Study: 33 million have an 'I-Don't-Have-a-Problem' alcohol problem

Researchers from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) asked 36,000 adults about lifetime drinking habits, including current or within the past year. In the study published June 3 online in JAMA Psychiatry, 14 percent of adults were current or recent problem drinkers, or nearly 33 million nationally. Thirty percent – almost 69 million – had been at some point in their lives.

The study uses a newer classification of alcohol use disorders from the Diagnostic and Statistical Manual (DSM-5) released in 2013. Using the older DSM-IV definition, the rates of problem drinking were still higher: 13 percent for current or recent problem drinking and 44 percent for lifetime prevalence – up from 9 percent and 30 percent in the agency’s 2001-02 survey.

Alcohol abuse and the disease alcoholism (see, Know the Difference) are often untreated, partly due to society's stigma on those with alcohol use disorders, and in part due to denial. According to recovery book Every Silver Lining Has a Cloud, “people with the disease of alcoholism often point to others as having a problem, but they personally don't have one, because it is the only disease that convinces the carrier that he/she doesn't have it.”

The study's author, the NIAAA's Bridget F. Grant, says, “This study highlighted the urgency of educating the public and policy makers about alcohol use disorder and its treatments, destigmatizing the disorder, and encouraging among those who cannot reduce their alcohol consumption on their own, despite substantial harm to themselves and others, to seek treatment.” The numbers may be low, too. In a Nov. 18, 2011 ABC News/Gallup Poll, 67 percent of Americans admitted to having ever abused alcohol. The CDC puts the number at 61.2 percent currently drinking frequently and 14 percent former regular drinkers. Drinking problems were most prevalent among men, whites and Native Americans. Low-income adults, those younger than 30 and those who never married also relatively high rates. Problem drinking also was more common among city dwellers than those in rural areas, while the West and Midwest had higher rates than other regions.

NIAA director, George Koob, said it’s unclear why problem drinking has increased but that many people underestimate the dangers of excessive alcohol. “Many won’t seek help because of stigma and denial, and many don’t realize that medications and behavior treatments can help.” A new alcoholism recovery book,Adding Fire to the Fuel, is being released at the REEL Recovery Film Festival in San Francisco June 13 and addresses the stigma of alcohol use disorders. “It's a disease: Same kind of chronic, progressive, incurable-but-treatable, primary and fatal classification as cancer or diabetes. When we handle people with those other diseases with empathy, and dish out distaste to alcoholics or recovering ones, we create a social and economic problem that's passed its tipping point,” notes the author.

The new book looks at the stigma around alcoholism and alcoholism recovery as a $226 billion annual problem hiding in plain sight. “The story of alcohol and America's affair with it keeps it from being recognized as the problem. Instead, people with the disease of alcoholism are considered the problem. 'Alcoholic' is a pejorative today. That's ripe for change.”

The book includes a graph delineating the differences between alcohol abuse and alcoholism. People interested in evaluating their own alcohol consumption can take any number of self-tests (see related video, Alcoholism Screening Explained). Naturally, the most recommended assessment isn't one done alone, but by a medical or counseling professional. The DSM-5 lists 11 criteria for alcohol use disorders. In the past year, have you:

1. Had times when you ended up drinking more, or longer than you intended?

1. More than once wanted to cut down or stop drinking, or tried to, but couldn’t?

1. Spent a lot of time drinking? Or being sick or getting over the aftereffects?

1. Experienced craving — a strong need, or urge, to drink?

1. Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?

1. Continued to drink even though it was causing trouble with your family or friends?

1. Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?

1. More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?

1. Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?

1. Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?

1. Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

“If you have any of these symptoms, your drinking may already be a cause for concern,” reads the manual, however any two or more of the criteria constitutes an alcohol use disorder as identified in the NIAAA study.

Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Host Ed Forteau led a discussion on the health risks and myths of health benefits of drinking.  Lucy Pireel's "All That's Written" included a feature on Every Silver Lining Has a Cloud called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud also can be found on www.alcohologist.com, plus an interview with Christoph Fisher Books.  Mr. Fisher is an acclaimed international author from the UK, among his works is the Alzheimer's book "Time to Let Go."  Download the FREE Alcohology app in the Google PlayStore today.

The hypocrisy of the NFL wrapping itself in PINK

This is the first October Sunday of the NFL season.  It's Breast Cancer Awareness Month, so the league and its teams wrap stadiums and players in all the pink it can to show support for those impacted by the disease.

It's hypocrisy of the highest order when the same league derives an enormous amount of its income from the alcohol industry, which encourages women to consume a product that is the ONLY dietary factor tied to an increase in breast cancer risk.

A 2013 study links the amount a woman drinks in the years prior to having children to breast cancer years later. The Journal of the National Cancer Institute released the study results online Aug. 28, 2013 showing a double-digit increase in breast cancer risk for women who drank as little as one drink daily prior to conception. The results were independent of drinking after first pregnancy.

"The risk increased by 11 percent for every 10 grams a day of intake, about six drinks per week," said study author Dr. Ying Liu of Washington University School of Medicine in St. Louis. A drink, or 10 grams of alcohol, is a 4 oz. glass of wine or a 1.5 oz. shot of hard liquor... or one 12 oz. can of the product of the Official Beer Sponsor of the NFL.

Researchers 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. 

One in eight women will have an encounter with breast cancer in her lifetime. The only dietary factor with a proven connection to increased breast cancer risk is alcohol consumption. More than 100 studies 1920-2014 have conclusively linked alcohol consumption to increased breast cancer risk. A consensus panel formed by the American Institute for Cancer Research (AICR) in 2007 concluded: "The evidence on cancer justifies a recommendation not to drink alcoholic drinks" ... a recommendation still maintained by the organization. And it takes relatively little alcohol to boost that 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. 

Alcohol increases production of the hormone estrogen. Estrogen increases are behind 80 percent of breast cancers. Toxic alcohol also creates another toxin -- acetaldehyde -- as it is metabolized by the body. That second toxin has been shown to alter DNA and breast tissue in drinkers, leading to increased cancer risk later in life, even after quitting drinking.
(View the Breast Cancer segment on The Sobriety :60)

Of course the NFL can't not embrace the pink campaign for the cure. It would be bad corporate citizenry to ignore the biggest advocacy campaign in America, and it would fly in the face of the league's stated goal of attracting more female fans.  How about keeping it real, making a massive donation, and telling the women (and men) what those 12 golden ounces cause instead of pimping it in every endzone camera angle and commercial break?
www.alcohologist.com

Visit alcohologist.com for a replay of the Bringing Inspiration To Earth show feature with Scott Stevens. Lucy Pireel's "All That's Written" included a feature on Every Silver Lining Has a Cloud called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud also can be found on www.alcohologist.com, plus an interview with Scott Stevens on Health Media Now and one at Christoph Fisher Books.  Mr. Fisher is an acclaimed international author from the UK, among his works is the Alzheimer's book "Time to Let Go."  

In the time it takes to read this article, 15 people will die an alcohol-related death

In the two and a half minutes it takes to read this story, fifteen people will die an alcohol-related death. A death toll surpassing violence, TB and AIDS combined hangs on what many view as a benign substance found in nearly every grocery store and ballpark. Alcohol, the world's third-leading cause of preventable injury and death, claims 3.3 million lives a year according to a May 12 report by the World Health Organization (WHO).

Including intoxicated driving, alcohol-induced violence and a causal relationship with more than 60 diseases and disorders, alcohol causes one in 20 deaths globally every year, says the WHO. "This actually translates into one death every 10 seconds," says Shekhar Saxena, who comment on the WHO's 2014 Global Status Report on Alcohol and Health. Intoxicated motorists are responsible for one in seven of those deaths.
Alcohol caused the deaths of 7.6 percent of men and 4 percent of women who died in 2012, the year of the study data.

