came in the form of a phone call from an old friend, a renowned drinker who sounded uncharacteristically sober.

Wilson assumed his old pal was looking for their usual drunken revelry. Instead, the friend announced that he'd given up drinking in a religious conversion.

Inspired, Wilson conceded that he couldn't defeat alcohol on his own. He checked into a hospital for his withdrawal symptoms and, in what he called a supernatural experience, gave up drinking.

He became deeply religious, an experience he relied on to help him resist the temptation to drink.

But he soon determined that eschewing alcohol wasn't enough. Certain that the support of someone who understood his problem would help, he called friends in search of another alcoholic.

He finally reached a doctor, Bob Smith, by phone in what's now widely referred to as the first Alcoholics Anonymous meeting.

It worked, and Wilson got past his hurdle. He and Smith decided their method might benefit others as well, and within a few years the group formally came into being. The pair set up open meetings at which participants could talk about their struggles and offer encouragement to others. (Smith died in 1950 of cancer, just after AA's first international conference.)

Wilson, originally part of a religious fellowship called the Oxford Group, decided that faith or lack of it shouldn't preclude someone from seeking help. He eventually split the effort off as a separate entity focused on alcoholism.

Reassurance And Support

He called the group Alcoholics Anonymous. The name aimed to reassure those seeking help that they wouldn't be judged or humiliated. The chapters didn't require membership dues, and no one was expected to give a last name.

To lay out the plan in an easily understandable format, Wilson wrote a book about his experience. For his message to reach a wide audience, he described it in simple terms.

He summarized his knowledge in a 12-step program, writing the book "Alcoholics Anonymous" under the name "Bill W." That quest for anonymity would become a powerful way to keep the group from getting too closely tied to individual personalities — even his own. To keep it beholden to no one, he declared that the group wouldn't take outside contributions. Even today, no member can contribute more than $2,000.

Wilson maintained a humble lifestyle. To keep the focus on his cause and not himself, Wilson refused to be photographed for news stories. He eventually ceded control of the group to an advisory board.

Yet he understood the power of good publicity. A Saturday Evening Post article in 1941 propelled the group to the national stage.

So the group wouldn't lose focus, Wilson adopted 12 "traditions," which included not letting the group involve itself in current events or controversies, including those involving alcohol. And while the group supports other sobriety efforts, it doesn't align itself with any.

By the time he died, Wilson had turned down numerous honors. Still, Time magazine recently named him one of the most important people of the 20th century.

Investor's Business Daily

Alcoholics' relapses similar to other chronic diseases

Mel's relapse was a public humiliation. Robin, who "found himself drinking again'' after 20 years of sobriety, according to a statement released last week, had a private one. Both are back in treatment as some of their legion of followers "tsk-tsk,'' shake their heads and conclude that two more stars have failed.

But such relapses are fairly common during the lifelong struggle against what science considers the chronic disease of alcoholism. A relapse into renewed drinking, experts say, is no more a treatment failure than is a second heart attack in a cardiovascular disease patient.

And alcoholics are no worse -- and maybe a bit better -- at responding to treatment, and sticking to it, than are patients with other chronic diseases. "It's not like appendicitis, where they have surgery and it's cured,'' says Dr. Donald Kurth, chief of addiction medicine at Loma Linda University. "It's more like diabetes. You can manage it, but you have to work at it every day.''

The changing treatment model -- outpatient, instead of in-patient -- further reflects a growing body of science that gives patients and doctors more choices and more hope that abusive drinkers can eventually change.

William R. Miller, professor of psychology and psychiatry at the University of New Mexico, has studied addiction for 40 years. He doesn't even like the word "relapse.'' "I think it's a pejorative term,'' Miller says. "If you think about asthma, we're not surprised if a person who is treated has an asthma attack. With high blood pressure, if it becomes elevated we don't shame them because they've relapsed.''

Dr. A. Thomas McLellan looked at three conditions medicine shows can be managed, but not cured, and compared treatment outcomes with those for alcohol dependence. The other diseases were high blood pressure, asthma and diabetes. After a review of studies, published in the Oct. 4, 2000, Journal of the American Medical Association, he found after treatment for alcoholism, regardless of treatment type, about 40 per cent to 60 per cent of problem drinkers remained abstinent for at least a year. Other chronic diseases, including diabetes, asthma and high blood pressure, have similar or worse relapse rates a year after medical treatment.

Fewer than 60 per cent of asthma and hypertension patients take their medications as they should, McLellan found, and fewer than 40 per cent of adult diabetes patients adhere to their medication schedules. When it comes to lifestyle changes, more than 70 per cent of patients with asthma, hypertension or diabetes fall off their prescribed diet-and-exercise wagon.

Yet doctors continue to treat people whose blood pressure, diabetes or asthma gets out of control. "We wouldn't tell someone they can't get treatment because they continued to eat doughnuts,'' Kurth says. "We don't scold them, we don't chastise them. We treat them.'' With alcoholism, a setback isn't a reason to give up. The ever-present threat of those setbacks, after all, is why people in Alcoholics Anonymous call themselves "recovering'' not "recovered.''

Treating the disease means treating people through their relapses. The trouble is, while an alcoholic is learning to stop drinking, every slip contributes to the disease's $185 billion annual cost, according to the U.S. National Institute on Alcohol Abuse and Alcoholism, in crime, lost productivity and social problems..

Treatment needs vary, but for the majority of alcoholics, outpatient treatment has become common -- and in many cases, preferred. The 28-day in-patient treatment programs, such as those at the Betty Ford Center in Palm Springs, Calif., or Hazelden in Minnesota, were once considered the gold standard of care. For many, they may still be the best choice. But they depend on months of followup care, including individual counselling and group programs such as AA.

Of the 700,000 people currently getting treatment for alcohol dependence on any given day in the United States, 13.5 per cent are in a hospital or residential treatment centre, while 86.5 per cent are getting outpatient treatment, the reported choice of Mel.

A strong predictor of who is going to get better, even after relapsing, Miller says, is that a message makes its way through even the worst alcohol fog. Maybe when a spouse leaves. Or when an employer warns that a job is on the line.

Or, in the case of a celebrity, the message that alcohol is messing up one's life might arrive when humiliating behaviour gets plastered all over newspapers, TV and the Internet.

The Record

12-step followers should keep at it

If you’ve been attending Alcoholics Anonymous or another 12-step recovery group following treatment for a substance use disorder, keep going.

That’s the conclusion of a study funded by the National Institute on Alcohol Abuse and Alcoholism that was released this week.

The three-year study followed 227 recovering alcoholics who had been through treatment, concluding that the more frequent the attendance at AA or similar recovery support groups, the higher the rate of not using an addictive substance and the lower the consumption in the event of relapse.

The study looked at a variety of mutual-help support groups for people dealing with addictions and found that most participants attended AA, probably because AA is more available than other groups.

The study also confirmed what professionals in the addictions treatment field have long believed: the more time spent attending recovery meetings, the better the outcome for the individual.

“Research on AA is difficult due to the anonymity issue,” said Joe Diament, director of the adolescent treatment initiative at New Futures, a statewide organization dedicated to public education and reducing substance use disorders. “Recovery support is absolutely pivotal in treatment.”

Diament, who was director of Odyssey House, an adolescent treatment center in Hampton for 19 years, said the research is “very clear” that “continuing care” is vital to a successful and ongoing recovery for the chronic disorder.

“In my experience, it’s absolutely true,” he said.

