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Tuesday, December 31, 2013

Dry January 1, 2014

 
 
"When I drink over the naïve people saying that alcoholics, even those in recovery, are weak and hopeless... to them I've proven their point."

Dry January is an important initiative to stay alcohol-free and reduce the risks of harm caused by alcohol.  Each day's calendar page can be found on the Every Silver Lining Has a Cloud Facebook page and on Twitter @AlcoholAuthor.

The New Scientist editorial "Is Dry January really worth it" explains some of the overwhelming positives to putting down the booze or avoiding relapse if you're already sober.
(http://www.newscientist.com/article/mg22129502.600-our-liver-vacation-is-a-dry-january-really-worth-it.html#.UsQHnH7nbIV)

www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Goodbye 2013, 2014...glad to meet you. Coming soon on alcohologist.com...


Thank you for following Alcohologist.com in 2013.  Watch for more in 2014... beginning with Dry January and a return of the SATURDAY REWIND and SUNDAY SNIPPET in February.  There will be ongoing updates on the Affordable Care Act's impact on addiction treatment resources.  And of course there will be continuous coverage of the latest alcohol/health news and research on the disease of alcoholism. 

Alcohologist.com will offer a few more giveaways throughout 2014.  PLUS... Watch for the expected National Recovery Month release of my next alcoholism recovery book Adding Fire to the Fuel: The Stigma of Alcoholism. 

 
Make it a serene '14 


Alcohol alters DNA in young, otherwise healthy, social drinkers

A study of university students analyzed the effect of weekend alcohol consumption on their DNA. Until now, the damage done to genes in the early stages of alcohol abuse has never been documented, according to the researchers, because most of the studies are done at later stages of the disease of alcoholism with people who have been consuming alcohol in an addictive way for many years. “That is why this study is pioneering because it deals with the effect of alcohol on young, healthy people,” the researchers reported.

The idea of studying the damaging “oxidative” effect of weekend alcohol consumption came about when researcher Adela Rendón was lecturing in Clinical Biochemistry at the National Polytechnic Institute in Mexico. Many of the students turning up for class first thing on Monday morning displayed a lack of attention and general malaise due to having a social drinking weekend the students regarded as "harmless."

The students were divided into two groups: the control group made up of the students who did not drink alcohol and the study group of those who drank an average of around a six-pack of beer on the weekend. Blood tests confirmed the 18- to 23-year-olds were otherwise healthy.

Oxidative damage is evaluated by a biochemical test and although the researchers expected to find oxidative damage, they were surprised by the result, as Rendón explained. “We saw that the ones who drank sustained twice as much oxidative damage compared with the group that did not consume alcohol.”

The results revealed damage in 8 percent of the cells in the non-drinking group and 44 percent in the drinkers: 5.3 times more damaged cells. “The fact is, there should not have been any damage at all because they had not been consuming alcohol for very long, they had not been exposed in a chronic way.”

The means by which alcohol manages to alter DNA is unclear. “When we talk about youth alcohol abuse, we are referring to youngsters who drink alcohol without having become addicted. Addiction involves a more complex issue. This is social alcohol use,” said the researcher, “but use which causes damage in the long term and you have to be aware of that.”
--from examiner.com (see full article)
www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Resolutions, part IV: Alcohol-related tissue damage lingers years after quitting



New Year’s often brings resolutions to quit or cut back and/or avoid relapse. Quitting or cutting back can be as life-changing as pledges to work out more in 2014 or promises to get a new job for the new year. Here are additional long-term considerations about alcohol use disorders, quitting and staying sober.

Alcohol itself is toxic. It’s broken down in the body in the following sequence:
Alcohol>Acetaldehyde>Acetic Acid (vinegar)>Water+CO2
The first metabolite, acetaldehyde, is 30 times more toxic than alcohol and is responsible for damage to tissues.

The relationship between chemicals and your DNA is part of a field called epigenetics and epigenetics is now showing that the alcohol you consume and its acetaldehyde byproduct leave a biological imprint on your DNA, one that can surface in diseases later (Wall Street Journal, February 28, 2012). If the drinking doesn’t kill you immediately, it can kill you years down the road.

The weight of scientific evidence demonstrates a link between alcohol and a greater risk of mortality for diseases of the immunological, nervous, cardiovascular, and respiratory and digestive systems. This was most recently confirmed by researcher Domenico Palli, a scientist at the Cancer Research and Prevention Institute of Florence in 2012, and new links with diseases and alcohol are being reported nearly weekly. Absence of evidence is not evidence of absence. If you don’t have the following conditions now, there are provable connections to getting them years after abstinence… the longer a person waits to quit, the higher the risk.

Liver damage/disease
The alcohol user is eight times more likely to get cirrhosis, which is irreversible, incurable and fatal. Not all alcoholics will get it. One in 10 develops cirrhosis. However, it is not the only liver disease cause by alcohol/acetaldehyde.

A fatty liver occurs when alcohol consumption disrupts how the body chooses its fuel. Cell mitochondria—our body power plants—normally use fat to produce energy. As aacetaldehyde breaks down in the body it releases hydrogen, which mitochondria use before fat as fuel. The unused fat then accumulates around the liver. Even in someone who doesn’t look fat in their extremities or midsection, fat deposits choke the liver.

Alcoholic hepatitis is a third type of liver injury connected to alcohol misuse. It is a condition similar to the other hepatitis diseases, but is not the same as A, B or C hepatitis.

Liver problems are not the realm of only the hard drinker, they can be stimulated by amounts of alcohol between five to nine drinks in 24 hours. There are very few symptoms of liver injury until it becomes chronic because the liver has no pain nerves to tell you when it is hurt. If the liver had nerve endings, you’d never make it to the second drink.

Pancreatic damage
The pancreas is a long, flattened, pear-shaped organ located behind the stomach. It makes digestive enzymes and hormones including insulin. Alcohol users are 1.6 times more likely to develop pancreatic cancer, the most fatal of cancers. (Dr. Mirjam Heinen, Maastricht University, Netherlands, May 2009).

Men should be especially conscious of alcohol/acetaldehyde when it comes to the pancreas. University of Pittsburgh School of Medicine researchers isolated a gene variant in men that puts those who drink heavily at risk for pancreatitis.

Muscle disease
Acetaldehyde fragments muscle fibers, weakening them and allowing them to tear easily. Muscle atrophy or destruction can occur fairly easily. The weakness and atrophy have been known to medicine for 200 years as myopathy, but myopathy has come to be known as a common side effect of acetaldehyde and alcohol.

Nerve disease/neuropathy
Alcoholic neuropathy is identical to the neuropathy experienced as a side effect of diabetes. Neuropathy causes a tingling of burning sensation, or a loss of sensation all together. In Alcoholics, as with diabetics, it is an affliction of the limbs and especially the legs. Commonly there is a reduced sensitivity in the feet. You’re not able to feel pain. When this happens, foot injuries, like blisters, can become infected so severely because you cannot feel pain that amputation is necessary. But the fatal problem with the neuropathy is the increase in the risk of stroke it carries, covered in part five of this series.