More people in countries where alcohol consumption has traditionally been low, like China and India, are also increasingly taking up the habit as their wealth increases, according to the WHO report. "More needs to be done to protect populations from the negative health consequences of alcohol consumption," Oleg Chestnov of the WHO's Noncommunicable Diseases and Mental Health unit said in a statement.

The popular misconception is that alcohol causes only the disease of alcoholism, according to alcoholism recovery book Every Silver Lining Has a Cloud. However, drinking is linked to more than 200 health conditions, including liver cirrhosis and some cancers. "Many of the diseases don't appear until years after the person stops drinking. The damage is done early and cumulatively.”

A separate 2013 oncology report (see related article) went so far as to say, “When it comes to cancer, no amount of alcohol is safe.” Alcohol abuse also makes people more prone to contracting or worsening infectious diseases like tuberculosis, HIV and pneumonia, the WHO found.

Most deaths attributed to alcohol, around a third, are caused by associated diabetes and cardiovascular diseases. This despite observational claims that a moderate amount of red wine has cardiovascular health benefits. Researcher call those claims, “wishful thinking,” and say they don't hold up in evidence-based studies (see related examiner.com article).

The world's wealthiest nations – in Europe and the Americas – are boozier than people in poorer countries, but rising wealth in emerging economies is also driving up alcohol consumption. Eastern Europe and Russia are home to the world's biggest drinkers. Russian men who drink consumed an average of 32 liters (8.5 gallons) of pure alcohol a year, according to 2010 statistics, followed by other Western countries including Europe, Canada, the United States, Australia and South Africa.

On average, every person above the age of 15 worldwide drinks 6.2 liters (about a gallon and a half) of pure alcohol in a year, according to the report. Counting only those who drink though, that rises to 17 liters (4.5 gal.) of pure alcohol each year. Nearly half the world's adult population is entirely abstinent.
-- from examiner.com (See full article)
www.alcohologist.com

Scroll down for the replay of the April 13 Sound Health Options show feature with Scott Stevens. Lucy Pireel's "All That's Written" included a feature on Every Silver Lining Has a Cloud called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud can be found on www.alcohologist.com, plus an interview with Scott Stevens on Health Media Now and one at Christoph Fisher Books.  Mr. Fisher is an acclaimed international author from the UK, among his works is the Alzheimer's book "Time to Let Go."  

Philip Seymour Hoffman's three lessons for those of us who aren't celebs

Academy Award winner Philip Seymour Hoffman died from apparent heroin overdose Feb.2, according to updated reports in the New York Times. Hoffman spoke candidly over the years about past struggles with drug addiction. His passing packs three valuable messages to counter the over-the-top behavior of pop-music teen star Justin Bieber for a generation of abusers of alcohol and other drugs.

1. Addiction is the only disease that convinces you that you don't have it. Regardless of how long the disease is in remission, without vigilance, it will convince a drinker or drug user he “can handle it” of “have just one.” Twelve-step groups refer to it as the “cunning, baffling and powerful” nature of substance use disorders. Control is an illusion.

2. There is treatment, but no cure, for addiction and the disease of alcoholism. Hoffman sought treatment at least two times. In 2006, he said in an interview with CBS-TV's “60 Minutes” that he had given up drugs and alcohol many years earlier, when he was 22. Last year he checked into a rehabilitation program for about 10 days after a reliance on prescription pills resulted in his turning again to heroin.

Hoffman died in a relapse. He had 23 years of continuous sobriety. He was sober longer than Bieber has been alive. Then the addiction and urge to use became more important than anything else in his life. Within a year he was dead.

3. Drugs – and alcohol is a drug – do not discriminate. They can kill, regardless of social status, religion, career, education, bank account, genes, tolerance, gender, size, race, ethnicity or marriage. And it isn't glamorous.