Even those outside the recovery network have observed the power of the AA model. The Rev. Stephen Edington, for example, minister at the Unitarian Universalist Church in Nashua, said his church has provided space for a Monday night AA meeting and a Friday night Narcotics Anonymous meeting for at least 10 years.

“They’re strong and thriving,” Edington said of the groups. “They pack the room.”

Edington said he sometimes sees group participants “coming and going” while he is working at the church.

“I think what people find in a recovery group is similar to what they find in any healthy religious community,” he said. “They feel something is missing from their lives, and they’re hoping the community can provide it for them.”

Diament said anyone with an addiction to alcohol or other drugs requires treatment before entering a support group.

“Once you’ve been through treatment, any constructive, healthy recovery is better than none, and 12-step groups are particularly effective in maintaining sobriety,” he said.

The study, published in the August edition of Alcoholism: Clinical and Experimental Research, was authored by Robert Stout, director of the Decision Sciences Institute of the Pacific Institute for Research and Evaluation, and John Kelly, associate director of the Massachusetts General Hospital/Harvard Addiction Research Program.

“To me, there’s no question it’s true,” said Nashua resident Mary Bock, a recovery advocate. “The beauty of it is, you come in with a life that’s unmanageable, and it gives you the tools to reconcile with the past and a framework for responsible daily living.”

Nashua Telegraph

Realistic recovery: surviving 1st year

Once you've emerged from any alcohol or drug treatment program, the real work begins: staying clean and sober. People in recovery and those who support them all agree that the first year is the most difficult, a bewildering time when relapse is most likely to occur. Here are some tips for beginners or those trying again:

BLOOD SUGAR: Hypoglycemia is common among active alcoholics, but instead of burning sugar, they're burning alcohol. For people in recovery, the body's craving for sugar often gets mixed up with a craving for alcohol -- that's why there's always lots of candy around Alcoholics Anonymous (AA) and other self-help meetings. Find a substitute for alcohol to deal with the biological cravings caused by fluctuating blood sugar; consider a hypoglycemic diet, with six meals a day to avoid wide swings.

EMOTIONAL REMINDER: One stress management acronym widely used in the recovery community is H-A-L-T, which is a reminder to avoid becoming hungry, angry, lonely or tired.

AVOID TRIGGERS: Stay away from people, places and things that are going to remind you of drinking or using drugs.

SUPPLEMENTS: In addition to eating healthy, consider taking B complex vitamins. Thiamine, in particular, helps prevent delirium and tremors in alcoholics. Also L glutamine, an amino acid available in health food stores, has a unique function in the brain and is said to offer a natural way to help the body fight off cravings.

EXERCISE: Develop a regular exercise routine, even if it's only walking on a daily basis. During a good workout, the brain releases endorphins that create a "natural high," one that is certainly less potent than what you're used to, but still a mood elevator.

SEEK SUPPORT: Regularly attend a supportive group, such as AA, Narcotics Anonymous (NA) or one of the alternatives to 12-Step programs, to help deal with depression, which is common among alcoholics, particularly women. Meeting with others in recovery can help you understand the scope of the disease and prevent you from becoming bitter or angry.

PLAN AHEAD: Make a list of dangerous situations and how to deal with them. Let's say you're invited to a wedding. Be prepared to leave early or make sure in advance that a nonalcoholic beverage will be at the table if you're going to be called upon to make a toast.

ANALYZE YOUR PATTERNS: Examine your drinking or drugging life carefully to decide what situations might have stimulated you to use. If you realize that every time you visited your mother there was an argument and you started to drink, then it's probably a good idea to stop seeing mom in early sobriety or until you've worked with a therapist through the issues that cause the arguments.

EDUCATE YOURSELF: Read everything you can, attend public lectures and watch TV specials to try to understand what your addiction does to your body and mind. It will equip you to treat addiction like the progressive disease it is and provide insight into yourself as well as your new friends in recovery.

CLEAR OUT THE CLUTTER: Make it massively inconvenient to use your substance of choice. Get rid of alcohol, binge foods, cigarettes and drugs. Also dump the barware, wine glasses and beer mugs. Remove suggestive items, such as powdered sugar or baking soda (which looks like cocaine), sage (which smells like dope), flavoring extracts (which contain a remarkable amount of alcohol) and paraphernalia like handheld mirrors, ashtrays and even the music or incense you used to create a mood or cover up your using.

CHOOSE YOUR FRIENDS: Keep in contact with people who are in good recovery.

AVOID NEW ADDICTIONS: If your recovery isn't going well, chances are you may have additional addictions. It's very common for recovering addicts to simply switch addictions.

RELY ON RITUALS: Establish new routines and rituals, which can provide meaning, connection and even future promise. These can range from morning prayers and meditation or simply reciting the same encouraging words each morning to daily journal writing or a regular exercise routine.

RESIST ROMANCE: Striking up a new relationship in the first year can be dangerous because if it fails, the potential for relapse is greater. Don't use a romantic relationship as an excuse to get clean; in AA and NA parlance, this is called "13th stepping." Get clean for yourself -- not somebody else.

TRY AGAIN: Cycling more than once through treatment, recovery and relapse is not uncommon, so continue seeking help. The good news is that the cycles often are a precursor to stable recovery.

Sources: "Staying Sober: Tips for Working a Twelve Step Program of Recovery," by Meredith Gould; Dr. Nicholas A. Pace, National Council on Alcoholism and Drug Dependence board of directors; AddictionZ in Canada; Alcoholics Anonymous.

Portsmouth Herald

Diverse Groups Helped by AA

Study shows gender, religion and mental illness are not barriers

Alcoholics Anonymous and other mutual-help groups seem to help people recover from alcoholism no matter what their religious beliefs and gender, or whether or not they have mental disorders, according a new study released today.

The three-year study of 227 recovering alcoholics who went through treatment showed that greater attendance of AA or other meetings following treatment resulted in improved rates of abstinence or in less intensive alcohol consumption in the event of relapse. These beneficial effects were not influenced by gender, religious preferences, psychiatric disorders or whether the patient had prior attendance at AA or other groups.

The study is one of the few to examine the effectiveness of 12-step programs prospectively among different types of people with substance use disorder. The study assessed all types of addiction mutual-help groups that patients attended and found that patients mostly went to AA meetings, probably because they are more available.

“Here’s a widespread, chronic disorder that seems to respond well to an inexpensive resource – mutual-help groups such as AA,” said Robert Stout, Ph.D., a co-author of the study. “Not only do we need to get more addicts engaged in these groups, but we also need to gather evidence on this issue and make sure that the public, policy-makers and practitioners know about it.”

Stout, a mathematical psychologist who has been studying addiction treatment for nearly three decades, is director of Decision Sciences Institute of the Pacific Institute for Research and Evaluation.

The results of the study also support the belief in recovery circles that the more you put into it, the more you get out of it.

"There is a clear dose-response relationship: If you don’t go to any meetings, you have the worst outcomes," said co-author John F. Kelly, associate director of the Massachusetts General Hospital/Harvard Addiction Research Program. "If you go to a few, you have a little bit better outcome, and if you go to a lot, you have an even better outcome."

While not everyone benefits from AA, this study suggests that even people who are not seen as a good fit for mutual-help groups can still derive benefit. For example, critics of 12-step programs say they aren’t suited for atheists or agnostics, or for people with fundamentalist religious beliefs, because the programs promote a belief in a higher power while allowing wide latitude in defining it. Some clinicians are uncomfortable referring clients to 12-step support groups because of their spiritual aspect.