Stomach disease
Gastritis—sharp stomach pains—and gastric ulcers are very common results of regular alcohol use and can last for years after abstinence. Alcohol slows the emptying of the stomach, which allows more acid to build up in the stomach and therefore more time for it to permanently damage the stomach lining. Cancer of the stomach is called gastric cancer. Gastric adenocarcinoma is the most common type of stomach cancer. It arises from those cells in the stomach lining.

Chronic gastritis also is a predisposing factor in developing stomach cancer (“Alcohol and stomach cancer in northern Italy,” in the Nutrition ResearchNewsletter, September 1994) The newsletter concluded, “heavy intake of total alcohol (at least eight drinks/day) or wine (six to eight or at least eight drinks/day) was associated with a small but significant increase in stomach cancer risk.”

A more recent study put the cancer risk in much more exact and troubling terms. Researchers evaluated information from the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

More than 400 cases of stomach cancer were diagnosed among study participants. Heavy alcohol consumption increased the risk of stomach cancer in men. Men who consumed an average of more than four drinks per day were 65 percent more likely to develop stomach cancer than men who were very light drinkers. The link between alcohol and stomach cancer appeared to be stronger for beer than for wine or spirits.

Breast cancer
One out of eight women will have an encounter with breast cancer. Alcohol use is the ONLY dietary factor increasing the likelihood of getting breast cancer.

Breast cancer risks increase 10 percent for every 10 grams of alcohol consumed daily. That’s about one drink.) Women who consumed even “modest” alcohol (equivalent to 3-6 glasses of wine per week) were linked with a 15 percent increase of developing the disease. Researchers also found that the increased risk of breast cancer for those who drank at least 30 grams of alcohol per day on average (at least two drinks daily) was 51 percent higher compared to women who never drank alcohol.

In addition, when the researchers looked at alcohol consumption levels between the ages 18 to 40 and after the age of 40, they discovered that both were strongly linked with an increased risk of breast cancer. The connection with alcohol consumption still remained even after controlling, reducing or quitting alcohol consumption after the age of 40.

Other cancers
Dr. Palli’s 2012 research identified “significantly” higher risks for cancers of the pharynx, oral cavity and larynx and higher rates for cancers of the esophagus and rectum. “Alcohol’s role as a dietary carcinogen emerged quite clearly,” said Palli. An older study put the numbers at an estimated 75 percent of esophageal cancers in the U.S. are attributable to chronic, excessive alcohol consumption and nearly 50 percent of cancers of the mouth, pharynx, and larynx are associated with heavy drinking.

According to Annual Review of Pharmacology and Toxicology, alcohol misuse results in abnormalities in the way the body processes nutrients and may subsequently promote certain types of cancer later in life. Alcoholism also has been associated with suppression of the immune system. Immune suppression makes you more susceptible to various infectious diseases and, theoretically, to cancer.
--Adapted from Every Silver Lining Has a Cloud

Image: Adamr
www.alcohologist.com


Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Monday, December 30, 2013

Resolutions, part III: The short-term consequences of drinking alcohol


New Year’s often brings resolutions to quit or cut back and/or to avoid relapse. Quitting or cutting back can be as life-changing as pledges to work out more in 2014 or promises to get a new job for the new year. Here are additional considerations about alcohol use disorders, quitting and staying sober.

About eight percent of the population is has the disease of alcoholism and 35 percent are alcohol abusers, but in a 2011 ABC News/Gallup Poll, 67 percent of Americans admitted to having ever abused alcohol. The Centers for Disease Control and Prevention (CDC) puts the number at 61.2 percent currently drinking frequently and 14 percent former regular drinkers. Four percent of deaths globally – 5.5 percent in the U.S. – are linked directly to alcohol according to the University of Toronto Centre for Addiction & Mental Health 2009 study.

Here are the direct health risks for anyone who uses alcohol. The risks apply to light to moderate drinkers, not just a hard drinker. The direct impacts of alcohol are associated with getting drunk, being drunk or activity while drunk. (Parts four and five of this examiner.com series cover the long-term and indirect causes of death and illness from drinking.) The most common categories for direct causes of death documented include the following:

Alcohol poisoning
The first symptom most people experience is sudden death. There is no way of accurately gauging how close you are to a lethal dose of alcohol until you pass it. Coma and death are possible at Blood Alcohol Concentrations (BACs) above .30, however lower BACs can produce the same result depending upon tolerance and health.

Alcoholics can have an extremely high tolerance and the margin between the tolerance dose and the lethal dose is razor thin: They can die at a BAC of .50 or higher without even feeling buzzed. They also can experience sudden drops in tolerance, increasing the risk from death by alcohol poisoning.  Singer Amy Winehouse died in 2011 at a .40 BAC but twice before had been hospitalized at higher BAC levels. You just don’t know when you are not going to wake up.

Withdrawal
Absence of alcohol can and does kill alcoholics because the disease quickly alters the body’s tissues. They become dependent upon alcohol, requiring it in the bloodstream constantly or the body begins to shut down during withdrawal, much as it would without oxygen. Alcohol withdrawal is the only drug withdrawal other than benzodiazepines that can be fatal. Not heroin or meth, the alcohol you find in aisle six of the Winn-Dixie.

Researchers Glen Hanson, Peter Venturelli and Annette Fleckenstein in the book Drugs and Society found “About five percent of alcoholics in hospitals and perhaps 20-25 percent without treatment during withdrawal die” suffering from delirium tremens (DTs—high fever, heartbeat irregularities, etc.). Medically supervised detoxification is a requirement for severe alcoholics because of life support, not for the sedatives to make the other pains of withdrawal more bearable.

Accidents and violence
The number one cause of emergency room visits and 21 percent of all injuries is alcohol (Alcoholism: Clinical and Experimental Research). This includes injuries to someone who was drinking and injuries by someone who was drinking. Two hospital admissions each minute are attributable to alcohol directly, according to the North West Public Health Observatory. This was a 65 percent increase over five years.
. . . 30 percent of transportation injuries are alcohol-related
. . . 22 percent of the 12 million home-accident injuries in 2012 were alcohol-related
. . . 58 percent of fire fatalities have alcohol in their systems, which presumably kept them from fleeing safely
. . . 45 percent of drownings are alcohol-related
. . . 15.5 percent of occupational injuries are alcohol-related
. . . And 56 percent of assault victims have alcohol in their bodies . . . when you drink you are at a two-and-a-half-times greater risk of a violent death.

