Breast Cancer Awareness Month: Revealing alcohol's role begins to unravel the ribbon

Ladies... and men who care... listen up: There is one and only one unchallenged dietary link to an increased risk of breast cancer. That link is alcohol consumption.

To date, the only dietary link to an increased risk of breast cancer is alcohol use. One in eight women will have an encounter with breast cancer in her lifetime. It takes relatively little alcohol to boost the cancer risk. As little as one drink a day can provide a double digit increase in the chance of getting the disease. Three or more servings of alcohol per day gives you the same risk as a daily pack of cigarettes.

Think about that for a minute: With all the news regarding the link between smoking and cancer, the alcohol link is as strong and well documented, but far less publicized. For now. 

The whitepaper, Alcopocalypse, predicts the next 10 years for the alcohol business will look like the last 20 have for tobacco. 

Alcohol's causal relationship with breast cancer isn't new. More than 100 studies 1920-2017 have conclusively linked alcohol consumption to increased breast cancer risk. New research continues every year, delving deeper into the link, especially how alcohol disrupts hormones and even genes. 

Alcohol increases production of estrogen. Estrogen increases are behind 80 percent of breast cancers. Toxic alcohol also creates another toxin – acetaldehyde. That second toxin has been shown to alter DNA and breast tissue in younger drinkers, leading to increased cancer risk later in life. A Journal of the National Cancer Institute report showed a double-digit increase in breast cancer risk for women who drank as little as one drink daily between the first menstruation and the first pregnancy. The results were independent of drinking after first pregnancy. That study also discovered an increase in benign breast disease, a non-cancerous condition which accounts for 80 percent of breast lumps. These benign lumps do increase the risk of breast cancer by 500 percent. The more alcohol consumed between the onset of the first menstrual period and the first pregnancy, the greater the risk for both benign breast disease and breast cancer.

In another recent study, a University of Houston researcher and his team have discovered an important link between alcohol and breast cancer by identifying a cancer-causing gene triggered by alcohol. The 2015 Houston research shows alcohol enhances the actions of estrogen in driving the growth of breast cancer cells and diminishes the effects of the cancer drug Tamoxifen on blocking estrogen by increasing the levels of a cancer-causing gene. 

A consensus panel formed by the American Institute for Cancer Research (AICR) a decade ago concluded: "The evidence on cancer justifies a recommendation not to drink alcoholic drinks" ... a recommendation still maintained by the organization.

Only one in 10 adults knows alcohol is a carcinogen. 'Why haven't consumers been advised of the increased risk?' is a simple question to answer. Where do most people get information about alcohol? From the alcohol makers or from studies funded by them. Their information has been manipulated to protect the profitability of the drug they make, according to a new study by London School of Hygiene and Tropical Medicine (LSHTM) and Sweden's Karolinska Institute. The study claims alcohol giants are not exactly striving to educate consumers and marketers are misleading customers by hidieng facts from the public about cancer links to alcohol. Published in the Sept. 2017 journal Drug and Alcohol Review, the study found in 2016, that 30 companies misled the public about alcohol's connection to breast cancer risk. See Hey Alcohol Biz: The 90's called and wants their liars back.

Bottom line: Alcohol is a drug that's toxic and carcinogenic. Drinking it and expecting healthy results is like peeing in a Mr. Coffee and expecting Starbucks.

Scott Stevens, is the author of four alcohol books including the December 2016 release, I Can’t See The Forest With All These Damn Trees In The Way: The Health Consequences of Alcohol. Get the new BookLocker title now on Amazon (viewbook.at/prehab), alcohologist.com, and everywhere you buy books.  Click Alcopocalypse for the author’s 2017 Alcohol Awareness Month whitepaper. Image by  Peter Lecko, used with permission.

Busting the flashy car for 75 mph to let the 250 mph Peterbilt pass

The public relations approach to hiding an alcohol pandemic

In opioid news this week, state attorneys general across the country are stepping up their game against the opioid crisis. Awhile back, the AGs sent letters to insurers, asking them to do more to curb the opioid epidemic. Now, they say they're expanding an ongoing investigation into pharmaceutical companies make or distributing opioids. That's according to MedPage Today. The publication also reports the Substance Abuse and Mental Health Services Administration (SAMHSA) offered up an additional $144 million in grants for preventing and treating opioid addiction … a crisis costing the economy $78.5 billion a year.