Others say that the focus on “powerlessness” espoused in the first of the 12 steps can be detrimental to women because it reinforces low self-esteem and a diminished societal role.

And, some mental health practitioners believe that substance use disorders among psychiatric patients are the result of self-medicating, and therefore if the mental health disorder is successfully treated first, substance use will diminish, obviating any need for addiction-focused program. Another concern is that people with mental illnesses will have trouble becoming engaged in socially-oriented fellowships, or that the need to take psychotropic drugs will meet with disapproval from other AA members.

“There are a lot of unsubstantiated ideas about AA floating around out there,” Stout said. “Our study shows that mutual-self help groups will work for a wide range of people that some say wouldn’t be helped. We need more studies to get to the bottom of what really is and isn’t working.”

The study is published in the August edition of Alcoholism: Clinical and Experimental Research. It was funded by the National Institute on Alcohol Abuse and Alcoholism.

Health News Digest

Young addicts offered help

Underage drinkers swigging cider in Oxfordshire's parks, young crack cocaine addicts and other substance abusers are being urged to get help from a new advice service.

Oxford-based Evolve has helped 35 young people aged between 10 and 18 since it was set up six months ago.

Homeless teenagers, children excluded from mainstream schools, young offenders and isolated teenagers in rural areas are among the people Evolve workers are supporting.

Senior harm reduction worker Chris Courtney said: "One of the most challenging things is reaching those young people who really really need the service.

"It is those ones who are street homeless and are very much underground we need to be reaching.

"When you reach those young people and they respond, that is the most rewarding part of this work. When they are not responding, that is very hard."

He said they offer help to teenagers to help them know how to avoid predicaments like the one 14-year-old David from Wallingford, got himself into.

David spent three hours on a drip in hospital after downing a litre of vodka.

Evolve manager Jane McDonald said: "The challenge is getting into the rural areas, like this case in Wallingford."

As well as Mr Courtney and Ms McDonald, Evolve employs three project workers and is set to get a nurse and a psychiatrist.

Mr Courtney said some youngsters are reluctant to respond to help offered by Evolve, while others are really motivated.

It is not an abstinence-based project, but encourages 'harm reduction' and staff produce a support package for each young person they work with.

When youngsters get to Evolve, which is based in Park End Street, Oxford, they are allocated a key worker.

Ms McDonald said: "Often it's the relationship with the key worker that is the key thing, having someone they can trust and talk to."

Mr Courtney said he has to accept some of the young people he works with will continue to use drugs.

He said: "You give them the tools to make their use a lot safer.

"It may be as simple as telling them not to use drugs on their own or talking about how much they use, or telling them to smoke drugs rather than inject, or if they are drinking, how to stay safe on the streets."

He said hopefully after that kind of intervention, a young person may decide they want help cutting down or giving up drugs or alcohol.

The average age of a youngster referred to Evolve is 15 for Oxfordshire as a whole and 16 for Oxford.

The main problem is alcohol and cannabis in the county and class A drug use in the city.

So far, they have had children as young as 13 referred to them, but have not yet had any 10-year-olds.

Ms McDonald said the 13-year-olds tend to be into alcohol and cannabis and it is the older ones who are more likely to have started taking heroin and crack cocaine.

Anyone who wants more information can log on to www.evolve.oxon.co.uk or call 01865 723909.

Case study

After drinking alcohol and smoking cannabis for four years, an Oxford 17-year-old is turning her life around with the help of Evolve.

The teenager, who asked not to be named, had a conviction for assault causing actual bodily harm and said she used to get into fights after binge drinking.

She was referred to Evolve by her social worker three months ago, and since then has cut down on her alcohol intake and started college.

She said: "I have been a binge drinker, drinking cider and vodka in the park. I have a conviction, but I haven't offended since I have been with Evolve.

"I started off smoking cannabis and was quite a heavy user, then my group of friends went from cannabis to alcohol, and it was every day.

"Evolve has helped to motivate me. Before, I would have been sat drinking in the park because I didn't have anything else to do."

She said her Evolve substance misuse worker, Merlene Napier, had helped set her goals like seeing how long she could go without drinking alcohol.

She also set up an interview at an Oxford college and registered her with job agencies.

The girl said: "I've kept a drink diary and written down how much I'm drinking, what the price is and how many calories I'm drinking.

"It's quite scary because if you don't write it down, you don't remember. I have cut down on my drinking, I am not drinking to get drunk any more.

"Evolve is helpful because it motivates you to see the health risks and what you are doing to your body.

"When I first got here it was quite scary, but the workers are really easy to get on with.

"It has helped me to see there is a future other than drinking and it's made me see that drinking like I was is not normal."

Oxford Mail

Pooja attends Alcoholics Anonymous

I don't know what it was that made me tag along to the 49'TH anniversary of the Alcoholics Anonymous one sultry Sunday morning this May… My father was pleasantly surprised and the organizers delighted to have an additional family member to grace the occasion…I apologized for crashing their party… they smiled delightedly and tried to coerce me into giving a speech.

I clamed up… what would I say at an occasion as important as this? I was aware that I was certainly no expert and could not pretend to educate a room full of doctors, intellectuals and most importantly, alcoholics on the topic or hope to inspire them to continue to stay off the wagon…I scanned my memory bank for facts, terms, a smart quote perhaps… nothing came forth…when I feigned ignorance and tried to be let off the hook I was firmly led up to the dais and asked to speak from my heart.

Come on Pooja, you've experienced my alcoholism so vividly and closely, you have a living reference point. Share your experiences. That's what people want' urged my father… so I took a deep breath and reluctantly agreed to go on. Everyone has their own take on alcoholism…Some view it as a medical malady, some see it as a psychological problem, while others view it as a social dysfunction or a moral weakness.

A question that came up often that day was 'How do you know if someone is an alcoholic? How do you define them?'…. Where is the line drawn between drinking socially or casually, albeit heavily and being classified as an alcoholic? How much alcohol is 'too much' alcohol? And how often does one need to drink to be termed an alcoholic? Weekly? Daily? But then lots of people who call themselves alcoholics are not daily drinkers. Instead they indulge on weekends, on special occasions, once a month, once a year or at any given time… My father put it in perspective by simply saying, 'if you are truly an alcoholic, you know it…. you might deny it to the whole world and especially to yourself… but deep down inside, you know it'.

I grew up in a home with a father who was an alcoholic and saw my parent's marriage crumble on account of it… A decade and a half later, I watched mutely as alcohol claimed a dear friend…She was 40 and an alcoholic who was totally in denial…one brilliant, blue skied morning, she had a massive stroke…we watched her slip away a day later in a grim hospital room, helpless… dazed with grief…and what did we do that night to fight our confusion and pain? We got together and mourned her death by numbing ourselves with a 'drink'…. It gets worse.

A few years later, I even readily got into a relationship with an alcoholic…my father warned me that I was heading for disaster but I chose to ignore him… I was foolish enough to believe that I could 'rescue' my alcoholic boyfriend somehow… but maybe it was me that needed rescuing…a fact that became painfully clear when I found myself a victim of domestic, 'alcohol induced' violence which destroyed my faith in love and ensured that gory details of my messy personal life were emblazoned across every newspaper in the country… jolted back to reality , I swore of toxic relationships and the occasional glass of wine… but then with time and life, something marvelous happened, my scars healed and I met the man I eventually went on to marry.