The media has overemphasized alcohol’s role in car wrecks but has under-reported the role of alcohol in other violent or accidental deaths. A 2012 Ohio State University study concluded that news organizations failure to report alcohol in those cases dampens public support of alcohol-control laws or abstinence.
-- Adapted from Every Silver Lining Has a Cloud



Image: Adamr
www.alcohologist.com


Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Sunday, December 29, 2013

Resolutions, part II: Alcohol's a greater public health menace than tobacco


New Year’s often brings resolutions to quit or cut back and/or avoid relapse. Quitting or cutting back can be as life-changing as pledges to work out more in 2014 or promises to get a new job for the new year. Here are additional considerations about alcohol use disorders, quitting and staying sober.

Alcohol is a mass killer in the United States and is the defining public health issue for the 21st century. Driving under the influence has statistically little to do with those conclusions.

Just under 10,000 motor vehicle deaths, 40 percent of the total, stem from alcohol-related crashes. To put that into context with other preventable deaths:
157,000 lung cancer deaths annually
50,000 people are killed in gun violence
39,520 breast cancer deaths
37,000 fatal overdoses from prescription drugs
34,000 suicides
30,000 Americans still die of the flu
18,000 people are killed in our hospitals by staph infections

Every alcohol-related car crash death is heartbreaking, but by the numbers, those deaths make up very little of the death toll from alcohol use. Even if you ended drinking and driving, alcohol is still our nation’s number one killer:
89,000 other deaths (not in cars) are directly attributed to alcohol; and,
1,000,000 more fatalities from diseases are indirectly attributed to alcohol (e.g. alcohol causes a condition leading to death).

It’s easy to be offended by drinking and driving. What’s even more offensive is the underreporting of the health effects of alcohol that prove alcohol is our defining health issue. Tobacco has at times held that mantle, but by comparison, only 473,000 die annually of smoking-related illness. Beverage
alcohol kills more than a million. A 2012 study by the German University Medicine Greifswald found that heavy drinkers are at more risk of death than those who smoke.

The way America has responded to tobacco awareness campaigns holds promise for alcohol awareness campaigns, should one be mounted. In 1967, smoking was “in.” Seventy-six percent of adult men smoked. Today smoking is “out” and health officials at the Food and Drug Administration believe by 2020 smoking will be banned in all states. This is happening within just a generation and a half because smoking’s health effects are no longer underreported or reported only in obscure medical publications. With alcohol as with smoking, people are entitled to their own opinions, but they are not entitled to their own facts. The remaining three parts of this series cover the direct and indirect causes of illness or death attributed to alcohol use.
--Adapted from chapter eleven of Every Silver Lining Has a Cloud.

Image: Adamr
www.alcohologist.com

(The usual weekly post, SUNDAY SNIPPET, will return Feb. 2)

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Saturday, December 28, 2013

Resolutions, part I: Five things to know about getting and staying sober


New Year’s often brings resolutions to quit or cut back and/or avoid relapse back to alcohol. Quitting or cutting back can be as life-changing as pledges to work out more in 2014 or promises to get a new job for the new year. Here are five things to know about alcohol use disorders, quitting and staying sober.

1. Alcohol abuse and alcoholism are not the same thing. (See this related examiner.com story for the difference.) Cutting back on alcohol consumption may be a practical outcome for an alcohol abuser. If a person has the disease of alcoholism, total abstinence is the only way to put the disease into remission.

2. Nine out of ten people who quit drinking fail to stay sober the first time they quit. More than half drink again within six months. Set your expectations accordingly. Lapse or relapse or slips are as likely with alcoholism than with any other disease. They are not the end of recovery. It just means you have another chance to quit. One man, who might be the most famous alcoholic ever, lapsed four times in 22 months. He quit a fifth time though. That’s Bill Wilson, one of the founders of Alcoholics Anonymous (AA).

3. AA is not the only game in town. There is rehab if you have the resources or insurance, either inpatient or intensive outpatient. There is counseling, either one-to-one or as part of a group… there are also several other self-help groups, such as Self-Management and Recovery Training (SMART), Secular Organizations for Sobriety (SOS) and Women for Sobriety (WFS). None of the latter enjoys the widespread availability of the 12-step program of AA however. Those who have success in sobriety acknowledge one common thing: No one gets sober and stays that way without help, whether through counseling or self-help groups or both.

4. A chronic, heavy drinker should never attempt to stop drinking on his or her own. Alcohol withdrawal is the only other drug aside from benzodiazepines (think Valium) in which the withdrawal can be fatal. Heroin withdrawal is not fatal. Cocaine withdrawal is not fatal. Alcohol withdrawal can be. Alcohol changes the body tissues. Once the tissues become dependent upon alcohol, it is possible that taking the alcohol away will cause cardiac arrest, stroke or seizures. Supervised detox means medical assistance is nearby and nearly all supervised detox involves medication to ease the physical discomfort of withdrawal, which increases the probability for success.

5. Changing a habit takes three to four weeks, which is one reason many inpatient rehabs have a 28-day program. But that isn’t nearly the end. More severe alcoholics are barely medically stable after just a month. It takes effort – some days more than others – for the first year of sobriety, and an acknowledgement that alcoholism is not curable so the change will mean making adjustments for the rest of one’s life. Alcoholics and non-alcoholics alike return to alcohol for the same reasons of stress, grief, guilt or shame. Getting sober and staying sober only begins with a desire to stop drinking and getting some help in the first part of abstinence. The rest of recovery is learning to live without alcohol for those stressors.


Image: Adamr
www.alcohologist.com

(The usual weekly post, SATURDAY REWIND, will return Feb. 1)

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Tuesday, December 24, 2013

Welcome to Christmas 2.0

This is the Christmas 2.0 -- the first sober version -- for many people in recovery. Congratulations on the gift you've given yourself and loved ones and please pass on a little courage to those who are still working on the old version.
 

Sunday, December 22, 2013

SUNDAY SNIPPET: December 22

There are several reasons Every Silver Lining Has a Cloud notes in favor of attending some sort of self-help group. Attendance can help stave off relapse, but on a more basic level it provides a place to talk and to be heard and to be understood. It doesn't have to be the 12-steps. There are other alternatives, some are quite effective and might be a better fit given a person's location or belief system. The fact is, regardless of belief system, we need a place to talk about The Things We Don't Talk About.
 
 
"I’m no shill for AA. (No member is: They're anonymous at the level of publicity. It's attraction rather than promotion.) The AA slogan factory drives me nuts. More about this in a moment. I hate the coffee. The Higher Power thing is tough for some people to swallow. Some people stay away from 12-step meetings because they don’t see themselves in the people around the tables or hear their stories told in the tragic stories of others. That is the point in going: To make sure you’re communicating what is stressing you before you go back to the drinking and become those tragic stories. You go because you don’t want to become The Alcoholic You Don’t Want To Be.
 
I screwed that one up, big time.
 