Hoffman died like many drug users. Alone. Discovered by a friend who found his body in the apartment and phoned police. FoxNews.com reports authorities are investigating whether Hoffman received a more potent type of heroin that's being blamed for numerous deaths over the past two weeks, first in the Pittsburgh area and later along the east coast. The substance combines heroin and fentanyl, an opiate used to soothe the pain of cancer patients, and is being blamed for dozens of deaths across the country. Average people. Not celebs.

Ego makes a person say, “That can't happen to me.” Hoffman's death is a tragic reminder that “Oh, yes it can.”
-- from examiner.com (see full article)

Resolutions, part V: Alcohol leaves lasting legacy in brain and heart

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 2013 or promises to get a new job for the new year. Here are additional long-term brain and heart considerations about alcohol use disorders, quitting and staying sober. If you don’t have the following conditions now, there are provable connections to getting them years after abstinence.

Heart disease
Heart disease is a leading cause of death in the U.S. and carries a definite link to alcohol misuse despite French studies showing low amounts of red wine benefiting the circulatory system. Acetaldehyde – a byproduct of the metabolism of alcohol – causes hypertension, a.k.a. high blood pressure. In a 2007 Medical University of South Carolina study, 120 alcohol users charted lower blood pressure only 12 weeks after abstaining.

Alcohol itself raids the body of vitamin B (Thiamin) which is essential for a healthy heart. B-deficiency enlarges the heart and creates distended neck veins, narrow pulse pressure, elevated diastolic blood pressure (the second number in your BP) and peripheral edema. Acetaldehyde also physically weakens muscle, the heart being your body’s most important one. Think of how the tongue muscle is weakened from drinking (slurring) and leg muscles are weakened (wobbliness) and the same thing is happening to the heart muscle. However, with the heart, the weakening causes damage that accumulates.

Acetaldehyde also increases cholesterol, especially triglycerides. High cholesterol is a leading indicator of heart trouble on the horizon and the number one condition treated with prescription drugs in the U.S.

Brain damage/mental disease
Cadaever brains have provided conclusive evidence of a brain atrophying (shrinking) after alcohol misuse. However, Dr Ernest Noble of University of California—Irvine says, “Brain damage caused by alcohol, in relatively small quantities can affect the ability of brain cells to make proteins and RNA . . . essential for metabolism and organization of all cells as well as their ability to duplicate themselves.” A former social drinker, he quit drinking at all upon conclusion of his study.

A 2012 study similarly indicates that moderate drinking reduces the production of new brain cells by 40 percent. The November 8, 2012 journal, Neuroscience, reports the level of alcohol intake was not even 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 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 immediately noticeable, but over time, weekly drinking could have so dramatically reduced the neurons that learning or remembering things becomes more difficult. 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.

The impact on mental health and the many fingers of the mind are varied. On one hand there are those who endure years of heavy drinking with the mind’s fingers remaining as nimble as a pianist’s. Others emerge not so deft. It is believed alcohol increases the chances for Alzheimer’s and earlier onset of dementia. Stanford University research in 2010 also proved that alcohol abuse and the disease of alcoholism cause deficits in working memory and visio-spatial abilities (think: coordination) even after abstinence.

Sociologist William Anixter pointed out in 1990 before the Anxiety Disorders Association’s Washington, DC, conference that 80 percent of Alcoholics suffer from depression. The unanswered question more than two decades later is how much of that was there organically and how much was caused by the alcohol/acetaldehyde. A 2007 study does make the connection between alcoholic liver disease and the mind. The frontal cortex—responsible for reasoning and memory—is more impaired in patients when they have cirrhosis.
--Adapted from Every Silver Lining Has a Cloud


Image: Adamr
www.alcohologist.com

(The usual weekly post, SUNDAY SNIPPET, will return 1/5)

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. 
 
www.alcohologist.com

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. 

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. 

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. 

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. 

SUNDAY SNIPPET: December 1

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.”

– from Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety, pg. 79

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.