Life was ablaze…I was 'happy' again… and foolish enough to drop my guard and do something that was anything but marvelous, I started drinking socially again… I guess I must have been suicidal because it's a known fact that children of alcoholics are FOUR times more susceptible to becoming alcoholics themselves… and there I was chugging away at the champagne every time there was cause to celebrate or bury my failures…. Why and how could I do that? Especially after experiencing the disastrous consequences alcohol has had in my family and my life ever since I was a little girl...It was time to do something about it… it was time to finally STOP.

A famous author once wrote that words are not simply "a darkness pulled out of us." Rather, they are an attempt to 'pull out' the darkness, expose it to light, let it burn away the veil that keeps us from reconciling with our parents, our families, our inner ghosts and erasing the carefully buried pain… I did all of the above on the dais that Sunday morning … but most importantly, I did the most essential thing of all… I put my hand up and pledged to be 'responsible'…. The first and only step that 'Alcoholics Anonymous' implores you to take.

The audience, generous beyond belief, rose to their feet…I was overwhelmed to say the least…but through my tears shone a clarity and strength unlike ever before… it was a spiritual feeling… and I vowed to never have another sip of alcohol again…. And I won't… Not to enhance a win, numb a failure, celebrate the birth of a friends child or even my own, to relax, forget, remember or the countless other excuses we use to justify having a drink.

RS Bollywood Online

All part of managing an alcoholics disease

Mel Gibson's relapse was a public humiliation. Robin Williams, who "found himself drinking again" after 20 years of sobriety, according to a statement released last week, had a private one. Both are back in treatment as some of their legion of followers "tsk-tsk," shake their heads and conclude that two more stars have failed.

But such relapses are fairly common during the lifelong struggle against what science considers the chronic disease of alcoholism. A relapse into renewed drinking, experts say, is no more a treatment failure than is a second heart attack in a cardiovascular disease patient.

And alcoholics are no worse — and maybe a bit better — at responding to treatment, and sticking to it, than are patients with other chronic diseases.

"It's not like appendicitis, where they have surgery and it's cured," says Dr. Donald Kurth, chief of addiction medicine at Loma Linda University. "It's more like diabetes. You can manage it, but you have to work at it every day."

The changing treatment model — outpatient, instead of inpatient — further reflects a growing body of science that gives patients and doctors more choices and more hope that abusive drinkers can eventually change.

William R. Miller, professor of psychology and psychiatry at the University of New Mexico, has studied addiction for 40 years. He doesn't even like the word relapse. "I think it's a pejorative term," Miller says. "If you think about asthma, we're not surprised if a person who is treated has an asthma attack. With high blood pressure, if it becomes elevated, we adjust treatment. We don't shame them because they've relapsed."

Dr. A. Thomas McLellan looked at three conditions which medicine shows can be managed, but not cured, and compared treatment outcomes with those for alcohol dependence. The other diseases were high blood pressure, asthma and diabetes. After a review of studies, published in the Oct. 4, 2000, Journal of the American Medical Assn., he found after treatment for alcoholism, regardless of treatment type, about 40% to 60% of problem drinkers remained abstinent for at least a year. Other chronic diseases, including diabetes, asthma and high blood pressure, have similar or worse relapse rates a year after medical treatment.

Fewer than 60% of asthma and hypertension patients take their medications as they should, McLellan found, and fewer than 40% of adult diabetes patients adhere to their medication schedules. When it comes to lifestyle changes, more than 70% of patients with asthma, hypertension or diabetes fall off their prescribed diet and exercise wagon.

Yet doctors continue to treat people whose blood pressure, diabetes or asthma gets out of control. "We wouldn't tell someone they can't get treatment because they continued to eat doughnuts," Kurth says. "We don't scold them, we don't chastise them. We treat them." With alcoholism, a setback isn't a reason, either, to give up. The ever-present threat of those setbacks, after all, is precisely why people in Alcoholics Anonymous call themselves "recovering," not "recovered."

Treating the disease means treating people through their relapses. The trouble is, while an alcoholic is learning to stop drinking, every slip contributes to the disease's $185-billion annual cost, according to the National Institute on Alcohol Abuse and Alcoholism, in crime, lost productivity and social problems. The personal costs are just as steep. Drinking distorts reason, and lays waste to marriages, friendships and careers.

Treatment needs vary, but for the majority of alcoholics, outpatient treatment has become common — and in many cases, preferred. The 28-day inpatient treatment programs, such as those at the Betty Ford Center in Palm Springs or Hazelden in Minnesota, were once considered the gold standard of care. For many, they may still be the best choice. But even those programs depend on months of follow-up care, including individual counseling and group programs such as AA.

Of the 700,000 people currently getting treatment for alcohol dependence on any given day in the United States, 13.5% are in a hospital or residential treatment center, while 86.5% are getting outpatient treatment, the reported choice of Mel Gibson.

"That could be more effective because you learn how to live in your community, rather than being off in some resort type setting," says Eric Goplerud, director of Ensuring Solutions to Alcohol Problems, a research center at George Washington University. Intensive outpatient treatment generally involves three to four hours of one-on-one and group treatment most days of the week for several weeks. The patient keeps going to work and continues to live at home.

"One of the supports that people need for staying sober is holding their job," Goplerud says. "Outpatient treatment allows them to hold their job and work out the system for staying sober in the context of their everyday life." While in treatment, they're still dealing with everyday stresses from a spouse, kids, commuting or the temptation to drive past a favorite bar.

A strong predictor of who is going to get better, even after relapsing, Miller says, is that an undeniable message makes its way through even the worst alcohol fog. Maybe the signal comes when a spouse leaves. Or when a drinker ends up in court, or lands in jail. Or when an employer warns that a job is on the line.

Or, in the case of a celebrity, the message that alcohol is messing up one's life might arrive when humiliating behavior gets plastered all over newspapers, TV and the Internet.

Los Angeles Times

How low prices keep booze flowing for teens

It is what the average Scottish child gets for pocket money every week. But £10 can buy enough alcohol in city stores to leave a group of four or five teenagers in a drunken stupor.

Aggressive discounting on booze by supermarkets has raised growing concerns about the toll on the nation's health and the habits of teenagers in particular.

Now an Evening News investigation has discovered the startling array of super-strength ciders, high-alcohol beers, and cheap wine and spirits you can buy for under a tenner.

Our survey at five city supermarkets discovered offers such as a litre of 7.5 per cent cider for just £1.99, 20-bottle packs of Stella Artois for £7.49 and a "three bottles of wine for a tenner" promotion.

The extent of the special offers we discovered disturbed GPs who said the "crazy prices" would fuel binge-drinking among teenagers.

They said drinking among youngsters was one of the main reasons for huge increases in pregnancy and sexually transmitted diseases among teenagers in the Lothians.

Campaigners today called for separate booze aisles and tills in supermarkets and restrictions on advertising as part of tougher controls over the sale of alcohol.

Industry leaders said they had set up a special task force to look at measures which would help tackle Scotland's binge-drinking culture.

That could lead to a voluntary code of conduct that may place limits on special offers for drinks.

Dr Dean Marshall, a GP based in Dalkeith, Midlothian and chairman of the Scottish General Practitioners Committee (SGPC), said our findings highlighted one of the biggest issues in the debate over alcohol abuse.

He said: "That is pretty scary prices for such powerful alcohol.

"Those sort of prices are likely to encourage binge-drinking, particularly among young people who don't have much money.

"The thing that worries me the most is that young people may not be fully aware of the differences in strengths of the alcohol and that can lead to all sorts of other problems."