That's correct. Opioid use and addiction costs the U.S. $78.5 billion.  

Alcohol use and addiction costs the U.S. $250 billion a year, using the same measurements of health care costs, lost productivity, and legal system expenses.

We focus on an epidemic, so we don't have to focus on a pandemic. The 75 mph 'vette gets the ticket. The 250 mph Peterbilt gets a pass. Classic PR.

The public relations tactician works it something like this: 

Pick a drug – One that is sold only by prescription, generating profit for a few, wealthy souls vs. a drug sold nearly everywhere in the U.S., generating profit (and tax revenue… but not as much as you think) for every restaurant, bar, retailer, grocer, hotel, gas station, henhouse, outhouse, and doghouse where it's sold. Villify alcohol? Not on your life.

Draft in support – According to FollowTheMoney.org, Big Pharma contributed $163 million to local, state, and federal candidates in 2016… alcohol interests (manufacturers, distributors, retailers) donated $219 million. Don't bite the hand.

Choose an opponent you can outspend – BusinessInsider.com put beverage alcohol spending at $421 million in a single calendar quarter. Every one of those ads tells Americans we can drink a toxin and known carcinogen 'responsibly.' You're not going to run with these big dogs. Stay on the porch.

Capitalize on ignorance – Fewer than 1 in 10 Americans know that alcohol kills three times as many people as opioids (89,000/yr. vs. 30,000/yr). Less than 1 in 4 know that alcohol's a carcinogen and a third of the 22,000 annual alcohol-related U.S. cancer deaths occurred in people who had downed one and a half drinks a day or less. Alcohol is legal. Legal equals 'safe' in our society. Except for those nasty drunk drivers, binge-drinking college kids and hard-core, red-nosed alcoholics, this isn't a drug: It's responsible and fun in moderation. Opiates and opioids are controlled substances, illegal without a prescription, and have a high risk of addiction and/or overdose. Nevermind the medicinal relief in chronic pain situations: Opioids are definitely the baddie.

Don't make them think, either – There is a short line between opioid use and overdose death. Drinking alcohol is more like stepping out onto the highway and waiting for the Peterbuilt to hit you: It could take years or decades. Too many dots to connect – and other causes to which to pin the death while you're waiting. Brevity is better in our 'always-on' planet. A recent Pew Internet study in the US suggests that people benefit from instant access to a wealth of information from numerous sources, but their attention span and desire for in-depth analysis is consequently diminished. That's how we got the term bounce rate. “If you start a message and I can't see the end from the beginning, I will find it elsewhere… and bounce.” Opioid tragedies tell what time it is… alcohol deaths tell how to build a watch.

Sell the sizzle, not the steak – There are 91 deaths a day from opioid overdose. Opiates and opioids take lives in a single-dose for some people. And sadly, the lives are often kids and young adults that society wouldn't have picked out as a drug user. The old newsroom saying was, “If it bleeds, it leads.” Crass and cynical? Yes. Accurate? Pretty close. Stories of an honor student dying are tragedies with great images on par with hurricanes, school shootings, and blazes… compared to someone dying a death from alcohol-related illness like heart attack, stroke or cancer.

Wag the dog – We have a genuine health crisis. The opioid problem is real and tragic and a worthwhile fight. Now, if we turn a genuine health crisis and spin it up to an epidemic… maybe we don't have to talk about a pandemic or other health crises like fetal alcohol spectrum disorders (FASDs) which are now more prevalent than autism. It's the sleight of hand performed by politicians, PR wags, confidence men, and magicians for millennia: Watch what I do with this hand, while the other takes your wallet. Or your health. 

And, most importantly of all, don't make enemies – According to the 2015 National Survey on Drug Use and Health (NSDUH), 86.4 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime; 70.1 percent reported that they drank in the past year; 56.0 percent reported that they drank in the past month. Even if you went with the lowest figure, 56 percent of adults used alcohol in the last thirty days. That's 137 million adults. By American Society of Addiction Medicine (ASAM) stats, 2.5 million adults have substance use disorder involving prescription pain relievers or heroin. You've got a good shot at convincing me something is bad if you're not doing it. You're even more effective telling me something is bad if I'm not doing it.

