Friday, May 31, 2013

Vaportinis and Oxy Shots risky ways of boosting the alcohol buzz

Move over alcohol enemas for the extreme crowd, the new rage is freebasing the booze (see article online). And doctors are not amused by the health dangers and potential increase in alcohol abuse and the disease of alcoholism.

The attraction: Inhaling alcohol cuts the potential weight gain out of getting intoxicated by bypassing the stomach and small intestine. And according to YouTubers, it produces a pretty intense high in addition to avoiding the extra calories. Claims that the practice is diet-friendly are unsubstantiated, as are suggestions that inhaling doesn't affect the liver. In both claims, the alcohol is still entering the bloodstream, where it is metabolized by the liver, and there are calories regardless of how alcohol enters blood, typically about 90-120 per 1.5 oz. depending upon the proof. (See "Alcohol plugs 100 calories into the average daily diet.")

They're called “Vaportinis” – an elegant (and trademark-pending) way of describing freebasing liquor by super-heating it over a candle or torch and sucking the escaping alcohol vapor, which is highly concentrated, through a tube. By skipping the glass and the mixer, the alcohol goes from 80 proof straight to nearly 200 proof and enters the blood and directly to the brain immediately via the lungs rather than 20 minutes later through the intestine, where 85 percent of alcohol is absorbed.

The concept brings a potentially more dangerous meaning to the phrase, “Inhaling your drinks.” But the concept is not new, it's only recently become more affordable. In 2004 a North Carolina company offered a bulky, $3,000, UK-patented machine to vaporize liquor for inhaling. Now a more simple device developed by a Chicago bar owner uses a $35 tea-light-fueled mechanism to bring inhalable alcohol downmarket. It's also accomplished by pouring 80-proof over dry ice and huffing the resulting gas.

Medical professionals warn that alcohol is a drying agent and can dehydrate mucous membranes in the nose and lungs when using it as an inhalant. The super-concentrated booze can also cause alcohol poisoning more readily than drinking would. However, research hasn't caught up – yet – with the specific medical impact of alcohol inhalation. “To my knowledge there have been no human studies on the effects inhaling alcohol,” said Dr. Thomas Greenfield, director of the National Alcohol Research Center. He notes, however, that in research laboratory rats have been known to be more perceptible to alcohol addiction through inhalation, which is how alcohol tests are conducted on the rodents since they will not drink alcohol. “Certainly the animals experimented upon have high levels of intoxication and addiction.”

The contrivance will not fool alcohol test devices, especially portable breath testers (PBTs) used by law enforcement in drinking and driving stops. For minors it's still illegal, even though there is no drinking, because the alcohol is “possessed and consumed.”

In Spain, similar alcohol misters or foggers (known as “oxy shots”) were banned in parts of the country after health authorities cited severe health risks associated with inhaling alcohol.
-- from my examiner 5/31 post

Wednesday, May 29, 2013

New .05 BAC proposal for drinking and driving: Too restrictive vs. not tough enough vs. not doable

Drinking and driving arrests could spike, temporarily, while drivers get used to new regulations if alcohol limit is lowered, according to one view of the NTSB's recommended lowering of the intoxicated driving threshold.  Some restaurant owners want what is safest for their customers (so they return), while some are looking at reduced margins if fewer diners imbibe with their meals.  Here's a synopsis of developments in the two weeks since the board suggested the change from .08 to .05, from today's article.
A May hearing by the National Transportation Safety Board (NTSB) produced ideas for reducing drinking and driving deaths, among the ideas, lowering the alcohol limit legal for driving from .08 to .05 blood alcohol concentration (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."
Georgia lawmakers are perusing data from an Atlanta Journal Constitution series that showed in 2001, when the state was at a .10 limit, there were 406 alcohol-related road deaths and in 2008, at .08, there were 416. There were fewer motorists in 2001 however.
Mothers Against Drunk Driving (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 National Highway Traffic Safety Administration (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. (See the article “What 53 feet means” for more on driver impairment.)
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 "Fingerprint scanner lets employers check workers for alcohol"), 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

Sunday, May 26, 2013


One of my favorite sections of Every Silver Lining Has a Cloud is the chapter on a major stressor for Alcoholics: Forgiveness. Not one of us expects a shrine built on our behalf just because we quit drinking. Some people, however, are hell-bent on never letting us move on.
A healthy recovery is going to rely upon you forgiving other people, too. We Alcoholics really suck at this. We grip resentments like a chubby trick-or-treater grips a bag full of Snickers. We have to—have to—knock that off and forgive, even the people who are downright hostile toward us.
You will be able to initiate the process with someone by whom you feel hurt in about two-thirds of the situations. Most of your injurers are not going to come knocking on your door seeking a clean slate for judging you, and the other third are likely to have slammed the door on you and moved on from your drama. Remember the “full” line you passed.
Forgiveness isn’t a pardon, releasing a person from accountability for the injury they caused. Pardon, a la President Ford pardoning Nixon, assumes one person has authority over another. Forgiveness isn’t forgetting either. Author Beverly Flannigan (Forgiving the Unforgiveable, Macmillan Publishing, New York 1992) says you have to remember to forgive someone. “To forgive, one must remember the past, put it into perspective and move beyond it. Without remembrance, no wound can be transcended.”
To transcend or close wounds with the two thirds who haven’t slammed the door to you, forgiveness is a transaction. The Transactional Model follows a sequence described in 1953 by J.A. Martin (“A Realistic Theory of Forgiveness,” in The Return to Reason, Henry Regnery Press, Chicago).