The number of teenage girls in Edinburgh falling pregnant has risen by 56 per cent in the last decade.

A total of 61 girls aged between 13 and 15 fell pregnant last year compared to 39 in 1994.

Dr Ian McKee, an Edinburgh-based GP, said that many of these pregnancies can be linked to alcohol abuse.

He said: "In my experience the short-term damage of teenage drinking often presents itself in other ways than just damaging your liver.

"The huge leap in chlamydia and teenage pregnancy is normally down to people losing their inhibitions when drunk."

Hundreds of litres of alcohol were seized from children as young as 11 during a summer crackdown on underage drinking by police earlier this week.

Officers carried out dozens of swoops on drinking dens in the south of the city, including the Meadows, and caught groups of up to 30 youngsters downing bottles of booze.

Some drunk youths were rushed to hospital by officers for medical treatment while others were taken home to their parents.

Police were forced to deal with as many as 20 calls a night on Fridays and Saturdays from members of the public concerned over teen drinkers.

Tom Wood, chairman of Action on Alcohol and Drugs in Edinburgh, called for restrictions on alcohol advertising and more restraints on in-store promotions for drink.

He said: "It just confirms that the price of alcohol is such that it is within the reach of most people now. If you look around the world the two things that are used to control alcohol abuse is price and availability.

"You can control the supply but then you also have to control the demand side of things. The new licensing laws will bring in greater restrictions on promotions but I would like to see more focus on alcohol off-sales.

"Young people are not getting their booze from pubs but from shops and supermarkets."

A number of key industry trade associations, representing everyone from the breweries to supermarkets, are working on a new set of guidelines to tackle Scotland's binge-drinking problem.

The steering group wants to make it tougher in Scotland than anywhere else in the UK for children to buy drink and is understood to be focusing its attentions on improving training for staff selling alcohol and making health warnings on products and in shops clearer.

Fiona Moriarty, director of the Scottish Retail Consortium, said: "This is the responsibility of everyone in the trade from the manufacturers to all retailers. But it would be silly to go for knee-jerk reactions, such as clamping down on supermarket sales, because this won't make the problem go away.

"The majority of people do enjoy alcohol in a sensible way but we need to tackle the binge and underage drinking issues."

Paul Waterson, chief executive of the Scottish Licensed Trade Association, said: "Much of the focus on Scotland's binge-drinking problem has been on pubs but the majority of sales come through supermarkets.

"If we are going to do something about the fact that people, particularly youngsters, are not using alcohol responsibly then the supermarkets have to play their part.

"The prices are just silly in the supermarkets and alcohol is treated like any other product like a tin of beans but what we need to do is mark it off - put it in separate isles and checkout queues to make it known that it is not like other products."

Alistair Mackinnon, chief executive of Fast Forward, a voluntary organisation that educates hundreds of the city's teenagers each year on the dangers of alcohol, maintains that prevention is better than cure when it comes to solving the teenage drinking problem He said: "Education is vital - cracking down on the places youngsters can buy drink itself is not going to solve the problem alone.

"A lot of teenagers do get mixed messages when it comes to drinking because they see binge-drinking among adults, particularly in the home environment, and it does have an effect on them. There is definitely an increase in the awareness of the dangers of drinking and it is the biggest substance misuse issue in Edinburgh, particularly because it is legal."

Edinburgh News

Borough's battle with demon drink

Halton has a higher rate of under-age drinking than almost anywhere else in the North West. Nearly all under 16-year-olds questioned said they drank.

And significantly more girls - 95% -than boys - 85% - admitted boozing.

The figures - revealed in the Halton Alcohol Audit - have caused widespread concern because youngsters who drink are more likely to have sex at an early age, fail to use contraception and become involved in crime and anti social behaviour.

National figures reveal that binge drinking is more common in areas of increased deprivation.

Several areas of Halton are among the poorest in the country with four falling into the lowest 1% nationally for income.

In Runcorn's Windmill Hill ward almost half of the households with children have no working adult.

The audit was commissioned by the council as part of a Government crackdown to reduce alcohol-related harm in four ways: nBy improved education. nBetter identification and treatment of alcohol problems. nBetter enforcement to tackle crime and anti social behaviour. nEncouraging the alcohol industry to promote responsible drinking.

Most European countries have experienced a decline in drinking.

However, in the UK alcohol consumption continues to increase. The council's audit notes that if present trends continue, the UK will rise to the top of the consumption league within the next decade.

The report says: 'Alcohol misuse does not lead automatically to harm, but it does lead to an increased risk of harm.

'In recognition of the dangers of excessive drinking in a single session, the Government has issued daily guidelines for sensible drinking. These include a maximum intake of two-three units of alcohol per day for women and three-four for men, with two alcohol-free days after heavy drinking.' A quarter of men and a fifth of women in Halton are drinking at levels that may be expected to result in some degree of damage to their health.

And 20% of patients at hospitals and doctors' surgeries are likely to be excessive drinkers. Each GP in Halton will see more than 360 heavy drinkers every year.

Alcohol cases make up a large proportion of admissions to Warrington Hospital's A&E department and Halton Hospitals minor injuries unit.

Seven per cent of admissions to Whiston Hospital's A&E department had been attacked with a bottle or glass.

Every year for the past five years, the borough has been ranked among the four worst in the country for deaths of all causes, with the most deprived wards - Ditton, Halton Lea and Norton South -experiencing the worst problems.

Cancers - liver and stomach -linked to drinking, contributed to a high level of premature deaths.

More than two thirds of suicides are linked to alcohol and Halton with 14.6 deaths per 100,000 has a higher suicide rate than the rest of the UK.

But it is the drinking habits of Halton's youngsters which has sparked the biggest cause for concern.

The report reveals: 'Young people under the age of 16 are drinking twice as much today as they did ten years ago and report getting drunk earlier than their European peers.

'As part of a long term alcohol harm reduction strategy, it is vital that young people are educated to make responsible choices about their drinking behaviour.'

As part of a survey conducted by Trading Standards North West, 730 Halton youngsters were interviewed about their drinking habits.

It found that nearly two thirds of teenagers admitted drinking more than once a week.

Two thirds claimed to regularly drink at home with their parents.

Runcorn Weekly News

Alcoholics Anonymous chapter turns 60

Alcoholic's Anonymous is marking 60 years of sobriety in New Westminster.

Besides drinking, denial is something alcoholics can be very good at. And Pearl was a master at it.

In her drinking days, she totalled her car, lost custody of her children and chased away friends without ever admitting she was an alcoholic. Other evidence she ignored included growing up in an alcoholic family.

“I knew I had problems, but didn’t realize I was an alcoholic,” said Pearl, a longtime member of Alcoholics Anonymous (AA) in New Westminster.

“We all have visions of what an alcoholic is and that wasn’t me. I pictured someone drunk all the time and staggering around in a trench coat.”

Then one night Pearl had a moment of clarity when her drunken stare caught her reflection in a mirror.

“I saw my problems for what they were. The denial wasn’t there for a few seconds,” she said.

It’s been 27 years since Pearl had a drink and she still thinks of herself as an alcoholic. Despite her abstinence, she doesn’t say she’ll never drink again. Instead, every morning she promises not to drink that day.

“What we do is one day at a time, and the program is based on one day at a time.”

Pearl, who’s name was changed to protect her anonymity, believes she owes much to friends way back then who told her she had a problem. “What that achieved was it helped break down my denial.”

Today she thanks members of the New West AA, which celebrates its 60th year next month. “I handle life so much better now. I’m able to go with the flow.”