When I first went to a 12-step meeting, I was Alcoholic. No Doubt About It. But I didn’t hear myself as I presently was in the stories. I heard the horror stories. I was a functioning, maintenance drinker with a great job, two cars, etc. I didn’t have this low bottom I heard in the other stories. So I walked away, not realizing that day could have been my bottom. Their stories of grief and shame weren’t me. I had great empathy for their ordeals. What I failed to see was that they were a gift, showing me where I was headed, not where I was. That these ordeals of theirs were mine if I didn’t make that day my bottom. They were the Alcoholics I Didn’t Want To Be.
 
At the dawn of AA in the 1930s, the makeup was men and women with low, low bottoms. Over the years, that changed mainly because those who had hit low bottoms were able to raise the bottom to a level where it applies to Alcoholics-in-training like me who hadn’t had a low bottom. Yet. I failed. I didn’t listen . . . there’s that communication thing again . . . to what they were saying that they, too, were one day in the same shape I was. And then I became the Alcoholic I Didn’t Want To Be a few years down the road. While we have to talk about the stuff we don’t talk about, it pays to listen. A lot. I go to 12-step meetings for this, but there are other options out there, too. Use them. Most are free.  All are free of excuses not to attend."

Alcoholics Anonymous has -- you guessed it -- a slogan.  Sometimes, the clichés get it right.  Meeting Makers Make It. Especially when it comes to beating relapse.  Doesn't have to be AA, though it works for me and many. Just GO.


Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Saturday, December 21, 2013

SATURDAY REWIND: People who know at least one alcoholic, average three more among their friends

Survey results reported Jan. 31 by the support group Al-Anon show a new dynamic in the relationship between alcohol abusers, those with the disease of alcoholism and the people around them. Only 20 percent of those surveyed for the 2012 Al-Anon Family Groups Survey who said they have had a problem drinker in their lives reported just a lone relationship with an alcoholic. The report shows 60 percent had two-to-four alcoholics in their lives, including one or both parents, a spouse or romantic partner, children, grandparents, siblings or friends. Twenty percent have had five-to-11 alcoholic relationships.

The survey has been conducted every three years since 1984. It provides data on the demographic characteristics of Al-Anon’s membership – the families and friends of alcoholics -- and the health benefits members may come to realize in learning to cope with the negative effects of someone else’s problem drinking.

Pamela Walters, Al-Anon Family Groups Information Analyst, says, “These numbers validate that alcoholism is a family illness, as many Al-Anon members have come to understand. Alcoholism is more than just the drinker's addiction to alcohol. It has complex emotional and social effects on family members and anyone else who has a close relationship with an alcoholic.

"In Al-Anon, the friends and families of alcoholics find their way to recovery from the effects of alcoholism as a family illness, just as alcoholics work toward their own recovery from the addictive effects of alcohol, in Alcoholics Anonymous (AA),” Ms. Walters said. “Even people who do not think their lives have been affected by a problem drinker are surprised at what they learn in Al-Anon meetings.”

From September to October of 2012, the Al-Anon Family Groups World Service Office conducted the Membership Survey of its members located in the U.S., Bermuda, Puerto Rico and Canada. More than 3,200 Al-Anon members participated.

Al-Anon Family Groups are for families and friends who have been affected by a loved one’s drinking. Nearly 16,000 local groups meet throughout the U.S., Canada, Bermuda, and Puerto Rico every week.
--from examiner.com (see full article, image:stockimages)
www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 


Tuesday, December 17, 2013

AAA poll: 96 percent against drinking and driving but 20 percent do it anyway

A not-so-surprising disconnect exists between the public attitude toward driving while impaired and the personal responsibility to do something about it.  "No way should THEY drive like that, it's dangerous.  But me?  I'm fine."


“Do as I say, not as I do,” is the prevailing mindset among motorists when it comes to intoxicated driving. The annual American Automobile Association (AAA) survey, The 2013 Traffic Safety Culture Index, was released online Dec. 17. In it, one in five U.S. motorists who drink say they’ve driven at least once in the past year when they thought their blood alcohol concentration (BAC) might have been close to or above the .08 legal limit.

About 19.5 percent said they took the wheel impaired, according to a statement from AAA’s Foundation for Traffic Safety. The percentage is up over the prior two surveys, and contradicts another AAA finding that 96 percent of drivers believe it’s somewhat or completely unacceptable for people to drive when they think they might have had too much to drink.

Intoxicated driving – or drunk driving – killed 10,322 in 2012 according to the National Highway Traffic Safety Administration (NHTSA). The NHTSA figures also represent a year-over-year increase. (See related Impaired Driving Awareness Month alcohologist.com post)

The AAA survey also showed that two thirds of respondents are in favor of requiring new cars to have built-in devices that would test drivers to make sure they are sober before the ignition starts. Similar technology is in use today to monitor those with intoxicated driving arrests and people abstaining due to the disease of alcoholism. About 63 percent approve of lowering the legal BAC limit to .05 from .08. Both measures were among 20 recommendations in a May 2013 report by the National Transportation Safety Board (NTSB) on how to reduce or eliminate drinking and driving deaths.

AAA advises drinkers to stay overnight, designate a sober driver or use public transportation or a taxi rather than get behind the wheel impaired. One out of 10 arrests for all crimes in the U.S. were for Operating While Impaired (OWI), accounting for one out of every 80 licensed drivers. The AAA also revealed its estimate for 2013 year-end holiday travel is 94.5 million travelers, an increase for the fifth consecutive year. The holiday travel season is when alcohol-related travel deaths peak at an average of 48 per day. The average for the entire year is 25 per day.

-- from examiner.com, see full article

www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Sunday, December 15, 2013

SUNDAY SNIPPET: December 15

Shame is one of the four stressors related to relapse emphasized in Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety.  Our disease is more than biochemical and the majority of the book looks at other happenings in the eight inches between the right ear and the left that sabotage recovery .  In addition to being bluntly personal, I turn to many of the established pros in addictions and psychology... men and women who know the stigma the word "alcoholism" carries. This excerpt continues a couple pages after where the December 8 SUNDAY SNIPPET left off on the subject of shame and stigma.


"Your brain is an echo chamber for the toxic shame words: You’re Not Normal. They are amplified, too. You hear over and over that you’re flawed even when the words aren’t spoken directly to you. Staying sober helps reduce the echoes, but they stubbornly refuse to vanish. The longer they hang on, the more the Symptoms hang on.

One of the foremost authorities on the impact of toxic shame is John Bradshaw. (Healing the Shame that Binds, Health Communications, Deerfield Beach, FL 1988) Bradshaw makes a direct connection between shame and lapse because alcohol provides an escape from the feelings you get from the Symptoms and the labels. Labels that don’t fit but others have tagged onto you leave you feeling wounded. You want to medicate the wound by having a drink. You’re caught between the dog and the hydrant.

The shame causes stress . . . the shamer causes stress . . . not conforming to your body’s request for a shot or two causes stress . . . and knowing you’ve never in your life just had one or two causes stress. Knowing you’ll easily spiral back downward into a new bottom causes stress.