A) Injured accused injurer
B) Injurer admits it
C) Injured gives reasons he feels violated
D) Injurer admits he was wrong
E) Injured punishes
F) Injurer takes it
G) Injured seeks assurance it won’t happen again
H) Injurer promises
I) Injured accepts the promise and requires nothing further
J) Injurer trusts forgiveness is permanent
That’s pretty civilized, optimistic and tidy. And it works. You’ve probably practiced the model without the extensive analysis since you played in a sandbox. But the model is hardly realistic when you encounter the kind of bitterness and stigma Alcoholics face. The emotional sensitivity Alcoholics have in common doesn’t help, and creates an imbalance in the model because the belief systems of injurer and injured are out of whack. Steps C and D can become a snarl when one side doesn’t accept the difference between drinking problems and problem drinkers. If the bitterness persists, you may have to walk away with the satisfaction that you tried: You attempted the transaction.
There’s hope still, even when the Transactional Model fails or is inappropriate because someone slammed the door on you and is long gone, unable to participate in the transaction. They’re gone believing they have been injured. Without the opportunity to confront the injurer, you’re pretty much left to repair the damage and wipe the slate clean by yourself.


Saturday, May 25, 2013

SATURDAY REWIND: Many who fought wars, today fight alcohol

When battles end for men and women who serve in the armed forces, another battle – a battle with the bottle – begins for half of the troops. I retrieved this article about active duty and retired soldiers, the brave we honor this Memorial Day weekend, to demonstrate how their service on our behalf renders wounds unseen to many.

While most of America’s warriors return home without traumatic brain injuries or damaged arms or legs, beer and liquor are the crutches for an alarming and growing number of those who serve our country. Servicemen and servicewomen who fought abroad – from Korea to Vietnam to Bosnia to Afghanistan – return home to fight alcohol use disorders at a rate nearly two times higher than the general public.

Many of those who have seen active duty turn to alcohol to try to deaden the images of what they’ve endured. The National Council on Alcoholism and Drug Dependence, Inc. (NCADD) reports that of nearly 30 million veterans in the United States, 56 percent of male veterans and 41 percent of females have problems with alcohol and 23 percent of males and 14 percent of females binge drink.

Additionally, according to the Armed Forces Health Surveillance Center, one in eight troops returning from Iraq and Afghanistan from 2006 to 2008 were referred for counseling for alcohol problems after their post-deployment health assessments. The number of soldiers enrolled in treatment after being diagnosed with alcohol use disorders has increased 56 percent since 2003.

Alcohol use disorders are divided between alcohol abuse and the disease of alcoholism. (See the related article, Know the difference between alcoholism and alcohol abuse, for the distinction.)
To gain a fuller understanding of alcohol use disorders among younger veterans and active-duty personnel, the Millennium Cohort Study is following a representative sample of U.S. military from 2001 to 2022. It is the largest prospective study in military history. Findings from this study suggest that Reserve and National Guard personnel and younger service members who deploy with reported combat exposures are at an increased risk for the onset of heavy weekly drinking, binge drinking and other alcohol-related problems.
All service branches, the Department of Veterans Affairs and the National Institutes of Health (NIH) are trying to address the alcohol crisis. In one project, researchers are using smart phones and wearable wireless sensors to record real-time responses to stress among veterans suffering from addictions and trauma. The VA offers a brief, anonymous and confidential tool on their website to help veterans who may have concerns about their drinking. The Drinker’s Check-Up is another easy-to-use website developed for veterans under a grant from the NIH.
The referral process and accessibility of treatment options for veterans with alcohol use disorders are only slightly better than the resources available to the general public today, however, the military was playing catch-up with their budgeting for such resources for the past decade. They are taking education, treatment and prevention seriously, today, as we welcome home more of our nation’s warriors from the Afghanistan war, but the resources are available to all veterans.
Whether one agrees or disagrees with reasons for entering a conflict on foreign soil, those who serve and their families deserve our support and salute.  They are owed our help and attention, not the stigma Americans attach to alcohol use disorders. 

Sunday, May 19, 2013


Denial is a word tossed around liberally when it comes to the disease of Alcoholism. It's most often a reference to the very early phases of the drinking when the drinker denies (to himself) he has a problem when it is obvious to those around him he does have a problem. To get to any level of sobriety, an Alcoholic has already tackled that form of denial. What this excerpt from Every Silver Lining Has a Cloud addresses is a different form of denial that rears its head during recovery: The denial that life has, or has to, change because we lost something. It is a stage of the grief process.
“Alcoholics have a tendency to cling to their denial of their losses, not of their problem. By lingering in the stage, it only makes the cortisol worse. Even though the reason we linger in denial is simply that we don’t want to feel worse, we’re actually feeling worse because of the cortisol. To move away from more of continued Symptoms, the denial evolves into anger. Ashley Davis Prend identifies it as going from “Not me” to “Why me?” and it takes a long time.
“On average it takes one to three years to work through the disorganization and anger stage. That’s because you need to process the grief repeatedly so it can sink in, settling on deeper levels of consciousness over time.”
Simply put, you’re not going to be pissed off one time for one day, but you’re entitled to it and it is a healthy part of what comes naturally during mourning and recovery. Different anniversaries rekindle the anger. Social losses and financial ones have long tails and breed anger over and over. Impatience sparks the anger, too, because all of us Alcoholics have a little control freak in us.
Unfortunately, some of us never get past the anger because that’s where we lapse. We drink at the anger. Or if we don’t drink, we become what’s known as a dry drunk, a bitter and angry person who doesn’t and won’t drink. The dry drunk won’t find recovery, but will maintain sobriety because they cling to the anger. They become dry drunks because of a false sense of power anger provides. It does beat being sad. Sad feels so broken, anger feels powerful, but sadness is the next stage. Rather than moving forward, the dry drunk chooses the power of anger rather than feeling like the ornament at the bottom of the Christmas storage box. They’re usually more of a pain in the ass than they were when they were drinking.”