Despite being sober for so many years, she still goes to an average of four AA meetings per week.

New Westminster AA is one of the oldest groups in the province with only Vancouver being around longer. There are five groups in the Royal City with members able to attend a meeting every day if they want to.

And many alcoholics do, said Pearl. “The meetings remind me what would happen if I drink again. If I didn’t go I would forget what it was like.”

Someone told her the letters I, S and M in alcoholism stand for incredibly short memory, and she believes that.

Alcoholics Anonymous celebrates its 60th anniversary in New Westminster, Sept. 8-10 at Queensborough Community Centre. It was originally formed with just five members and covered New West and the Lower Fraser Valley. Now there are hundreds of members and each is a cause for celebration, said Pearl.

Burnaby News

Concern over North's drinking trends

Worrying figures show the extent of alcohol abuse in England.

And drinkers in Huddersfield and the rest of the North are more likely to binge drink, be admitted to hospital and die younger than their southern counterparts.

In the North East and North West 23% of adults admitted to drinking double the daily recommended level compared to less than 16% in the South.

In Yorkshire the figure stood at 22%.

Health experts said Britain had gone from a nation "enjoying a harmless tipple" to one developing "a dangerous alcohol addiction".

The research was published by the Centre for Public Health at Liverpool John Moores University and the North West Public Health Observatory, and is based on figures from 2004 to 2006.

The strong views have been backed in Huddersfield by Alan Walker who runs Alcohol Support, a Huddersfield-based support group which offers one-to-one counselling and advice for those with alcohol-related problems.

Mr Walker said: "If you go down to Huddersfield on a Friday night it's like a war zone.

"There's a lack of personal responsibility and I don't think the conditions in our country help. The government has a mollycoddling attitude. They're encouraging this lack of responsibility.

"They play lip service and pretend to be doing something. I can't see a solution other than to teach more responsibility.

"Young people have a big disposable income. It's getting difficult for young people to buy a house so some are saying: 'I'll spend it on alcohol'.

"There's a lot more advertising and encouragement especially on trendy drinks.

"The whole culture seems to be to get out of it.

"In some places drinking alcohol is a sign of respect.

"People say stress is to blame for the increase in binge drinking, but that's just an excuse.

"Trying to escape stress through alcohol is a temporary measure."

Mr Walker was general manager of Kirklees Alcohol Advisory Service.

ic Huddersfield

AWOL - inhaling alcohol

A new way of consuming alcohol that offers an immediate hit with no hangover the next day has been introduced in the United Kingdom.The new method is known as AWOL, an acronym for 'Alcohol With Out Liquid', and could become a hit in the global club scene due to the euphoric 'high' created when alcohol is vaporised, mixed with oxygen and inhaled. Billed at launch as the 'ultimate party toy', AWOL machines serve bar customers via tubes and could be seen as a modern version of the 'Nargile' or 'Hookah' water-pipe which originated in India and became an important part of society in Turkey and Middle Eastern countries in the 17th century, eventually becoming the height of fashion at sheik Western society parties during the late 19th and early 20th century.

Like the Hookah, the AWOL machine has a central body and a number of tubes running from it.The user chooses which spirit will be used and the spirit is loaded into a diffuser capsule in the machine. The oxygen bubbles are then passed through the capsule, absorbing the alcohol, before being inhaled through a tube. The resultant cloudy alcohol vapour is then inhaled from the end of the tube via a device akin to an asthma inhaler.

Once inhaled, the alcoholic gas goes straight into the bloodstream to give an instant 'hit'. The potent combination of oxygen and alcohol creates a feeling of well-being which intensifies the longer the vapour is inhaled.This high-tech 21st century 'Hookah' is the brainchild of 30 year old UK entrepreneur Dominic Simler, and has a patent pending.

"The vapour produces an instant 'high' with no hangover the next day,' said Simler, who will market the machines to clubs and bars in the UK to provide 'partygoers and hedonists with a radical new way to consume alcohol."

The outcry by the British media has been predictably damning of the new device, with an article in the Sunday Times dated 15 February quoting the Chief executive of the UK Alcohol Advisory Service referring to AWOL as 'solvent abuse for adults.'Professor Oliver James, the head of clinical medical sciences at Newcastle University in the UK was quoted in the article as saying, 'by snorting the alcohol it can go directly into the brain without being filtered by the liver. What is getting into your brain could be the equivalent of many times more than by drinking it.'

Professor James has since stressed that the comments that he made to the Sunday Times were purely speculative and theoretical, that his statements were made without first seeing or trying AWOL and that he made it clear to the reporter that he has no previous professional experience or clinical evidence of alcohol being consumed via vapour.

Professor James has now agreed to carry out independent tests on AWOL and Simler is hoping that the tests will 'remove any element of doubt regarding the safety of AWOL.'Until the results of the university tests on AWOL are available the company has advised all customers that the application should only be used to inhale alcohol vapour orally and not via the nose. Professor James has confirmed that AWOL is safe to be consumed in this manner.

gizmag

Happy hour – but how long will we be laughing?

Drinkers in the North East are killing themselves with alcohol. People living in the North are far more likely to binge-drink, be admitted to hospital for alcoho-related illnesses, and die younger than those elsewhere in the country.

The frightening statistics show more than a quarter – 26.7 per cent – of Wearsiders binge-drink, compared with a national average of just over 18 per cent.

Binge drinking is where adults consume double the daily recommended level of alcohol at least once a week.

Now, experts are warning Britain has gone from a nation which enjoys a harmless tipple, to one developing a dangerous alcohol addiction.

Although Sunderland's figure was frighteningly high, Durham was even worse, with the number of binge drinkers at 27.6 per cent.

The research, published by the Centre for Public Health at Liverpool John Moores University and the North West Public Health Observatory, is based on figures from 2004 to 2006.

When it came to hospital admissions for alcohol-related conditions, those in the North East and North West proved the biggest burden, with 1,100 men and 610 women admitted per 100,000 population in 2004/05.

This compared with less than 700 men and 400 women per 100,000 in the South East.

Middlesbrough was one of the worst areas, with more than 1,400 men admitted per 100,000 people – 70 per cent higher than England as a whole.

Across the country, the average cut in life expectancy because of drinking was 10 months for men and five months for women.
But in Sunderland, this rose to 11½ months for men and six-and-a-half months for women.

Professor Mark Bellis, director of the Centre for Public Health, said: "These profiles illustrate the growing costs of cheap alcohol, a night-time economy almost exclusively packed with bars and clubs and a failure to deliver a credible drinking message.

"Health agencies, police and schools all have major roles to play in reducing the damage caused by alcohol but so do the alcohol industry, employers and the general public."

Drink-related hospital admissions in England have reached record levels. Numbers admitted to hospital with alcoholic liver disease have more than doubled over the past 10 years.

Shadow Home Secretary David Davis said: "This shows why it was wrong of the Government to unleash 24-hour drinking without a proper assessment of the consequences."

A Department of Health spokeswoman said: "The government is working hard to raise awareness about alcohol misuse and ensure that treatment is available to those who need it."

She pointed out that £217million a year was spent on alcohol treatment, with more than 60,000 people being treated by specialist alcohol services.

Drinkers 'are storing up future trouble'

Kevan Martin, founder member of a Sunderland-based alcohol group, said the latest figures are no surprise.

Kevan, chairman of the North East Regional Alcohol Forum, said it was further evidence that 24-hour drinking should never have been introduced to the UK.