If/When you drink because of the shame someone else heaps onto you for being Alcoholic, the more right the shamer becomes. You prove their points. And you earn more shame. Bradshaw sees this cycle of shame begetting more shame and guilt as a squirrel cage, beginning at the point at which you’ve been labeled. You then want relief, you take a drink, get relief, then get shamed for getting the relief which puts you back to wanting relief from yet more shame.

For an Alcoholic in sobriety, only a single spin through the squirrel cage—maybe two—and you’re well on the path from lapse to relapse.

People expect more out of someone who’s put his Alcoholism into remission. There’s the expectation that the Alcoholic avoids relapse. Forever. There’s the demand that he achieves new levels of productivity on the job. He’s not allowed other human problems, like overeating. They insist he pursues spiritual enlightenment. And if he fails in any of these areas, they’re actually disappointed in him and label him again as a failure—as if non-Alcoholics routinely achieve such goals! Just because you never can drink does not mean you never can be allowed to live without someone reminding you of it each day.

You don’t need to have a really low bottom to have attracted shamers. People shame high-bottom Alcoholics, too, whether or not they’ve been a victim of his drinking. These are the people who are on you for having a disease like ants are on a popsicle melting on the sidewalk. There will always be some Bozo who is going to help you into the squirrel cage because shamers and shame go hand-in-hand with Alcoholism."




www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Saturday, December 14, 2013

SATURDAY REWIND: Mixing alcohol and energy drinks harmful

There's been a lot of ink this week on the dangers of mixing energy drinks like Monster or Red Bull with alcohol: Red Bull and vodka has been a meat-market bar staple for more than a decade.
The warnings are not rocket science, because energy drinks are stimulant-loaded and alcohol is a depressant.  And the warnings are not new.  As this piece from the alcohol research news archive points out, JAMA gave physicians an official heads-up about the toxic mix a year ago.


Commentaries published December 19 (2012) online in the Journal of the American Medical Association JAMA suggest negative health effects from excessive consumption of caffeine, especially in conjunction with alcohol.

One commentary details the health effects of alcohol mixed with energy drinks, including premixed "alcopop" drinks, such as the 12-percent-alcohol Four Loko, and self-mixing of highly caffeinated energy drinks with various types of alcohol. (See the related article on alcopops .)

Citing surveys showing up to 56 percent of college students mixing energy drinks with alcohol, the authors established the potential for public health consequences for this recreational use of energy drinks, which often contain herbal ingredients, including botanical sources of caffeine that contribute to the overall average of 80 to 140 mg of total caffeine content. The popular Red Bull energy drink, for example, has 80 mg of caffeine in a 10-ounce can.

At issue are concerns the caffeine counters the sedating and intoxicating effects of alcohol, thereby impairing judgment relative to risky behavior. JAMA concluded the scientific evidence on the alcohol/energy drink combination’s effects "on perceived intoxication and sedation has been inconsistent," but noted mixing alcohol with energy drinks has been correlated to "increased risk for negative consequences of drinking."

Take 18-year-old college student Danny Hummel, for example. He died of acute alcohol poisoning. Hummel's Blood Alcohol Concentration (BAC) exceeded .40, eight times the limit considered too impaired to drive. His family attorney reported he also had several energy drinks prior to drinking. Without the energy shots, the attorney claims, Hummel would have “puked or passed out” long before reaching such a lethal BAC.

The JAMA report acknowledges action by state and federal officials against energy drinks containing alcohol help increase awareness and help marketers of these products, and most young people will continue to mix energy drinks and alcohol. "Thus, it is important that policy makers, parents, university administrators, health care professionals and consumers of alcohol mixed energy drinks have accurate information regarding the drinks as a public health danger," they advised.

In addition to the commentaries, JAMA also published a Patient Page containing information on the energy drink market, including common ingredients, caffeine content of various known energy drink brands, and some health risks associated with energy drink use — increased heart rate, palpitations blood pressure, sleep disturbances, urine production and blood sugar.with the disease of alcoholism. (Related: What's the difference between alcohol abuse, alcoholism?)

-- from examiner.com (see full article)
www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Thursday, December 12, 2013

The elevator doesn't work in alcohol recovery: Taking the steps on 12/12

Many self-help groups employ the 12 steps originated in the book, Alcoholics Anonymous, 74 years ago. The group named after the book, AA, remains the most successful organization in handling the disease of alcoholism today. The only membership requirement: A desire to stop drinking.

The Substance Abuse and Mental Health Services Administration (SAMHSA) in 2008 reported an annual average of five million people 12 and older attended a group self-help meeting in the prior 12 months. One third also went for one-to-one counseling or group therapy. Because 12-step groups are so widespread, most one-to-one counseling and group therapy is based on the 12-steps and those counselors encourage participating in 12-step group self-help to boost sobriety. In fact, the National Treatment Center Study Summary Report from the University of Georgia found 90 percent of 450 treatment centers are based on the 12 steps, while 10 percent rely on “Behavior Therapy.”

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) seems to endorse the 12-step approach in group therapy as well. In 2008, it found Behavioral Therapy less successful than 12-step methods. “Individuals in 12-step oriented therapy have increased subsequent Alcoholics Anonymous (AA) participation and it is the AA involvement that leads to better outcomes by buffering the effects of social pressures to drink. AA exposes a person to a network of people who have a goal of sobriety and support one another in achieving that goal.”

Group therapy requires signing up and showing up. Group self-help like AA requires only showing up. One thing to note though, if it is confidentiality you seek, one-to-one counseling is the only route 100 percent confidential. Anonymous is not a synonym for confidential. Ask yourself, though, does recovery really need to be confidential? Far too many get ticklish about talking “publicly” about their shame and other stressors. The alternative is not talking. And that leads to relapse. A twelve-step meeting is not the town newspaper. Even if it was, some alcoholics’ under-the-influence feats were more public than anything they’d say in a group self-help meeting ever would be.

These are safe venues in which to communicate. They consist of people who share the exact same struggles. Talking things out among them is cathartic. You don’t need to talk about every confession you have. You don’t get style points for deeper traumas. You do get style points for creating a climate of trust by putting on the table the things that are giving you challenges in sobriety.

Alcoholics risk reaching out because they need a new label, a new place to belong, and there is safety among others who are also trying to shed old labels and stressors. If You’re Not Normal is the three-word death sentence to recovery, Me Too is the two-word pardon alcoholics get at 12-step meetings.

Even if an alcoholic does not ever buy into the 12 steps as a design for living, they are suggested, not required, for membership. “The only requirement is a desire to stop drinking,” the literature says. Twelve-step meetings are places to be among others who feel the same, wore the same masks, suffer the same struggles and have a desire to communicate rather than drink over them. “The most desperate need of mankind today is not a new vaccine for any disease or a new religion or a new way of life,” wrote Taylor Caldwell in the novel The Listener. “His real need, his most terrible need, is for someone to listen to him, not as a patient but as a human soul.”