Saturday, May 18, 2013

SATURDAY REWIND: Liquid divorce, or three of alcohol's impacts on sex and relationships

June is traditionally the big month for weddings. I pulled three articles from my news archive that demonstrate how alcohol use disorders can doom the "I do's" years later.

Divorce is predictable (article)
Couples who drink together may not stay together according to a study posted in the May 2013 issue of Alcoholism: Clinical and Experimental Research. The study concludes that divorce is more likely, though not by as much, if the couples drink about the same amount of alcohol, compared to couples who don't drink, study lead author Fartein Torvik of the Norwegian Institute of Public Health said.

The massive study included nearly 20,000 couples in one county who were surveyed over a 15-year period. The researchers found that heavy drinking by the men or women increased the risk of divorce, even after adjusting to remove "light drinkers." No determination was made about alcohol abuse or the disease of alcoholism. The institute found that even when they filtered out demographic factors and mental distress, heavy alcohol use by one or both spouses was a predictor for dissolution of marriage.

The likelihood of divorce was especially high when only the woman drank. A different study presented at the annual meeting of the American Sociological Society in January concluded that men drink less after saying “I do” and women drink more. That study noted that being married to a man who is more likely to drink creates a new social environment that may promote drinking among women.

Torvik noted in a statement about the Norwegian study, "The risk of divorce is estimated to be tripled when the husband's level of drinking is low and the wife's drinking is heavy, compared with couples where both drink lightly."

The research found that couples where neither spouse drank had lower probability of divorce. "This study demonstrated that both the level of alcohol use and compatibility in alcohol use are important predictors of marital dissolution," the journal wrote as a conclusion.

Women drink more after marriage (article)
Men – or marriage – can drive women to drink. Women consume more alcohol after they say “I do” while men actually cut down after marriage, a January 22 study found.

Men are more likely than women to hit the bottle after a divorce, according to the survey into marriage and alcohol conducted by sociologists at four universities. The study was based on surveys of 5,000 men and women conducted over 47 years.

Lead researcher Corinne Reczek, professor of sociology at the University of Cincinnati, said, “Stable marriage curbs men’s drinking, yet is associated with a slightly higher level of alcohol use among women. Our findings suggest that being married to a man who is more likely to drink creates a new social environment that may promote drinking among women.”
Reczek added, “Some research suggests that men are more likely to cope with stressors in “externalizing” ways such as drinking more alcohol, possibly contributing to alcohol abuse or the disease of alcoholism. Women are more likely to cope in “internalizing” ways such as depression rather than alcohol abuse.

The study found that while husbands drank less alcohol than single men and widowers, their consumption increased sharply if the marriage ended. Reczek insisted that men who fail to converge with their wives’ drinking habits in marriage may set a trajectory towards divorce and continued heavy drinking.

Men who cut back on drinking are more likely to have a happier marriage.

The study findings were presented at the Annual Meeting of the American Sociological Association.

SEX (article)
Men who want to avoid taking erectile dysfunction drugs such as Cialis might want to back off the booze. Drinking alcohol can cause lasting damage to men's sexual performance even after abstaining from the drinking, a newly published study suggests.

Researchers said men can suffer "brewer's droop" for more than a year after giving up heavy drinking. Spanish physicians asked personal questions of 109 men from nine different treatment facilities over two years. The men were questioned while they were heavy drinkers and when they had scaled back their intake. The research found alcohol had a residual effect that lasted many months.

Academics from Santo Tomas University in Colombia and the University of Granada in Spain said their results “partially contradict those of other authors who argued that alcohol causes transient erectile dysfunction.” Results show that, overall, all dimensions (pleasure, desire, arousal and orgasm) were moderately impaired. Pleasure and orgasm were the two areas most significantly impaired. After even two weeks of abstinence, no relationship was found between drug abstinence and improvement in sexual functioning.

Writing in the January online “early view” of the Journal of Sexual Medicine, they noted: “It does not seem to be just a temporary problem, because erectile ability was still affected after a year and, according to the results, did not seem likely to improve just with [alcohol] abstinence.”

The researchers also found that heavy drinkers tended to enjoy sex less than those who only drank moderately, and were less likely to want sex.

They wrote: “Alcohol users were found to have lower pleasure scores. To the best of our knowledge, no previous studies have related alcohol consumption with impaired sexual pleasure.” The research backs up years of speculation about alcohol use disorders and how they affect male performance and overall reproductive health.

Alcohol acts a fairly efficient chemical solvent to dissolve adhesives, oil residue and paint.  It's also fairly effective at dissolving jobs, respect, self-esteem and bank accounts.  These three unrelated studies demonstrate how alcohol dissolves relationships as well.  The last of the three articles is purely a physiological side-effect from alcohol consumption, the first two articles show how the physical/psychological/sociological/legal/professional/financial consequences of alcohol misuse will dissolve a relationship.  Sometimes, it's easy to blame the other spouse for "driving us to drink."  In fact, that drink might be driving him or her out.


Tuesday, May 14, 2013

Are U.S. drivers – and lawmakers – ready for a .05 blood alcohol limit or even more severe mandates?

The NTSB adopted 20 recommendations May 14 aimed at getting intoxicated drivers off the road and reducing the number of alcohol-related highway fatalities.  Among the recommendations is a lower threshold for the definition of intoxication.  The NTSB's recommendations carry a lot of weight, especially when Congress gets behind them by linking highway funding with the proposals as they did when the legal limit dropped from .10 to .08 in 2004 and in the 1980s when the drinking age was increased to 21.

Here's the report from, followed by a surprising response from Mothers Against Drunk Driving as well as some other observations on driving under the influence.

A hearing by the National Transportation Safety Board (NTSB) May 14 produced ideas for reducing drinking and driving deaths, among the ideas, lowering the alcohol limit legal for driving. “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.”