Kevan, a recovering alcoholic, said: "This just goes to show that it needs serious investigation by the Government on how to tackle alcohol-related illnesses.

"At the moment just one in 102 people suffering from serious illnesses caused by excessive drinking are getting the treatment they need and even then there is a nine-month waiting list.

"One of the people I work with came to me and said the doctor had put her on a nine-month waiting list for her liver complaint, but I don't think she will last nine months without treatment."

Kevan says youngsters need to be aware that binge drinking now will have serious consequences in years to come.

He said: "It is a terrible situation, where we have young people going out with the intention of getting hammered and they are giving their liver a serious battering.

"They don't feel it now, but within five or 10 years they will know the consequences. We have young people in their mid-20s in hospital and their livers are almost destroyed."

Kevan said most people don't realise alcohol is more addictive than any other drug, including heroin, and yet parents still allow their under-age children to drink.

Kevan said binge drinking was just one of the alcohol-related problems that needed to be addressed.

He said: "It is not just the people who are going out and getting drunk on a Friday and Saturday night. There are the people who drink excessively at home seven nights a week. Research shows that 86 per cent of people with an alcohol problem drink at home."

Brewer blames cheap ales at supermarkets

Brewer Scottish & Newcastle says supermarkets it supplies are fuelling binge-drinking with cheap deals.

The region's biggest brewer says the "big four" – Asda, Tesco, Morrisons and Sainsbury's – sell alcohol at a loss to get people into their stores.

S&N made the claims while giving evidence to a Government inquiry into supermarket chains.

Its submission to the Competition Commission reads: "We strongly believe the sale of alcoholic drinks at low cost, used primarily to drive 'footfall' into stores, is not consistent with the promotion of responsible drinking.

"There is now anecdotal evidence that drinkers are consuming cheap alcohol at home before a night out, and then topping up at pubs or bars."

Andrew Opie, the British Retail Consortium's director of food and consumer policy, rejected the claims.

He said: "Our members sell responsibly and their customers enjoy responsibly. We don't believe cheap beer is leading to irresponsible behaviour."

Sunderland Today

UK has 'dangerous booze addiction'

Britain is developing a dangerous alcohol addiction, with drinkers in the North most likely to binge, researchers claim.

Experts warn that Britain has gone from a nation "enjoying a harmless tipple" to one developing "a dangerous alcohol addiction".

At least 18 per cent of adults binge at least double the daily recommended level in one or more sessions a week.

Drinkers are the North are more likely to die of alcohol-related illnesses than their counterparts in the South. They are also more likely to be admitted to hospital because of their love of booze.

Areas such as Liverpool, Manchester and Middlesborough had around 70 per cent more admissions than England as a whole, with more than 1,400 men admitted per 100,000 people.

And Blackpool was named as having one of the worst problems with booze, researchers said.

Across the whole of England, the average loss of life due to drinking was ten months for men and five for women.

But in Blackpool, men could expect to shave 23 months off their life and women 13 months - around 140 per cent above the English average.

Professor Mark Bellis, director of the Centre for Public Health, said: "These profiles graphically illustrate the growing costs of cheap alcohol, a night-time economy almost exclusively packed with bars and clubs and a failure to deliver a credible drinking message to both youths and adults.

"We hope that making these statistics widely available will highlight that we are no longer a nation enjoying a harmless tipple but increasingly one developing a dangerous alcohol addiction."

Shadow home secretary David Davis said: "This alarming research shows why it was wrong of the Government to unleash 24-hour drinking on all our towns and cities without a proper assessment of the consequences.

"Yet again, the public are put at risk by the irresponsible actions of this Government."

ITV News

UK 'developing a dangerous alcohol addiction'

Drinkers living in the North are far more likely to binge on alcohol, be admitted to hospital and die younger than their southern counterparts, research showed today.

Across all of England, 18.2% of adults binge drink at least double the daily recommended level in one or more sessions a week, based on the week in which they were questioned.

But the biggest binge drinkers lived in the North East and North West (23% of adults) compared to those in the South East, South West and East of England (less than 16%).

Experts warned that Britain had gone from a nation "enjoying a harmless tipple" to one developing "a dangerous alcohol addiction".

In Newcastle upon Tyne, Liverpool and Durham, more than 27% of adults said they binge drink, compared to areas such as East Dorset, where less than 10% of adults do so.

The research was published by the Centre for Public Health at Liverpool John Moores University and the North West Public Health Observatory, and is based on figures from 2004 to 2006.

When it came to hospital admissions for alcohol-related conditions, those in the North East and North West proved the biggest burden - with 1,100 men and 610 women admitted per 100,000 population in 2004/05.

This compared to less than 700 men and 400 women per 100,000 in the South East.

Areas such as Liverpool, Manchester and Middlesborough had around 70% more admissions than England as a whole, with more than 1,400 men admitted per 100,000 people.

Across England, rates stand at 826 men and 462 women per 100,000.

The lowest burden for hospital admissions was in areas like Wokingham and West Berkshire, where fewer than 430 men and 240 women per 100,000 were admitted in 2004/05.

Across the whole of England, the average loss of life due to drinking was 10 months for men and five for women.

But in Blackpool, men could expect to shave 23 months off their life and women 13 months - around 140% above the English average.

Manchester, Barrow-in-Furness and Salford, in Lancashire, all suffered badly, with men losing around 16.5 months of their lives.

In comparison, men lost just two to four months due to alcohol if they lived in the Isles of Scilly or East Dorset.

In 2005/06, 367,000 violent offences due to alcohol were recorded - equivalent to 7.3 violent crimes per 1,000 people across all of England.

In London the figure was 9.8 and in Yorkshire and the Humber it stood at 8.2.

Outside of the City of London, which has an unusually high crime rate, the City of Westminster, Islington in north London and Leicester all saw 14 to 15 violent crimes per 1,000 people.

In comparison, there were 5.6 crimes per 1,000 people in the East of England.

In East Dorset and South Cambridgeshire the figure dropped to less than two violent offences per 1,000 population.

Professor Mark Bellis, director of the Centre for Public Health, said: "These profiles graphically illustrate the growing costs of cheap alcohol, a night-time economy almost exclusively packed with bars and clubs and a failure to deliver a credible drinking message to both youths and adults.

"More importantly though, they are a means to identify those areas worst affected and over time examine what can work to stem a rising tide of alcohol related ill health and anti-social behaviour.

"Health agencies, police and schools all have major roles to play in reducing the damage caused by alcohol but so do the alcohol industry, employers and the general public.

"We hope that making these statistics widely available will highlight that we are no longer a nation enjoying a harmless tipple but increasingly one developing a dangerous alcohol addiction."

Professor John Ashton, North West Regional Director of Public Health said: "We have made significant progress in reducing the toll of death and disease from heart disease and cancer in recent years, meanwhile alcohol is racing ahead as one of the biggest threats to public health not least in some of the most disadvantaged parts of the country.

"Fears of being accused of being part of the nanny state have intimidated governments from tackling head on the manufacturers of cheap alcohol in the same way that they would if this was any other kind of drug.

"We can stand by and reap the toll of mental and physical wreckage or decide as a society that enough is enough and so solicit a willingness to roll back the tide of alcohol that is washing over us."

Recent figures from the Information Centre for Health and Social Care showed that drink-related hospital admissions in England have reached record levels.

Numbers admitted to hospital with a diagnosis of alcoholic liver disease have more than doubled over the past 10 years, with 35,400 admissions in 2004/05, up from 14,400 in 1995/96.

A spokeswoman for the Department of Health said: "We are working hard to raise awareness about alcohol misuse and ensure that treatment is available to those who need it.

"The first-ever national needs assessment concerning alcohol problems has just been completed and we are getting more people into treatment.

"We already spend an estimated £217 million a year on alcohol treatment and treat an estimated 63,000 people in specialist alcohol treatment services - with even more getting support from their GPs.

"An additional £15 million has been committed for 2007/08 to improve interventions for alcohol misuse.

"In addition, we are working with the drinks industry, police and health professionals to increase awareness of the dangers of excessive drinking and make sensible drinking messages easier to understand.

"Later this year we will be launching a joint campaign with the Home Office to promote sensible drinking."

Press Association

Drug 'classes' have little link to the dangers

Britain's antiquated drugs laws stand accused of failing millions of people because they bear little or no relationship to the harm caused by everything from a hit of heroin to a seemingly harmless pint of lager.

The Home Office has been warned by its own senior advisers that alcohol and tobacco are more harmful to the nation's health than the Class A drugs LSD and ecstasy.

Research by medical experts, who analysed 20 substances for their addictive qualities, social harm and physical damage, produced strikingly different results from the Government's drug classification system.

Heroin and cocaine, both Class A drugs, topped the league table of harm, but alcohol was ranked fifth, ahead of prescription tranquillisers and amphetamines.

Tobacco was placed ninth, ahead of cannabis, which has recently been downgraded from a Class B to Class C drug, at 11th.

Alcohol and tobacco, and solvents, which can also be bought legally, were judged more damaging than LSD (14th) and ecstasy (18th).

The warning on alcohol comes amid growing alarm among ministers over a surge of "binge drinking" over the last decade. They fear it is fuelling rising levels of violent crime and creating long-term health problems for the nation.

Methadone, used to wean heroin addicts off the drug, also scored highly, being judged more dangerous other Class A substances.

The research will put more pressure on the Home Office to a rethink the 35-year-old system for classifying illegal drugs as Class A, B or C substances. It reflects the penalties for possessing them or dealing in them, but that means heroin is categorised alongside drugs such as ecstasy.

The analysis was carried out by David Nutt, a senior member of the Advisory Council on the Misuse of Drugs, and Colin Blakemore, the chief executive of the Medical Research Council. Copies of the report have been submitted to the Home Office, which has failed to act on the conclusions.

Professor Blakemore told the BBC Radio 4 Today programme: "Alcohol, on our classification, is the fifth most harmful drug - more harmful than LSD and by a long way than ecstasy and cannabis and a whole range of illegal drugs.

"That's not to say there's any argument that alcohol should be made illegal, but it does give one a feel for the relative harm potential from any drug."

Strongly influenced by the research, MPs on the Commons science and technology select committee demanded an overhaul of the system to give the public a "better sense of the relative harms involved".

They called for a new scale to be introduced, rating substances on the basis of health and social risks and not linked to legality or potential punishments.

They questioned whether ecstasy and magic mushrooms should remain in Class A and called on the Government's drug adviser, the Advisory Council on the Misuse of Drugs (ACMD), to look at the issue.

Phil Willis, who chairs the committee, said the current classifications were "riddled with anomalies" and were "clearly not fit for purpose".

"This research shows why we need a radical overhaul of the current law and a radical review of the classification system," he said.

"It's clearly not fit for purpose in the 21st century, neither for informing drug-users or providing public information."

One committee member, the Liberal Democrat MP Evan Harris, said that putting drugs in the wrong category "undermined the whole system". "Lots of young people know that there's a difference between ecstasy and heroin," he said.

Martin Barnes, chief executive of the drugs charity DrugScope, said: "With ecstasy, although it is a harmful substance and has led to deaths, if you look at its harmfulness with other Class A drugs, it is much less harmful in terms of links to criminality, mortality and poor health.

"But one of the difficulties, if the classification of a drug is changed, is that that then becomes a key issue in terms of politically how it is received."

Cannabis was reclassified from Class B to Class C in 2004 on the advice of the ACMD. The move prompted fierce criticism in some quarters and was later reassessed in light of new scientific data.

Critics said the change sent out a message that cannabis was not harmful, and downgrading it had caused confusion over whether the drug was still banned.

But in January, the then Home Secretary Charles Clarke announced that after an ACMD review of evidence, the decision to downgrade cannabis would stand. His successor, John Reid, has so far made no pronouncements on drugs policy.

Lord Victor Adebowale, chief executive of the social care organisation Turning Point, said: "Our work across the country with people affected by drugs and alcohol tells us that a classification system should take into account the health, social and economic costs of substance misuse."

Independent

Diverse Groups Helped by Alcoholics Anonymous

Alcoholics Anonymous and other mutual-help groups seem to help people recover from alcoholism no matter what their religious beliefs and gender, or whether or not they have mental disorders, according a new study released today.

The three-year study of 227 recovering alcoholics who went through treatment showed that greater attendance of AA or other meetings following treatment resulted in improved rates of abstinence or in less intensive alcohol consumption in the event of relapse. These beneficial effects were not influenced by gender, religious preferences, psychiatric disorders or whether the patient had prior attendance at AA or other groups.

The study is one of the few to examine the effectiveness of 12-step programs prospectively among different types of people with substance use disorder. The study assessed all types of addiction mutual-help groups that patients attended and found that patients mostly went to AA meetings, probably because they are more available.

"Here's a widespread, chronic disorder that seems to respond well to an inexpensive resource - mutual-help groups such as AA," said Robert Stout, Ph.D., a co-author of the study. "Not only do we need to get more addicts engaged in these groups, but we also need to gather evidence on this issue and make sure that the public, policy-makers and practitioners know about it.

"Stout, a mathematical psychologist who has been studying addiction treatment for nearly three decades, is director of Decision Sciences Institute of the Pacific Institute for Research and Evaluation.The results of the study also support the belief in recovery circles that the more you put into it, the more you get out of it."There is a clear dose-response relationship: If you don't go to any meetings, you have the worst outcomes," said co-author John F. Kelly, associate director of the Massachusetts General Hospital/Harvard Addiction Research Program. "If you go to a few, you have a little bit better outcome, and if you go to a lot, you have an even better outcome."

While not everyone benefits from AA, this study suggests that even people who are not seen as a good fit for mutual-help groups can still derive benefit. For example, critics of 12-step programs say they aren't suited for atheists or agnostics, or for people with fundamentalist religious beliefs, because the programs promote a belief in a higher power while allowing wide latitude in defining it. Some clinicians are uncomfortable referring clients to 12-step support groups because of their spiritual aspect.

Others say that the focus on "powerlessness" espoused in the first of the 12 steps can be detrimental to women because it reinforces low self-esteem and a diminished societal role.

And, some mental health practitioners believe that substance use disorders among psychiatric patients are the result of self-medicating, and therefore if the mental health disorder is successfully treated first, substance use will diminish, obviating any need for addiction-focused program. Another concern is that people with mental illnesses will have trouble becoming engaged in socially-oriented fellowships, or that the need to take psychotropic drugs will meet with disapproval from other AA members.

"There are a lot of unsubstantiated ideas about AA floating around out there," Stout said. "Our study shows that mutual-self help groups will work for a wide range of people that some say wouldn't be helped. We need more studies to get to the bottom of what really is and isn't working."

The study is published in the August edition of Alcoholism: Clinical and Experimental Research. It was funded by the National Institute on Alcohol Abuse and Alcoholism.

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