It's not the back bumper of the Peterbilt that hits you

What we've got here, is failure to communicate: There's a drug acceptance problem in the U.S. There's not just an opioid overdose crisis. There isn't only an alcohol pandemic. There isn't a weed legalization debate. The problem is cultural in the way we normalize drug use, stigmatize those who've become ill from them, and throw too little money, too late, at treatment instead of prevention. Did any alcoholic become alcoholic without taking the first drink? Is any case of alcohol-related injury or illness possible without a first drink? Giving a 'gateway drug' a free pass negates prevention efforts on other drugs we find less 'responsible.'

No amount of PR is going to paper over it for long before it becomes fiscally unsustainable.

Scott Stevens, is the author of four alcohol books including the December 2016 release, I Can’t See The Forest With All These Damn Trees In The Way: The Health Consequences of Alcohol. Get the new BookLocker title now on Amazon (viewbook.at/prehab), alcohologist.com, and everywhere you buy books.  Click Alcopocalypse for the author’s 2017 Alcohol Awareness Month whitepaper. Image by  Peter Lecko, used with permission.

Gambling with FASD and the unborn: What. If. They're. Wrong.

A widely reported Sept. 8, 2017 analysis, based on data published in the online journal BMJ Open, indicates the possible harmful effects of light or occasional alcohol consumption during pregnancy is “surprisingly limited.” While the point of the study was that there is damage to the unborn no matter the quantity of alcohol...the article was spun up by the alcohol industry (and media in a rush to appease alcohol advertisers -- which Facebook actually did with this alcohologist.com post to kowtow to alcohol advertisers) as "there isn't much to worry about so drinking a little is ok while expecting."

That's relieving news to an expectant mom, right? What if the seemingly unchallenged and widely reported news is wrong?

The analysis is contrary to common sense, and does not mesh with pediatricians' recommendations. The American Academy of Pediatrics reiterated in a 2015 report that no amount of alcohol in any trimester is safe. Authors said in the report: First trimester drinking (vs. no drinking) produces 12 times the odds of giving birth to a child with FASD, first and second trimester drinking increases FASD odds 61 times, and drinking in all trimesters increases FASD odds 65 times. (For more on FASD, see the video below, or follow the transcript)

This new report doesn't pass the smell test and its broad distribution comes courtesy of the clout of the alcohol industry, known for distorting and denying the health consequences of the drug they manufacture. That, and a cultural willingness to believe in unicorns and other wishful thinking (see related story).  The new report was based on observational studies. Observational studies do not take into account all the other lifestyle factors of a mom-to-be. Or misinformation. Face it: When questioned by a physician – facing possible stigmatizing comments or fearing being 'reported' somewhere – what new mother is going to admit to the amount or frequency of alcohol use during pregnancy?

Fetal Alcohol Spectrum Disorders (FASD) are now more common than autism and a child is born with one in the range of FASDs every 4.5 minutes. There is nothing in any evidence suggesting drinking this 'safe' amount of alcohol during pregnancy will lower that statistic.

The unborn use the same blood and therefore have the same blood alcohol concentration (BAC) as the mother. The fetus lacks the ability to process the alcohol the way an adult does, so the BAC remains high for a long time, causing a number of physical, cognitive, social and neurological problems that are permanent and irreversible. And sometimes fatal. 

As many as 40,000 babies are born with an FASD annually, costing the U.S. up to $6 billion annually in institutional and medical costs. Costs of FAS alone are estimated at between 1 and 5 million dollars per child.

And what of a child exposed to alcohol in-utero who doesn't develop FASD? A 2016 study conducted by the Center for Development and Behavioral Neuroscience even suggests the child exposed to alcohol in the womb, with or without an FASD, is more prone to alcohol use disorders the rest of his or her life. Something you wouldn't wish upon your worst enemy.



Scott Stevens, is the author of four alcohol books including the December 2016 release, I Can’t See The Forest With All These Damn Trees In The Way: The Health Consequences of Alcohol. Get the new BookLocker title now on Amazon (viewbook.at/prehab), alcohologist.com, and everywhere you buy books.  Click Alcopocalypse for the author’s 2017 Alcohol Awareness Month whitepaper. Image by  Peter Lecko, used with permission.