Forty percent of U.S. highway deaths – or just under 9,900 lost lives – were attributable to driving while intoxicated in 2011, the most current year for which results are available.

The NTSB recommendation is based on results in other countries, 100 of which have limits below the .08 BAC limit in the U.S. In Germany, .05 is the limit, and 17 percent of traffic fatalities are alcohol related. In Australia, also at a .05 limit, 28 percent of motorists killed had a BAC over the limit. Fatal crashes decreased 18 percent in Australian states which lowered BAC limits from 0.08 to 0.05, despite having lower drinking ages and higher incidence of alcohol use disorders, such as the disease of alcoholism, than the U.S. Throughout much of Europe, the BAC limit also is .05 and alcohol-related traffic deaths were halved within 10 years of instituting the lower limit.

The Governors Highway Safety Association, which represents state highway safety offices, says expect push back from states on lower legal limits to curb drunk driving. “It was very difficult to get .08 in most states so lowering it again won’t be popular,” Jonathan Adkins, an official with the states' group, says. “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.”

Drinking may seem to affect individual drivers in different ways, however, 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. (See the article “What 53 feet means” for more on driver impairment.)

The lower BAC limit is among 20 recommendations in the "Reaching Zero: Actions to Eliminate Alcohol-Impaired Driving" report adopted by the NTSB. Also on the table is a system of passive alcohol detectors in all motor vehicles proposed December 19, 2012. (See related article). The passive technology could be similar to fingerprint scanning presently used by some U.S. And U.K. companies to monitor employees in high-risk or high-profile positions.

The NTSB is an independent agency which studies traffic safety issues and makes recommendations for law changes or safety improvements, but has no-law making authority of its own.
-- from

Mothers Against Drunk Driving (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 National Highway Traffic Safety Administration (NHTSA) also opposes the change to .05.  Republican leaders on Capitol Hill say, "Leave it to the states to decide." The beverage industry, naturally, called the proposal "ludicrous."

Where the rubber meets the road here is the question:  How far are we willing to go to save 10,000 lives?  If drinking and driving is the burning safety issue, there would be no push-back given other countries' experience with lower limits as well as ample research that proves "impairment" begins at .02.  That level is where Swedes set their legal limit for driving... and they rarely have an alcohol-related traffic fatality.

Rarely.  But they still have them.

Passive alcohol devices, as proposed in the 20-item NTSB platform, are something I mentioned three years ago in What the Early Worm Gets IF America really is serious about drinking and driving.  That's because...
... intoxicated driving deaths are 100 percent preventable with such a mandate.
NHTSA is behind it.  The Automotive Coalition for Transportation Safety is on board.  The U.S. mandated airbags in the name of saving lives.  The states mandated seatbelt use in the name of saving lives.  If we're interested in eliminating 10,000 entirely preventable deaths in the U.S., a passive detector mandate saves lives.  Lowering the limit still lets an impaired driver turn the key.

Sunday, May 12, 2013


It's Mother's Day in the United States. For many with the disease of Alcoholism, if we are fortunate to outlive our mothers, they have been the ones to post bail, take us to rehab, pick up our kids, mop up our literal and figurative messes, make our excuses or... just cry the tears moms cry over feeling utterly helpless in the face of the disease's carnage.

In some cases, these signs of caring go to the point of co-dependency. Part of chapter four in Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety delivers a succinct overview of co-dependent behavior from the point of view of both the co-dependent and the drinker. This excerpt makes an important distinction for both: One did not cause the other. They are two separate conditions.

Psychology professionals vastly smarter than I define co-dependence by its three stages of progression:
1. Normal problem solving skews . . . as a reaction to reduce the family crisis and ease the Alcoholic’s pain. This is sick thinking because it ignores the fact that a non-Alcoholic is powerless to control an Alcoholic’s disease. As the Alcoholic becomes increasingly preoccupied with getting, using and keeping booze, the co-dependent becomes more focused on him and begins to change her own behavior in response to the Alcoholic’s lifestyle. (I use “her” because co-dependents often are female, there are males, too. I know several, including myself.)
2. Self-defeating problem solving emerges . . . after the previous stage fails to achieve any progress the co-dependent tries harder. Here’s where a co-dependent becomes more obvious since they begin to take responsibility for the Alcoholic and does so at the cost of their own needs. They’re not as aware of how they feel but can go on and on about how the Alcoholic feels.
3. Chronic repetition takes over . . . regardless of the health of the Alcoholic (e.g. whether they are using, abstaining or in recovery) the co-dependent keeps tending to the Alcoholic because doing so has become her identity. A co-dependent doubts anyone would want them around otherwise, so she makes herself indispensable to the drinker. She’ll struggle when you get well because by stopping drinking you’ve removed from her the single way she made herself indispensable. Minding the Alcoholic has become the meaning of her existence and she needs the Alcoholic to be sick for her to feel well.

That last sentence is a huge source of guilt and conflict, and an ironic one at that, because you can feel guilty for getting better if it seems to be making her worse. You see her struggle with co-dependence even after you’ve had some measure of sobriety. She doesn’t seem to function well or at all without the drinking you. The quality of her life depends upon how much you need her and you feel guilt over that.

There’s no denying that co-dependents feel pain. Sometimes it’s even physical, usually gastrointestinal problems. Guilt is misplaced if you believe you’re to blame. The condition of co-dependence was there before you were sick.

An Alcoholic isn’t sicker than the co-dependent. You are both struggling with similar issues in dissimilar ways. In some ways, the co-dependent is trying to deal with your issues for you. Or attempting to. Dr. Charles Whitfield suggests the hallmark of co-dependency is a problem with boundaries and not knowing where she ends and you begin. “Co-dependents cannot develop without distortions in personal boundaries.” (Co-Dependence: Healing the Human Condition, Health Communications, Deerfield Beach, FL 1991) He didn’t say co-dependents cannot develop without an Alcoholic.

Every Alcoholic’s road back to health begins with an aha! moment when he realizes, “I have an alcohol problem.” A co-dependent needs to have her own aha! moment to realize she has a disorder. Her self-identifying is part of her process of healing and discovering she’s not sick like you or sick from you. You’re not the right person to give her the a-ha moment. Her own lemons; her own lemonade. You cannot rescue her just like NO ONE could rescue you. You can help her. You can’t be her. Show you care . . . which you can do without guilting yourself all the way to a relapse.

The best tribute you can pay to her is to pay attention to your sobriety and its Symptoms.
– from Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety, pgs. 46-47

One of the responsibilities in recovery is making amends to those you've injured. The injury of co-dependence is a very real, often untreated, lifelong one. It is not in the 12-steps or any other program that you have to cure this injury, only acknowledge it. Guilt over co-dependents' struggles can trigger a lapse. And it could also swing the pendulum back in the other direction because often times recovered Alcoholics turn into co-dependents themselves, trying to fix co-dependence they didn't create. Honor mom, know she and others suffered, and that co-dependence (if an issue) is curable.

Saturday, May 11, 2013

SATURDAY REWIND: Intoxicated driving no longer top killer of teen drivers, but being #2 is no merit badge

The no-kidding news this week was that texting behind the wheel is a bigger killer of teen drivers than drinking and driving. Teens killed texting and driving: 3,000. Teens killed drinking and driving: 2,700. A number of high-profile programs are aimed at avoiding crashes by stifling the distraction of the mobile phone. AT&T. AAA. The AdCouncil. All have top-of-mind messages about the texting-and-driving danger. Just because drinking and driving has slipped to the number two slot in the lethal list, does not mean it has become less hazardous... it just means more teens are tapping out messages instead of paying attention to the road.
Parents, schools and community leaders are mindful to not take the emphasis off the hazards of intoxicated driving just because a new killer has risen to the top of the list. But as the following article from my news archive points out, schools and communities have less of a role than parents in thwarting drinking and driving and underage drinking in general.

Parental involvement does more to discourage underage drinking than the school environment can, according to research released December 4 by three universities.

Specifically, the researchers looked at how “family social capital” and “school social capital” changed the chances for and/or frequency of alcohol use by children. Family social capital can be described as the bonds between parents and children, such as trust, open lines of communication and active engagement in a child’s life. School social capital captures a school’s ability to serve as a positive environment for learning, including measures such as student involvement in extracurricular activities, teacher morale and the ability of teachers to address the needs of individual students. Parenting is a better block to underage drinking than the schools, according to the North Carolina State University news release on the study.

"To be clear, school programs that address alcohol and marijuana use are definitely valuable, but the bonds parents form with their children are more important. Ideally, we can have both," says Dr. Toby Parcel, a professor of sociology at NC State and co-author of a paper on the work.

The researchers looked at data from a nationally representative sample that collected information from more than 10,000 students, as well as their parents, teachers and school administrators. The research, to be included in the quarterly Journal of Drug Issues, evaluated marijuana use and alcohol use separately.

“Parents play an important role in shaping the decisions their children make when it comes to alcohol and marijuana,” says Parcel. In both cases, researchers at NCSU (in conjunction with Brigham Young University and Penn State University) found that students with high levels of family social capital and low levels of school social capital were less likely to have used marijuana or alcohol – or to have used those substances less frequently – than students with high levels of school social capital but low family social capital.

More than 10 million American youth under the age of 21 drink alcohol, and more than a million of them are binge drinkers, according to the American Medical Association. One in four teens in the United States have consumed alcohol in the past 30 days. "Underage drinking should not be a normal part of growing up. It's a serious and persistent public health problem that puts our young people and our communities in danger," said U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) Administrator Pamela S. Hyde in a related November 26 story. "Even though drinking is often glamorized, the truth is that underage drinking can lead to poor academic performance, sexual assault, injury, and even death." Teen drinking also can lead to alcohol abuse as an adult or the disease of alcoholism.

The news headlines this week to dangers specific to teens behind the wheel, whether texting or drinking. The above article begins to address the life risks stemming from underage drinking aside from traffic accidents. Earlier this year, a Mothers Against Drunk Driving (MADD) commissioned study (see related article) concluded that two-thirds of alcohol-related underage drinking deaths were not from traffic accidents. Thirty percent of alcohol-related deaths in people age 15 to 20 are from homicides. Fourteen percent are from suicides. Nine percent are from alcohol overdose. Other causes, such as drowning and household accidents, comprise the remaining 15 percent.

Texting and driving might be the trending topic today, but as MADD points out, “Of all the dangers teens face, underage drinking is among the worst.” And it's not just behind the wheel.

Friday, May 10, 2013

Alcohol and blood pressure: Hypertension is caused by and worsened by drinking

May is Blood Pressure Education Month, emphasizing the causes and prevention of hypertension.  While many assume alcohol (especially red wine) is heart healthy, several studies in this article indicate the opposite may be the case. 

A third of adults have hypertension, or high blood pressure, but as many as one in four of them don't even know it. And it kills. High blood pressure contributes to nearly a thousand deaths every day.

May is National Blood Pressure Education Month, putting a spotlight on awareness of the $47.5 billion health condition. The statistics, from the U.S. Centers for Disease Control and Prevention (CDC), favor those who are being treated, but half of Americans with high blood pressure do not have it under a doctor's plan of care.

Hypertension makes a heart work harder, increases the stress on the heart muscle and arteries and leads to a thickened heart muscle. High blood pressure can also lead to plaque build-up in the arteries, upping the risk for a heart attack or stroke. (See the article on “Stroke Awareness Month, which also is May.)