Everyone, no matter how gifted, healthy or wealthy, encounters an issue that baffles them or breaks the spirit. Twelve-step groups are where alcoholics can communicate the baffling and the spirit-breaking. What all are trying to do together is acquire back self-esteem.

There are alternatives to 12-step groups, such as Women for Sobriety (WFS) and Self-Management and Recovery Training (SMART), however none have the track record of success AA boasts, and none are as widely available. Other 12-step groups are available for a number of addictions, from gambling to narcotics to overeating.

The Higher Power thing is tough for some people to swallow. Some people stay away from 12-step meetings because they don’t see themselves in the people around the tables or hear their stories told in the tragic stories of others. That is the point in going: To make sure you’re communicating what is stressing you before you go back to the drinking and become those tragic stories.

From a strictly medical standpoint, alcoholism is remarkably easy to arrest. It’s a lot less complicated than arresting cancer or diabetes. Abandon the bottle long enough and detox and biological functioning returns to something close to normal in a few weeks or months. From that point on, it is a matter of not going backward. That’s the drawback to having a disease that can be arrested but not cured: While it is under control it’s all too easy to forget what life was like when it wasn’t. Twelve-step groups remind alcoholics what it was like. Without the stigma.

One of the most treasured AA stories in print says, “Above all, AA taught me how to handle sobriety. I have learned how to relate to people… deal with disappointments and problems that once would have sent me right to the bottle. How do we do it? By sharing at meetings.”
-- Adapted from the recovery book, Every Silver Lining Has a Cloud. Photo credit: Marcus, Free Digital Photos
(See full article here)
www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Wednesday, December 11, 2013

Texan gets probation for murdering four while driving intoxicated: You can't make ice cream out of cow shi


A Tarrant County, Texas, judge was RIGHT in saying a teen who murdered four while driving intoxicated wouldn't get treatment while incarcerated. But the judge was gravely mistaken for punishing the murderer with probation. In Wisconsin, where I grew up, we have a saying: You can't make ice cream out of cow shi... And here's why nobody is making ice cream this week.


First, the case. CBS Dallas-Fort Worth reported a judge sentenced the 16-year-old teenager to 10 years probation for an intoxicated driving crash that killed four people in June. Hollie and Shelby Boyles had left their home to help Breanna Mitchell, whose SUV broke down. Brian Jennings, a youth pastor, was driving past the mother and daughter and pulled over to help. That’s when investigators say the Ethan Couch slammed into everyone. Couch admitted he was drinking and driving. At the time of the crash his blood alcohol was three times the legal limit.

Eric Boyles, a North Texas man who had two family members killed in the crash, walked from the court and tried to speak through the tears. “We had over 180 years of life taken, future life, not 180 years lived, but 180 years of future life taken and two of those were my wife and daughter.”

Defense attorney Scott Brown said, “There is nothing the judge could have done to lessen the suffering for any of those families.” Lawyers had argued that the boy’s parents should share the blame for the crash, because they gave him everything he wanted. The teenager’s attorneys pleaded for a sentence that involved therapy in California, at cost $450,000 a year, rather than years behind bars.

“She [judge Jean Boyd] fashioned a sentence that is going to keep him under the thumb of the justice system for the next 10 years,” Brown said. “And if he doesn’t do what he’s supposed to do, if he has one misstep at all then this judge or an adult judge when he’s transferred can then incarcerate him.”

Eric Boyles didn’t agree with the judge’s sentence or the assertion that therapy is what the young perpetrator needed. The victims families were hoping for closure. “Today could have been a good start at that, unfortunately the wounds that it opened only makes the healing process that much greater and more difficult,” Boyles said.

________

During sentencing, Judge Boyd noted that Jennings would not get the treatment he needed while incarcerated. And that is an unfortunate and expensive truth about the corrections system. I've written a book on it, reported on it, and I have been on the inside as an offender. People can and do get better in corrections' drinking programs, but it is rare. It is not treatment on the inside, it is mistreatment.

No broadly conceived treatment program for offenders exists today. The 12-step-oriented programs are kept at arms' length because of their spiritual leaning, even though their success rate is arguably better than all else.

(Some of the observations that follow come from What the Early Worm Gets, my 2010 book on coerced programs.) Sensory deprivation is the ONLY way for an educated person to avoid the rampant anti-sobriety messages in jail. Forty to fifty percent of the time in jail is spent scheming to get drugs or alcohol into jail, planning to deal or drink or get high on the outside on release day, or glorifying how they used drugs and alcohol (and people). It is a swap meet for bad ideas. This lively chit chat takes place between sleeping and watching cartoons or gambling. One face is worn during the program, and another anti-sobriety face is worn through the rest of the time in the facility.

The library was a refuge of sorts. The library did have several good books on sobriety and alcoholism and recovery. The books were not as popular as the Urban fiction or the hip-hop magazines. For example, Dr. Bob and the Good Oldtimers is a classic Alcoholics Anonymous book. It was checked out only eight times between 1995 and October 2009 and only once from April 2005 to October 2009.
 
Sadly, the anti-sobriety messages also were distributed by the program staff at the jail. They permit offenders who had their probation revoked – even dope dealers and those without any documented need for alcohol treatment – priority access to the taxpayer-funded alcohol programs. These are the same people who failed drug and alcohol tests after already having been released early once! Not once is any priority given to people who actually want to take the publicly funded programs. And that is the crux of recovery: A person has to WANT to change. Coerced treatment is a well-documented failure.

Yet, jails/prisons will always have the required headcount in those programs. Sometimes inmates cannot even get past the waiting list. Are we fixing the right people?

And are we fixing them at all? I struggle with this flawed system because we’re told to be sober by people who have no clue what it is like to be Alcoholic, and we’re told to succeed in sobriety among people who have no intention of embracing it.

We succeed in real recovery when we find a reason—a meaning—in sobriety. In jail- and prison-run programs you’re instructed to be happy when what we really need is a reason to be happy. It’s like having your picture taken. You can be told to say, “Cheese.” But the great pictures are when the smile is one you had reason to wear. You wear a smile when you learn to cope with shame and guilt. Prison works on the premise that you will be shamed into compliance.

In an exit interview the program director for the Corrections alcohol program I was in admitted two things. She said, “This is the only exposure most inmates get for alcohol problems,” and in practically the next sentence added, “On average a person has 13 programs before sobriety.” Not recovery, but sobriety. I don’t think these two facts are unrelated. If they go through 13 programs, you pay 13 times. Could the money be better used in prevention and education outside the fences? 