Hey, Alcohol biz: The 90's called. They want their liars back.

Sept. 2017 research by the London School of Hygiene and Tropical Medicine and the Karolinska Institute in Sweden has revealed the extent to which the alcohol industry is denying alcohol's causal role in cancer. In other words, the alcohol industry has torn a page from the tobacco playbook of two decades ago to take a 3-D approach to marking a known carcinogen: Deny. Distort. Distract.

In an infamous Congressional hearing in 1994, the leaders of the tobacco industry (pictured above) swore under oath that nicotine was not addictive and that smoking did not cause cancer. Notable among them was Andrew Tisch, then CEO of the Lorriland brands of smokes. The executives denied conclusions of a consensus of independent scientists and health experts that their product caused cancer. It was later revealed that the companies knew the cancer link decades before their Congressional 'come-to-Jesus' meeting and the Tobacco Settlement three years later.

Here we are again.

Over the past two decades, numerous studies have shown a strong link between even moderate drinking and cancer. (See related A-Files segments on the cancer connection: Episode B: Breast Cancer video transcript, Episode C: Cancer video  transcript and Episode Z: Zero Health Benefit video transcript, as well as the book I Can't See the Forest With All These Damn Treesin the Way: Health Consequences of Alcohol.) Bottom line: Scientists estimate that alcohol is responsible for at least four percent of new cancer diagnoses annually. The U.S. Department of Health and Human Services lists it as a known carcinogen. You wouldn't know it by listening to the alcohol industry. But would you really expect your mother-in-law to be a fair arbiter of your marital dispute?

The study authors looked at 30 websites from alcohol trade groups in the U.K., Europe, the U.S., Canada and Australia. One – The Wine Information Council – even claimed that wine actually protects against several forms of cancer including breast, lung and kidney. Another – U.S.-based International Alliance for Responsible Drinking – said that light to moderate drinking was 'not ‘significantly' associated with an increased risk of tumors.

The authors said the tactics used by the alcohol industry were very similar to those used by tobacco firms for 50 years to play down the risk of lung cancer and were particularly misleading about the link between breast cancer. Alcohol use is the only dietary link to an increase risk of breast cancer.

Professor Mark Petticrew, of the London School of Hygiene and Tropical Medicine, concluded: "The weight of scientific evidence is clear that drinking alcohol increases the risk of some of the most common forms of cancer. Our analysis suggests that the major global alcohol producers may attempt to mitigate this by disseminating misleading information about cancer through their 'responsible drinking' bodies.

"This has obvious parallels with the global tobacco industry's decades-long campaign to mislead the public about the risk of cancer, which also used front organizations and corporate social activities.”

The alcohol industry response is that the research was 'misleading' and said they were already advising consumers to drink responsibly. As if it were possible to consume a toxin and carcinogen 'responsibly.' Henry Ashworth, president of the International Alliance for Responsible Drinking, said: ”We do not agree with the conclusions reached in this paper. We stand by the information that we publish on drinking and health.” That sounds an awful lot like Tisch's statement that, “Smoking does not cause cancer.”

Public awareness of alcohol/cancer connection is low. It has been argued that greater public awareness, particularly of the risk of breast cancer, poses a significant threat to the alcohol industry. So we trudge back to the 90's and dig up some lies that only flew within the board rooms and marketing departments of companies profiting from the unobstructed flow of the drug, alcohol.

Deny. Distract. Distort.

The alcohol industry has the normal duty of any manufacturer to ensure that it does not market a defective product and that its products are as safe as possible. Alcohol – a toxin and known carcinogen – is not safe in any amount, for either gender, at any age.

Scott Stevens, is the author of five alcohol books including the acclaimed Look What Dragged the Cat In: The Rise of an Opioid Crisis. Get the new BookLocker title now on Amazon (viewbook.at/gatewaydrug), alcohologist.com, and everywhere you buy books.  Click Alcopocalypse for the author’s 2017 Alcohol Awareness Month whitepaper. Image by Kevin Carden, used with permission.