Some with high blood pressure rely on observational studies that claim alcohol – red wine, specifically – reduces hypertension. This notion is based on observation and is not evidence-based, meaning that patients on the wine-is-good-for-the-heart plan may be getting sicker rather than better. (See related “Wishful Thinking” article.) According to the CDC, “Patients can achieve greater hypertension control by taking their medications as directed, measuring their own blood pressure, and eating a lower-sodium diet.”

Part of the challenge with the “healthy” wine reports is many people aren't mindful of the other health consequences of drinking. In an American Heart Association survey, 67 percent of those surveyed agreed with the statement that wine can be good for your heart, yet only 30 percent knew the association's recommended limits for daily wine consumption. “This survey shows that we need to do a better job of educating people about the heart-health risks of overconsumption of wine, especially its possible role in increasing blood pressure,” said Gerald Fletcher, M.D., American Heart Association spokesperson.

If a person drinks at all, the association recommends no more than two drinks per day for men and one drink per day for women. 

Having more than three glasses of wine in one sitting temporarily increases blood pressure, but repeated binge drinking can lead to long-term hypertension. Heavy or daily use of any type of alcohol can dramatically increase blood pressure or cause heart failure and irregular heartbeats. The consequences go beyond blood pressure and the heart. There's also an increased risk of alcohol use disorders including the disease of alcoholism, suicide and accidents. And cancer: In a 2013 study, Boston University researchers concluded, “When it comes to cancer, no amount of alcohol is safe.”

Even modest alcohol consumption can cause blood pressure to increase, according to two studies conducted in Japan. Noriyuki Nakanishi, M.D., Osaka University Graduate School of Medicine in Japan and lead author of one of the studies, concluded that even very low alcohol consumption can be a health risk, especially older adults. Nakanishi and his research team observed that systolic blood pressure (the top number in a blood pressure reading) went up 1.4 points in those between the ages of 25 and 35, but increased 5.4 points for men between the ages of 48 and 59, for just 12g-22g of alcohol per day. A glass of wine contains about 20g alcohol on average.

In the second of the two studies, researchers from Kyushu University followed more than 1,100 people over age 40 for 10 years. One hundred men and 106 women developed hypertension, with the risk of developing hypertension higher for drinkers, even those who drank less than 23 grams daily. Both Japanese studies were published in the journal Alcohol: Clinical Experience and Research.

Quitting drinking has the expected benefit of reducing blood pressure. In one study reported in the journal Hypertension, researchers concluded that a reduction in alcohol intake among drinkers significantly reduced their blood pressure. They found that when alcohol consumption fell by 16 to 100 percent, there were significant drops in systolic blood pressure. Diastolic blood pressure (the bottom number) also dropped significantly in eight clinical trials. The greatest drop in blood pressure was seen in patients with the highest blood pressure before treatment and those who cut back on alcohol the most. However, the Mayo Clinic warns, “Heavy drinkers who want to lower blood pressure should slowly reduce how much they drink over one to two weeks. Heavy drinkers who stop suddenly risk developing severe high blood pressure for several days.”

Like all alcoholic drinks, wine contains calories and may contribute to unwanted weight gain — another risk factor for high blood pressure. For the wine drinker, dry wine contains fewer calories than sweet: 106 calories for five ounces of dry wine and champagnes… double it for five ounces of sweeter wines. A glass of wine before dinner, another glass with dinner and a sweet wine for dessert, that’s more than 400 calories in addition to the meal.

Another problem arising from drinking with hypertension: Alcohol can interfere with the effectiveness, or increase the side effects, of some blood pressure medications.
-- from

The media portrayal of drinking being good for the heart might not consider all the other health consequences of drinking... and the portrayal isn't widely encouraged by the medical community.  The key to the debate over alcohol and its purported heart benefit stems from the 1976-1992 Copenhagen City Heart Study, in which 13,285 men and women were observed. The results from this study suggested that patients who drank wine had half the risk of dying from coronary heart disease or stroke as those who never drank wine. Other research since the Danish study failed to show a beneficial effect for drinking alcohol, wine included.  The more recent reports suggest the lifestyle profile of the wine drinker's OTHER activities -- being more prone to exercise regularly and eat healthier than beer drinkers, for example -- has more to do with their longevity than the wine.

Scroll down to listen to the replay of the Feb. 10, 2014 interview about Every Silver Lining Has a Cloud.

Sunday, May 5, 2013

Cinco tequila facts for Cinco de Mayo, cinco hangover myths for the morning after

A staple of the Cinco de Mayo celebration of Mexican heritage and pride is tequila. The humorists note the agave beverage's side effects as a desire to fight in order to show off your new-found super-human strength, unexplained urges to pole dance, increased risk of your clothes falling off and discovery of a new apartment (because you don't wake up in yours). The jokes aside, here are five not-so-funny tequila facts I posted online this morning.

1. Darker alcoholic beverages (e.g. red wine, brandy, whiskey and tequila) may contain chemicals called congeners -- kind of like impurities. Congeners give a liquor most of its taste or odor, and contribute to or worsen hangovers. These substances include small amounts of chemical by-products of fermentation, such as acetone. Look on a bottle of nail polish remover for another use for acetone. (Here are cinco myths I've posted about hangovers.)

2. Urban legend spins a research study into health benefits of drinking tequila. Science does not back up any health benefit.  In 2007, Mexican researchers found the agave plant – the key ingredient in tequila – has a high level of inulin, which is credited with helping digestion, reducing cholesterol and retaining more calcium in the body. (Inulin is not to be confused with insulin.) Guillermo Toriz, a researcher at the University of Guadalajara, notes, "Inulin is very good to the digestive system because it helps you to grow good bacteria." That is the good news for the agave plant. Toriz says all of the health benefits found in the plant that produces it are lost when it's fermented to make alcohol.  It's one of those "wishful thinking" attributes drinkers try to pin on alcohol use I mentioned April 12.

3. An open clinical trial was carried out in 2004 on eight healthy non-obese, young male volunteers who were given tequila, one shot daily. The tequila-specific study found a significant increase in their glucose concentration. This can lead to prediabetes: When a person's blood glucose levels are higher than normal but not high enough to be type 2 diabetes It is a potentially dangerous health condition leading to type 2 diabetes.

4. A single margarita can carry half of the daily calorie requirement (see related examiner article). Tequila consists of more calories than vodka, rum and whiskey. That's before the margarita mix. One mix claiming “all natural flavors” listed it's main ingredients as high-fructose corn syrup, citric acid, sugar, corn starch, etc., totaling 30 grams of sugars and 33 grams of carbs per 4 ounces. . . and who has seen a small margarita on Cinco de Mayo?
5. Cinco de Mayo has become one of the biggest drinking holidays in the United States, and one of the deadliest. According to the National Highway Traffic Safety Administration (NHTSA), in 2011 — the latest year for which statistics were available — 35 percent of crash fatalities that occurred on May 5 were alcohol-related.

These health and safety risk are above and beyond the troubles of alcohol abuse and the disease of alcoholism.  With the holiday, any holiday, drinkers can and do find a way to drink.  Many are able to drink responsibly, which doesn't necessary mean "risk free."


This week's excerpt goes back to 2010's What The Early Worm Gets, a book in which the genetic and biochemical roots of the disease of alcoholism are probed. A significant body of research in the field of alcohology revolves around neurochemicals serotonin and dopamine, a.k.a. The Big Two brain chemicals.  They control the oldest part of the brain, the part that regulates what we need to survive based on primitive requirements – eat, don't get eaten, procreate. Dopamine tells the body we need something to survive. Serotonin alerts the body that the need has been met. Non-alcoholics have The Big Two in proportion to one another. In alcoholics, the dopamine is overproduced and serotonin never quite overcomes the dopamine to signal that we've had enough of something alcoholics are genetically wired to believe is a survival necessity: Alcohol.

“Alcohol is a central nervous system depressant. Use of alcohol in an Alcoholic will continue on a binge until the central nervous system becomes so depressed you pass out. There is not enough serotonin to tell the body it is okay. The dopamine keeps telling the body it needs more and is unopposed. It is for this reason that an Alcoholic doesn’t know that other people do not feel the way they do when they drink and that non-alcoholics (“normies”) don’t feel the same way an Alcoholic does when he drinks.
Non-alcoholics have no idea what it is like, how it feels, to drink alcoholically.
To complicate matters even further, some researchers theorize the alcohol molecule itself triggers release of more dopamine. The chemical composition of alcohol is so close to many neurochemicals that it could mimic or interfere with them, especially because alcohol is absorbed directly into the bloodstream at the small intestine without digestion or metabolization.
Treating the imbalance balance between dopamine and serotonin is not new ground. It was originally discovered in 1992 that obesity could be managed by combining Fenfluramine (which blocks the brain’s ability to reabsorb serotonin) with Phenteramine (which increases serotonin and decreases dopamine). The Fen-Phen combination also proved effective in treating Alcoholics in 1993. The Fen-Phen combination however proved also to be saddled with side-effects and fatalities and Fenfluramine was pulled off the market.
Rats have the same primitive structures in their brains and the same Big Two. Rats who have had serotonin removed from their brains have compulsive sexual activity and eating (Eat, Don’t Get Eaten, Breed) because there is nothing to counter the dopamine surges telling the body a survival need isn’t being met. If you have hunger, fear or an unconsummated sex drive, that represents Big Two imbalance. The imbalance stems from nothing you do or eat. A neurotransmitter responsible for the balance called Gamma Amino Butyric Acid (GABA) is controlled by your genes.
The physiological disease has its foundation in the genetic deficiency of the low or missing alcohol metabolism enzyme [discussed earlier in the chapter] PLUS the imbalance between the Big Two. What’s morality or character or behavior got to do with that? Where does willpower begin to fix that? An Alcoholic is no more capable of willing that physiological picture to correction than a starving person can will himself to a full stomach.”
– from What the Early Worm Gets, pages 60-61

Where willpower does come into play is resisting the first drink once sobriety is reached. A practicing alcoholic has no defense against this neurotransmitter imbalance once the alcohol is consumed. Once sober for awhile and the body's tissues have adjusted to not having the alcohol, then a dose of will is needed to keep it that way. An alcoholic has to will something other than the first drink. Once the first drink goes down, those neurotransmitters are still out of whack and there is no way an alcoholic can resist the second drink. Dopamine is running wild, and running the show at that point.  In fact, the low serotonin will make the body crave the second drink or the tenth as much or more than the first one.

Saturday, May 4, 2013

SATURDAY REWIND: More alcohol means more sunburn

Temperatures reached the 80's in parts of America's Heartland this past week. Pasty-white Midwesterners, and I count myself among the winter pale, finally had the warmth of the sun for the first time in what seem like ages. (Sorry about the snow that, the very next day, rearranged a few thoughts of warmth.) My beak and forehead got a little red from the sun... not the first time, nor is it likely the last. I went back to my archive and found this piece as a reminder of how drinking alcohol can contribute to worse skin damage in the sunny months ahead.


Alcohol consumption significantly reduces the level of protective antioxidants in the skin, leading to faster burning in the sun, according to a study reported in this week’s Dermatology Times. The Berlin, Germany, study demonstrated that simultaneously consuming antioxidant-rich food and drinks may help to mitigate this effect. This is of concern to alcohol abusers and those with the disease of alcoholism who get too much sun, particularly those in warmer climes or those who have outdoor occupations.

The study focuses on antioxidant substances called carotenoids, which come from consuming diets rich in natural foods, such as fruits and vegetables – two things people with alcohol use disorders are not known for consuming anyway.

What researchers at the Center of Experimental and Applied Cutaneous Physiology, University of Berlin, examined was the effect of alcohol intake on carotenoid concentration in the skin and whether drinking a carotenoid-rich drink would counteract the effects of alcohol (as in drinking orange juice with the vodka). Skins with lower levels of carotenoids were more susceptible to burning. Sunburn has been linked skin cancer for at least three decades.

Carotenoid concentration decreased after consumption of alcohol and alcohol plus orange juice; however, the decrease after alcohol alone was significantly greater. The concentration drop occurred about eight minutes after alcohol without the O.J. and lasted about 70 minutes. The decrease following alcohol plus orange juice occurred about 45 minutes later and lasted about 90 minutes.

A decrease in the carotenoid concentration in the skin after alcohol consumption can have far-reaching consequences concerning the self-protection mechanism of the skin,” the authors wrote.

Alcohol misuse is tied to several types of cancer inside the skin, preventing cancers of the skin on a sunny day is something even sober people don't do diligently. If you're inclined to drink, respect the risk and slather on the SPF 30 because the alcohol makes you more exposed than commonly believed. Don't forget the tops of the ears, a vulnerable area while boating or golfing, drinking or not.

Two things not mentioned by the German researchers:
Alcohol dulls sensation. With the skin already being vulnerable due to alcohol depleting protective carotenoids, heavy drinking increases the risk because the skin's owner cannot feel the burn that would otherwise warn him or her that it's time to cover up. 

b) Drinking doesn't go hand-in-hand with good judgment. It's remarkable how much effort is made to protect the ice-packed cooler from the sun, but applying and reapplying sunblock to protect the skin from the sun and an alarmingly common cancer isn't top-of-mind.

Friday, May 3, 2013

Wine is stronger today than a few years ago, could fool some drinkers and cause health issues

According to a May 2 report from global news agency Agence France-Presse, “Wines are stronger today than they were two decades ago.” As this morning's article points out, there are health and driving-while-intoxicated ramifications.  

The screw-cap bottle is no longer the sole domain for wine with higher alcohol content. Despite a growth in the low-alcohol wine market segment, wine experts have noticed premium wines are packing more of a punch. The higher-than-expected concentration could have health consequences and may unexpectedly push a driver over the legal limit for driving.

More selective grape harvesting and even global warming are blamed for the use of grapes with higher levels of sugar, which translates into higher alcohol content in the wine.

Wine connoisseurs and critics may be to blame, too, “because drinkers have developed a passion for fruity, aromatic wines with round, silky tannins, encouraged by high ratings from critics,” concludes the AFP. “The quest for ripe tannins has led to grapes with more sugar.” (Tannins, more dominant in red wines, come from the skins, stems and seeds of the grapes and affect the way a wine “feels” in the mouth. Less-ripe tannins = drier wine.)

What this means to the wine drinker is more alcohol consumed today in two glasses of wine than in the same two glasses just a year or two ago. Going from a couple of glasses of wine with 12 percent alcohol content to the same size glasses with 16 percent alcohol, could push a person over the .08 blood alcohol concentration (BAC) limit for driving. This trend in wine tends to skew the predictions of “safe driving” calculators that estimate a BAC level acceptable for driving based on a person's gender, weight and an “average” 5 oz. glass of wine at 12 percent alcohol. For example, a calculator could estimate a BAC of .064 for a 120 lb. woman who had two glasses of wine in a two-hour dinner assuming 12 percent alcohol. If the wine was actually 16 percent alcohol, her BAC could be .097 and over the limit.

Driving concerns aside, alcohol consumption causes alcohol use disorders, such as the disease of alcoholism, and also is linked by research to increased risk for several types of illness and injury, including cancer. Observational studies mention wine as reducing risk of some cancers (see related article), but evidence-based studies by Boston University earlier this year concluded “No amount of alcohol is safe." (see related article ) Alcohol-related illness or injury is now the third leading cause of death in the U.S. and worldwide.

Vintners are required to put the alcohol percentage on the wine label. U.S. law permits a 1.5 percent variance from the percentage printed on the wine label.

Here are alcohol percentage averages for wines from the Alcohol Content database:
Wine Coolers 4–7%
Table Wine general 8-14%
Claret 6-10%
Shiraz 10-14%
Rose 10.5%
White, medium 10.7%
White, dry 11.0%
Red, medium 11.5%
White, sparkling 12%
White, sweet 12.4%
Barley Wine 10–15%
Cabernet, Pinot Noir 11–14%
Dessert Wine 14-20%
Zinfandel 17-22%
Syrahs 17-23%
Port Wine 20%

Lower-alcohol versions of popular wine varieties are making it to beverage stores, however, as a result of health concerns. Richard Halstead, CEO of global market researcher Wine Intelligence, notes, “Alcoholic strength of wine is an issue that consumers take seriously across the world." According to beverage industry magazine Drinks International, "There has been widespread criticism of 15.5 percent alcohol blockbusters and requests for winemakers to aim lower."
-- from

The wine industry acknowledges the boosted alcohol content was not their aim, that they were only catering to the palates of their consumers who preferred fruitier tastes.  The low-alcohol wine market seems to have some appeal to wine judges, however.  A Napa Valley Cabernet Sauvignon won a double Gold Medal at the America Fine Wine Competition despite being a lower-alcohol wine judged head-to-head with stronger Cabs.  The World Wine Championships awarded 91 points (rated Exceptional) to a low-alcohol white blend judged next to its sportier peers.  The lower-alcohol varieties are not risk free.