Corrections is in the role of warehousing humans with varying levels of Antisocial Behavior Disorders. Sociopaths. Dr. Marc Schuckit, author of “Alcohol & Sociopathy: Diagnostic Confusion,” in the Quarterly Journal of Studies on Alcohol, put it this way. “It is necessary to distinguish between the alcoholic who engages in a limited sphere of antisocial behavior and of the antisocial who abuses alcohol as part of his behavior. The process and prognosis of these different varieties are distinct. (Ironically, the issue of Dr. Schuckit’s article I accessed was in a corrections’s own library, stamped, “Bureau of Program Services.” Perhaps they hadn’t yet gotten around to reading the 1973 article, as they make no effort to make such a distinction. Why, because corrections is in the business of warehousing sociopaths. Not in the “treatment” business for a complex medical and biochemical disease like Alcoholism. The judiciary doles out the punishment. The jail’s role isn’t punishment, it is housing those who are being punished.

There's a corrections saying: “You don’t go there for punishment, you go there as punishment.” Corrections is no more equipped to handle real treatment than an auto mechanic is trained as a French pastry chef. They are two different disciplines. And you wouldn’t pay Mr. Mechanic for his cooking. But you are paying billions for ineffective programs run by corrections with your tax dollars with sometimes toxic results.

Couch, the intoxicated driving murderer in Texas, wasn't heading for treatment for an alcohol use disorder.

Now, on to the sentence... no ice cream there either.
_______

As long as the public appetite is in favor of incarcerating intoxicated drivers, should a judge have such wide latitude to dole out an alternative like Couch got: Probation? No. If the public thinks jail sentences are a deterrent for drinking and driving, that is the will of the public. I know several offenders through the course of my work who did not murder a soul or dent a fender and spent time behind bars.

No sentence will bring the dead to life... but someone did kill them. And they call them “crashes” instead of “accidents” because it was no accident. An impaired person decided to drive a one-ton weapon into four people when he turned the key in the ignition... he just hadn't hit them yet.

Do longer sentences act as a deterrent? Not likely. Alcohol-related traffic deaths rose nationwide from 2011 to 2012 according to National Highway Traffic Safety Administration (NHTSA) figures despite a slew of enhanced laws including stricter sentences. And guess what: As awful a place as it is, the environment just is not a deterrent. Not for people who like living that way. It isn’t much of a deterrent for the six or eight percent of us who have alcoholism either because, if we have no fear of drinking ourselves to death, prison isn’t going to scare us too much, either.

That said, the law was broken, and the public said Couch should be incarcerated for his crime, not sent to Lindsay Lohan's treatment center. At a minimum, the families got a really cold, harsh slap in the face with Couch's slap on the wrist.

The Criminal Justice system is full of painters when it comes to jailing and rehabilitating intoxicated motorists. The real world’s treatment process, where there are consenting, active participants in the recovery process is full of eye doctors. A painter lets you see the world as he sees it. An eye doctor will let you see the world as it really is more clearly.

What we're seeing clearly in Texas is no ice cream, but something being spoonfed to the public and the surviving families that smells a lot like cow shi
www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Sunday, December 8, 2013

SUNDAY SNIPPET: December 8

Shame is one of the four stressors related to relapse emphasized in Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety.   The book leans heavily toward the neuroscience and endocrinology fields in parts of the first chapter of the book.  However, our disease is more than biochemical and the majority of the book looks at other happenings in the eight inches between the right ear and the left that sabotage recovery .  In addition to being bluntly personal, I turn to many of the established pros in addictions and psychology... men and women who know the stigma the word "alcoholism" carries.

"...That’s just one example of stigma or ignorance leading to the insensitivity behind shame other people bring to our doorsteps or the shame we find when we stand on their doorsteps. In a lot of ways the shame is as pain-provoking as the disease itself, especially when we’re treated this way by People Who Should Know Better. I once thought I had a huge fund of tolerance for people, but realized it could be quickly drained once I began dealing with otherwise smart people who say dumb things about Alcoholism.

The shamer may not want me to go to heaven because I’ve got this thing, but I want to go anyway, so who’s the one with the problem? The Person Who Should Know Better.

You do not expect them to build a shrine to your sobriety, but it isn’t too much to expect them to let you try to succeed. They are simply not strong enough to accept that negative things can happen in life randomly. It is a part of nature they have chosen to deny. They have a “conflict of visions of reality” to steal from Zen and the Art of Motorcycle Maintenance. (Robert M. Pirsig, HarperCollins, New York 1974) It’s the way people choose to see the world regardless of scientific discoveries.

Stigma is the shadow cast by ignorance, and ignorance about Alcoholism remains very strong in society. A poll cited in HBO’s 2007 series, Addiction: Why Can’t They Just Quit? reported that one half of the public believes Alcoholism is a “personal weakness.” In the face of 56 years passing since the American Medical Association deemed Alcoholism a disease, HALF the population still refuses to believe it is one, and are wed to a 3,000-year-old notion that it is a bad person rather than a bad medical condition. Call it lack of training or education to be more diplomatic, but it isn’t going to change by the time you finish this book. According to a truly common way of thinking called the “just world philosophy,” you’ve gotten what you deserved. In a just world, if you are careful, smart and moral you can avoid misfortune; and if you don’t avoid misfortune, you are misfortune. Shame on you.

In 1957 Dr. Jellinek’s disease model of Alcoholism authoritatively ended centuries of false conclusions about Alcoholism being tied to careful, smart and moral. People still have a hard time giving up the idea that it is some sort of problem that can be stopped by just walking in a different direction. They don’t isolate the science from the myth and rhetoric. The prevalence of shaming is a natural human tendency to be subjective rather than objective and that the untrained and closed mind will follow the path of least resistance. The American society shames the Alcoholic, so too must they.”

 

It's unicorns-and-rainbows thinking for those in recovery to try to single-handedly overturn the stigma that is rooted so deeply in our culture. We can work with others to fight stigma... the best first step toward that end is learning to live, live well and live sober around shame. When we drink over the shamers' dumb ideas, we prove them right.


Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Saturday, December 7, 2013

SATURDAY REWIND: You don't have to be alcoholic for drinking to damage the brain

Alcoholic Dementia and "wet brain" are two terrifying outcomes from excessive drinking and the disease of alcoholism.  Everyone who drinks -- or who is looking for yet another good reason to quit -- might benefit from new science demonstrating other brain hazards. From the alcohol research news archive, even so-called social drinking cuts into the brain's long-term health.

A recent study indicates that even moderate drinking reduces the production of new brain cells by 40 percent. The November 8 journal Neuroscience reports the findings that seem to deal a blow to those who promote moderate drinking as good for the heart: It appears to compromise the brain.

Moderate drinking is defined as three or four drinks in a night. This level of drinking is approximately equal to a Blood Alcohol Concentration (BAC) of .08, the amount under which it is legal to operate a vehicle. The level of alcohol intake was not enough to impair the motor skills of the rats in the study, however, the decrease in the brain’s ability to create new cells could have profound effects on learning and memory later.

The study also tied its findings to binge drinking, not drinking the three or four in a night but making up for it on the weekend. Men who drink 14 drinks a week are considered at-risk drinkers. The number for women is 7 drinks per week.

The area of the brain that produces the neuron cells is the hippocampus, which is associated with learning and memory. Affecting this part of the brain might not be something you notice immediately, but over time, weekly drinking could have so dramatically reduced the neurons that learning or remembering things becomes more difficult.

Learning and memory difficulties are common in people with the disease of alcoholism. (Related: What's the difference between alcohol abuse, alcoholism?) The study indicates that people don’t have to be alcoholic to do damage to brain structures and that social drinking may be more harmful to people than is currently perceived by the general public.
-- from examiner.com (see full article)
www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Wednesday, December 4, 2013

10,000 deaths, 100 percent preventable

Bookended by Thanksgiving and New Year's Day – the two deadliest days on the road – is National Impaired Driving Awareness Month. During the entire year, an average of 25 people are killed each day by intoxicated motorists. During the holidays, the average jumps to 45 per day. All are preventable with existing technology.

National Highway Traffic Safety Administration (NHTSA) is a sponsor of the campaign, along with Mothers Against Drunk Drivers (MADD) and the Governors’ Highway Safety Association. In the United States the NHTSA estimates the nearly 10,000 people killed in alcohol-related collisions, represented a third of total traffic deaths. One out of every 10 arrests for all crimes in the U.S. were for Operating While Impaired (OWI), accounting for 1 out of every 80 licensed drivers. The death toll is higher than the previous year, despite tougher penalties and more enforcement.

Most addiction professionals prefer the term “Operating While Impaired” over “Drunk Driving” because often “drunk” is a subjective term, but there's an objective legal standard for impairment. No distinction is ever assessed whether the driver is an alcohol abuser or has the disease of alcoholism: If you are impaired, you are under arrest.

Drunk or buzzed driving is the act of operating or driving a motor vehicle while under the influence of alcohol or drugs while motor skills are impaired. In the United States, the point of impairment is pegged at .08 Blood Alcohol Concentration (BAC). However, studies have demonstrated that motor-skill impairment begins at much lower BACs. Reaction time is 1/5 of a second for an unimpaired driver. With alcohol in the system, reaction time is slowed to 4/5 of a second at .06 BAC. At 60 mph, a second means 88 feet. A fifth of a second is 17.5 feet, 4/5 of a second is 70.4 feet. The Jetta slamming on the brakes in front of an impaired driver is 53 feet closer, reaction-time wise, compared to an unimpaired driver.

The specific criminal offense is usually called driving under the influence (DUI), and in some states driving while intoxicated (DWI), operating while impaired (OWI), or operating a vehicle under the influence (OVI). The first jurisdiction in the U.S.to adopt laws against drunk driving was New York in 1910, with California and others following. Early laws simply prohibited driving while intoxicated, requiring proof of a state of intoxication with no specific definition of what level of intoxication qualified.

The first generally-accepted legal BAC limit was .15. In the US, most of the laws and penalties were greatly enhanced starting in the late 1970s, and through the 1990s, largely due to pressure from groups like MADD, leading to a national standard of .08 as the definition of impairment.

A May 2013 hearing by the National Transportation Safety Board (NTSB) produced ideas for reducing drinking and driving deaths, among the ideas, lowering the limit legal for driving from .08 to .05 BAC. One hundred other countries have lower BAC limits for driving than the U.S. The idea is being debated around the country because the board has no authority to make the recommendation a law.

The last time the NTSB recommended a BAC change, from .10 to .08, it took two decades and the threat of Congress withholding highway funds for the idea to become law in all 50 states. An Indiana state legislator, Senator Michael Crider, R-Greenfield, predicts that is what it will take again. "If you look at the percentile drops, it's a pretty significant drop in the legal driving limit for drunk driving. It's going to be something not necessarily real popular, based on what I saw last time."

MADD, an expected ally of the proposed lower limit, is not behind it, instead focusing on its own three-pronged agenda for reducing impaired driving. The NHTSA also opposes the change to .05. Republican leaders on Capitol Hill say, "Leave it to the states to decide."

The states so far have voiced resistance. The Governors Highway Safety Association, which represents state highway safety offices, says expect push back because, “It was very difficult to get .08 in most states so lowering it again won’t be popular,” according to Jonathan Adkins, an official with the states' group. “The focus in the states is on high content offenders as well as repeat offenders. We expect industry will also be very vocal about keeping the limit at .08.”

The industry, via the American Beverage Institute, expectedly called the proposal "ludicrous."

Wyoming Gov. Matt Mead told the Associated Press he would prefer to increase penalties for drunken drivers, but he is willing to study the recommendation. However, Mike Moser, of the State Liquor Association, said the change could criminalize social drinking. Moser said it makes more sense to crack down on heavy drinkers who are more dangerous behind the wheel, an idea that does not register with a Chicago trauma surgeon who notes impairment begins far earlier than severe intoxication. Dr. Thomas Esposito, chief of the Division of Trauma, Surgical Critical Care and Burns in the Department of Surgery at Loyola University Medical Center, says, "The rationalization by critics that it penalizes the person who only occasionally has 'one too many' or who only drinks 'socially' makes no sense. One too many is just that; it's about impairment, not the number of drinks."

Lab research indicates at 0.02 to 0.05 BAC, the ability to see or locate moving lights correctly is reduced as is reaction time and the ability to judge distance. Even if not obviously impaired, at 0.05 BAC drivers are twice as likely to have a crash as before they started drinking...At 0.08 BAC drivers are five times more likely to have a crash than before they started drinking. Over .08, the crash likelihood jumps to 10 times that of a sober driver.

Highway alcohol-related deaths are 100 percent preventable. Passive alcohol detectors can measure a driver's BAC before starting the vehicle and render it unable to start. If the driver is intoxicated, he isn't driving. Critics claim the technology has not been perfected. However, the technology already exists for the non-invasive technique (see related examiner article), although the public appetite for the device does not.

Mandating these in-car alcohol detectors – the way seatbelts and airbags are required in U.S. cars – was among the 20 ideas the NTSB proposed at the same time as lowering the BAC threshold for drinking and driving. Detroit automakers have been testing in-dash systems since June 2012. The idea was suggested three years ago in the book What the Early Worm Gets as the way to conclusively eliminate all drinking and driving accidents.

“Our goal is to get to zero deaths because each alcohol-impaired death is preventable,” NTSB Chairman Deborah Hersman said. “They can and should be prevented. The tools exist. What is needed is the will.”

In 2011, 9,858 people were killed, 350,000 injured and $132 billion spent as a result of "alcohol-related" crashes. To Esposito's point, such classification does not mean the driver was over the .08 BAC limit, although usually that is the case, only that alcohol was present at the scene or detected on the breath or blood. No determination has to be made regarding level of intoxication, alcohol abuse or the disease of alcoholism but 4 million motorists admit to driving while impaired, according to NTSB estimates.
--from examiner.com (See full article)
www.alcohologist.com

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK.