Look What Dragged the Cat In: The rise of an opioid crisis

Excerpted from the 2018 USA Best Book Winner, Look What Dragged the Cat In.

The decade of the 2010’s shelled hospitals and first responders with an explosion of opioid-related illness, injury, and death. Preventable drug overdoses tallied 54,793 lives lost in 2016 – an increase of 391 percent since 1999. Accidental drug overdose deaths increased 327 percent over the same period. The majority of OD deaths (38,000) involve opioids, The drug category most frequently involved in opioid overdoses and growing at the fastest pace includes fentanyl, fentanyl analogs, and tramadol. The fentanyl category of opioids accounted for nearly half of opioid-related deaths. The dirty cat in the litter, heroin, accounted for the second highest number of deaths, claiming 14,606 lives.

America struggles with what the opioid cat dragged in: Hard-to-treat opioid addictions, fatal relapses, and needless loss of mainly young lives. Now legislators, first responders, treatment pros, and those in the medical field are forced to focus not on the death toll the cat dragged in, but instead what dragged the cat in.

Every opioid related death is alcohol related

The abuse of drugs, regardless of classification, begins with the permissiveness granted the world’s most lethal drug and third-leading cause of all preventable deaths: Alcohol. It’s a straight line.

Nearly every non-Muslim civilization on this rock has embraced alcohol. As a result, ours is largely a numbing planet, especially in the sedation-happy Americas. This is the root. This is the seed of the opium trade that has gone unstemmed since prehistory. There is legit medical use for opium derivatives: What has driven growth is demand – not by the sick but by people who cannot get the mind alteration they desire through alcohol use alone.

Alcoholics and non-alcoholics alike drink the first drink for the same reason: To relieve a stress. In the U.S., which has a laissez faire agenda toward alcohol since its prohibition failure, the culture embraces a drinking lifestyle. Americans normalize alcohol use. In other words, Americans (like many cultures) normalize drug use. The 1960’s have nothin’ on the 2010’s.

What you ignore, you permit. What you permit, you condone.

Opioid abuse happens when a person can’t get where they want to get with alcohol. The opioid crisis wasn’t created by doctors overprescribing, manufacturers wooing doctors, China shipping heroin and cheaper fentanyl via cartels and the U.S. mail. Drinking, especially binge drinking, is the pandemic that dragged in the opioid ‘epidemic.’ Americans condone the buzz, the sedation. We created this monster on our own.

What’s the way out?

Legislative attempts to curb use of potentially lethal drugs resemble shooting an arrow and then drawing a target around where it hit. Locking up dealers and traffickers, creating prescription databases and prescribing limits, and promoting Narcan availability all deal with control of the supply and its aftermath. The demand is unchanged. Within a cultural adoration of the buzz, our current crisis can only be curbed by control of the demand. If a drug user wants a drug, theywill get that drug. It’s the American freedom thing.

In 1967, 72 percent of adult men smoked. Today, 72 percent don’t. Prevention works. If there is genuine interest in healthy outcomes and preventing premature death from opioids, Americans’ permissiveness of the starter or feeder or gateway or predecessor drug has to be addressed on five levels to reduce demand for all antecessor drugs.

• Advertising agencies court alcohol manufacturers with a promise of creating demand for the drug. You can ban advertising without banning the product. When cigarette marketing/advertising was banned, demand dropped without banning the product. The National Bureau of Economic Research (NBER) studied bans in 20 countries over 26 years. The results indicate that an increase of one ban could reduce alcohol consumption by five to eight percent.

• Public drinking encourages drug use. Smoke-free regs cut down on the demand by curtailing where cigarettes can be smoked. Applying the same model for drinking – instead of popping up a brew pub on every corner – can reduce demand. The idea of having a cocaine bar on every corner is absurd, but a pub peddling a drug that kills more people (89,000 Americans per year) is somehow acceptable. The availability of alcohol can be regulated either through restricting the hours or days it can be sold or by reducing the number of alcohol retail outlets, according the a World Health Organization (WHO) study. Logicaly, reduced sales hours have been found to be effective in lowering consumption. In the former Soviet union in the mid-1980s, strict alcohol regulation, which included among other measures restricted hours and fewer outlets, led to a dramatic reduction.

• The ‘Smoking Stinks’ campaign brought an anti-smoking message down to the earliest grades. A modest effort to create similar anti-drinking messages demonstrating health risks of even moderate use (see viewbook.at/prehab) will stunt demand by discouraging the very first drink of the gateway drug.The American Journal of Public Health analysis of the anti-smoking campaign suggests that per capita consumption would have been one-fifth to one-third larger than it actually is, had the years of anti-smoking publicity never materialized.

• Increase the tax on the gateway drug. The bottom line is that many states and municipalities balance their bottom lines with so-called ‘sin taxes.’ The sin taxes on alcohol haven’t kept pace with inflation. These taxes are usually based on the amount of beverage purchased (not on the sales price), so their effects can erode over time due to inflation if they are not adjusted regularly. The Community Preventive Services Task Force (CPSTF) recommends increasing taxes on the sale of alcoholic beverages, on the basis of strong evidence of the effectiveness of this policy in reducing excessive alcohol consumption and related harms. Opioid use is a related harm. The CPSTF is an independent, non-federal panel of public health and prevention experts that provides evidence-based findings and recommendations about community preventive services, programs, and other interventions aimed at improving population health.

• Many will argue that legalizing recreational use of marijuana will reduce opioid abuse and erroneously point to Colorado as an example. (By the Center for Disease Control and Prevention’s (CDC) numbers, you can call BS: Colorado’s death rate from opioid overdose is barely in the top half of the state-by-state death-rate comparison … if you wanted to complete the morbid, pointless comparison. One death is too many.) What’s entirely missing from the debate is that no evidence exists that encouraging recreational use of another drug furthers public health in general. Marijuana is revenue-neutral when you subtract societal, medical, and legal costs.

When we rethink the drink we can douse the pandemic that begat the current opioid crisis. Legislators and treatment experts must lead the transition from managing aftermaths of the current crisis to prevention of the next one. And phase out the ancient alcohol crisis – the elephant in the room – America ignores.

Stevens is author of four alcohol, health, and recovery books and is principal of alcohologist.com. He is a founding influencer of the world’s largest medical portal, healthtap.com. He will Chair the 2018 International Conference on Addiction Therapy and Clinical Reports in Paris, France.

Seven clues that 2017 will be the Year of the Pandemic

Much of the decade leading up to 2017 has been characterized by an Opioid Epidemic, according to author Scott Stevens. For the final 1,000 or so days of the decade, America will continue to gain ground against painkiller and heroin deaths. However, according to Stevens, 2017 will “mark a switch in the dialogue from illicit drugs developed in pharmaceutical labs or grown in faraway lands to a homegrown pandemic that claims 90,000 American lives.” Here are the award-winning author's seven reasons why the U.S. will finally talk about the drug we love – alcohol – instead of the drugs we loathe.

1) Pro-marijuana factions are forcing the attention away from the problems created by their drug to the one that's already legal. Recreational pot — legalized and/or decriminalized in eight states now — is 'less dangerous' than both alcohol and tobacco. Granted, one side of the Titanic may, in fact, have been safer than the other, the 'safety' of marijuana versus booze is not a new claim. Well-bankrolled pro-marijuana interests are making hay with what they claim is, for the first time, research measuring the potential harm of these drugs in a more quantitative way. Their findings showed the dangers of marijuana "may have been overestimated in the past, while the risk of alcohol has been commonly underestimated.” They are at a minimum half correct no matter where you fall on the legalization/decriminalization argument. As the pro-pot teams swarm the media, America can't help but hear that it's wishful thinking that their favorite drug-of-choice is safe because it is legal.

2) Our new president is a teetotaler. Donald J. Trump doesn't drink. Like so many Americans he has a family history including the disease of alcoholism. He gets that it is a disease related to the use of a socially and physically toxic drug. But beyond alcoholic drinking, Trump doesn't buy that the moderate drinking (use of a drug) is acceptable.

3) Our new president is a business owner. He's not shy about talking about increasing efficiency in Making America Great Again. Among the measures a business owner uses is productivity. Even moderate use creates absenteeism (a productivity drain), and increased risk of accidents/injuries (another productivity drain). Tardiness/sleeping on the job. Hangovers and withdrawal affecting job performance. Poor decision making while under the influence of a central nervous system depressant. All clobber productivity.

Seventy percent of the $250 billion alcohol costs the U.S. economy every year comes from losses in productivity resulting from premature death, impaired productivity, institutionalized populations, incarceration, crime careers, and victims of alcohol-related crime. Other effects on society included crime, social welfare administration, motor vehicle crashes, and fire destruction and cost more than $40 billion. Government, private insurance, and victims bore most of the economic burden of alcohol and drug problems. That's a not-so-great anymore America he wants to make great again.

4) The Fourth Estate continues to become less dependent on the Big-Alcohol teat. History lesson… When much of the Glass/Steagall Act was repealed in 1999, financial services advertising rocketed to the top five of advertisers, and negative stories about the industry fell to the back page or out of the newscast. Would Enron, the Tech Collapse and the Mortgage Crisis have happened if news operations had been less beholden to the financial services industry? Yep. But would those calamities happened as swiftly and destructively? Doubtful.

Conversely, alcohol advertising has today tumbled out of the top-ten. Alcohol ads typically tie brands with cool, sexy, stylish, on-Fleek people and fun times. Ultimately, these concepts come together to suggest: if I use this product, I too can be cool, sexy, on-Fleek and successful like the people in the ad, having fun like they seem to be. Ads so influence young people that media is under pressure from groups like AlcoholJustice and The Center on Alcohol Marketing and Youth (CAMY) to keep the ads off air, out of public view in neighborhoods, off social media, and out of print. News outlets beholden to their advertisers – or at least not airing stories that will cost an advertiser business – are seeing less advertising from brewers and distillers. The result: More of the negatives from alcohol use can make it onto your laptop or into your living room.

5) American losses are too staggering to ignore any longer. More Americans die each year from alcohol than the number of Americans killed in the entire Korean and Vietnam conflicts combined. More than twice as many people die an alcohol-related death in the U.S. than die an opioid-related death (90,000 vs. 33,000). When opiates killed 10,000 in a single year it was an 'epidemic.' When the flu killed 30,000 in a year, vaccination levels ballooned. People did something. Three times as many die each year from moderate to heavy use of alcohol. People are starting to take note of what alcohol does to them rather than what they think it does for them.

This number of alcohol-related deaths is rising, too, not falling.

6) Healthcare reform reform will add the prevention element on which it has missed the mark. Twenty to 40 percent of general use hospital beds in the U.S. – those not used for specialties like maternity and birth – are used to treat alcohol-related complications. Two hospital admissions each minute are alcohol-related. Alcohol is a substantial driver of healthcare utilization.

And it is a substantial driver of illness. Alcohol is listed as a known (not a suspected) carcinogen by the Department of Health and Human Services. Eight cancers are directly tied to alcohol use: The higher the use, the greater the risk. It's the only dietary link to an increased risk of breast cancer. More than 60 diseases are linked to alcohol use. More than 200 prescription and over-the-counter remedies react adversely with this toxin. We've had a history lesson above in #4. Here's a math problem: More sickness + hospitalization = higher medical costs = higher insurance premiums. What causes problems, is one.

7) The status quo is unsustainable.

Addicted Minds' Editor-in-Chief, 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. The new BookLocker title is available now on Amazon (viewbook.at/prehab), alcohologist.com, and everywhere books are sold. See this release on PRLog.

Selling care: Patient brokering in addiction treatment

Ambulance-chasing. Society generally looks on with disgust at the attorney who markets directly to the accident victim in the hours after the ink on the police blotter dries. The practice isn't illegal, but it brings up the subject of ethics. A similar practice has smoldered silently in the addiction care business for the last decade and will be leading to more scrutiny – and crackdown – over the second half of 2016.

Treatment centers provide a service (detox, intensive outpatient, inpatient, partial hospitalization, or some combination of elements) for a fee, which is charged to the client or the client's insurer. It's America. Lawyers charge a fee in a time of need. Mutual fund companies charge a fee to manage the retirement money upon which you'll develop a need. Lawyers are regulated. Fund companies and their sales reps are regulated and supervised. The practice is largely unregulated in the treatment industry.

The ambulance chaser in the addiction care business solicits business in 12-step meetings and detox facilities and even emergency rooms. There are reputable recovery coaches and other addiction paraprofessionals in the service of those struggling with substance abuse who also attend to those venues and offer suggestions. When they are paid by a treatment entity to deliver those struggling heads to the facility's beds is the point in which the practice becomes predatory.

Take for example, Alcoholic Joe. Joe turns up in the emergency department, unconscious due to acute intoxication. (e.g., he's beyond drunk) A responsive ER staff will inquire about what he's had, how much, and how frequently. Maybe even a social worker or staff associate will address the possibility that Joe has a substance use disorder and suggest courses of action beyond the hospital's capability. Other resources may be given to Joe, if he inquires. He takes it to heart (or his wife does) and Joe goes to a 12-step meeting.

So far, so good. When Joe bumps into a counselor, a self-styled recovery guru or a fellow at the meeting, the conversation sometimes turns to treatment. If the person steering the conversation toward a facility is getting paid $1,000 or $5,000 a head to steer Joe toward that facility – and never discloses he or she is on the dole – is where the industry is getting its latest black eye.

It's not unfamiliar territory for the healthcare biz. Rewind the tape back to the early 90's when physicians were accepting elaborate junkets from pharmaceutical companies and medical device makers. The public bristled when the kickback exposed that the patient might not be getting the best medication or device for his condition, just possibly the medication or device offered by the company with the sweetest “conference” destination. In the early 2000's a similar practice in the mutual fund business was discontinued when fund companies were found to have influence over brokers who might not be offering the most suitable investment for the client, just the funds that landed on the “preferred list” because of the extras offered the broker or brokerage firm.

As the opioid epidemic continues to grow within the shadow of the alcohol pandemic, more treatment centers are opening. Which can only be considered a good thing if they are treating the patient and not the one who provided the patient. As start-up facilities – and some established ones – struggle to keep cashflow manageable, a pay-per-client (heads-in-beds) can be an attractive alternative to shelling out for a marketer's salary and benefits. A captive marketer is going to work for one facility or group of facilities. He or she may not have a component of their compensation based on the census of the facility (e.g. percentage of beds filled at a given time). But they are, in theory, still driven by getting the right fit between the client and the facility. Many even network with other centers' marketing staff and refer business to the right fit based on the cost, insurance and most importantly the client's needs. When a consultant makes a referral without accountability to the facility or for the outcome of the treatment for that client, but for what it appears to be the financial gain of a $5,000 payday over a $1,000 payday, the treatment industry's self-policing has a weakness.

There is no inference that every per-client marketer or treatment facility that employs the tactic is sketchy. As with any enterprise, there are scrupulous and unscrupulous sales people. This industry is no exception even though it is commonly referred to as a helping profession which comes in contact with families and clients during a real and human and emotionally charged crisis.

In the early part of this decade, healthcare officials as well as federal agencies have had the practice show up on their radars. In some cases, the fit between the client and facility or program was so poor, litigation ensued. In extreme cases, people have relapsed and/or died while in the care of a program. Not that the relapse is uncommon with the disease of addiction to alcohol or other drugs… it's not a welcome outcome in or shortly after treatment.

For now, the status quo is under greatest scrutiny in California and Florida, two treatment industry hotbeds. However the status quo remains as a practice that is not illegal – like ambulance chasing – just potentially unethical until greater oversight and guidance is provided. For the time being, it pays to ask a question if and how a person is being compensated for making a recommendation of one facility over another.

The entire 26 episode HD The A-Files: Alcohol A-Z series is available on disc, along with fact sheets, for helping professions. Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness.  Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com 

The A-Files, Alcohol A-Z for Alcohol Awareness Month: Younger Strokes

(See the video and online article)

Twenty-six episodes of 'The A-Files' air throughout Alcohol Awareness Month on YouTube, Facebook, LinkedIn, Alcohologist.com and AddictedMinds.com, among other web and social media sites. Episode Y looks at strokes, especially those at younger ages than anticipated. Strokes, and strokes at earlier ages, have been linked to alcohol misuse in a study by the University of California at San Francisco. "When a young person has a stroke, it is probably much more likely that the cause of their stroke is something other than traditional risk factors," according to one of the lead researchers in the 2013 study reported in the journal Stroke.

The UCSF researchers identified long-term changes in the heart as a result of alcohol abuse or the disease of alcoholism may put younger users at higher-than-average risk earlier in life.

Stroke disables more people in the United States than breast cancer. According to the Centers for Disease Control and Prevention (CDC), every year close to a million people have a stroke – either ischemic or hemorrhagic. A study of 2007 data found that almost five percent of people who had a stroke that year were between ages 18 and 44.

"Substance abuse is common in young adults experiencing a stroke,” according to the research team. "Patients aged younger than 55 years who experience a stroke should be routinely screened and counseled regarding substance abuse. One in five of strokes involves drinking.”

The study does not offer evidence that patients' drug or alcohol use directly caused their strokes. It's possible, for example, that people who drink also see their doctors less often.

A separate study in the journal Stroke in Jan. 2015 found that people who average more than two drinks a day have a 34 percent higher risk of stroke compared to those whose daily average amounts to less than half a drink. Midlife heavy drinkers were likely to have a stroke five years earlier in life, regardless of genetic and lifestyle factors. The stroke risk in those two studies, of course, is long term, but there's immediate danger as well. According to a 2010 Canadian study, one drink instantly doubles stroke risk. Two hours following that drink, the stroke risk remains 1.6 times higher than someone who isn't drinking. When it comes to stroke risk, drinking is like walking out into the road, waiting for the truck to hit.

The entire 26 episode HD series is available on disc, along with fact sheets, for helping professions. See the preorder special at tr.im/AFiles

Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness.  Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com 

The A-Files, Alcohol A-Z for Alcohol Awareness Month: X and Y Chromosomes

(see video and online article)

Twenty-six episodes of 'The A-Files' air throughout Alcohol Awareness Month on YouTube, Facebook, LinkedIn, Alcohologist.com and AddictedMinds.com, among other web and social media sites. Episode X is on the X and Y Chromosome (gender) differences in the way we handle alcohol. If you start from the perspective that alcohol damages tissues regardless of gender, you're on the right track. Drinking over the long term is more likely to damage a woman’s health than a man’s, even if the woman has been drinking less alcohol or for a shorter length of time. First and foremost, women have a greater concern for breast cancer. Alcohol is the only documented dietary connection to an increased breast cancer risk.

Second, in 2011, the University of Michigan Health System in Ann Arbor studied alcohol, sleep and genders. According to the lab readings, compared to men, the women slept nearly 20 minutes less and awoke more often for longer periods when they drank. Sleep is underrated in its regenerative value and how it sets up overall health.

Third, women generally are smaller, so the same amount of alcohol will be more impairing – and more damaging. But even if a man and woman are the same weight, the woman is at greater risk because they have less of the enzyme that helps break down alcohol in the body. Fourth, pound for pound, women have less water in their bodies and water is what dilutes alcohol in the bloodstream. Men are 61 percent water, women 52 percent. And that also means alcohol metabolizes slower in women, lingering longer to do more damage. This means, fifth, women are more likely than men to develop alcoholic hepatitis or die from cirrhosis, sixth, that women are more vulnerable than men to alcohol-induced brain damage, and seventh, women are more susceptible to alcohol-related heart disease. Eighth, drinking increases a woman’s risk of becoming a victim of violence and sexual assault. Lastly, there are obvious risks to an unborn child from drinking.

Drinking and drinking problems have increased in every generation of women born after World War II, according to Columbia University. Women in their early 20s are most at risk, but affluent, fit women over 50 may be particularly prone to heavy drinking, according to a 2015 study published in the medical journal BMJ. In one, single health statement, men and women are created exactly equal: Sobriety is better to have than to lack.

The entire 26 episode HD series is available on disc, along with fact sheets, for helping professions. See the preorder special at tr.im/AFiles
Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness.  Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com 

The A-Files, Alcohol A-Z for Alcohol Awareness Month: Weight Control

Twenty-six episodes of 'The A-Files' air throughout Alcohol Awareness Month on YouTube, Facebook, LinkedIn, Alcohologist.com and AddictedMinds.com, among other web and social media sites. Episode W looks at weight control, fat loss and the futility of dieting while drinking.

A third of men and nearly one in five women drank on a daily basis. Twenty percent of men and eight percent of women consumed more than 300 calories in alcohol per day. That's from the Centers for Disease Control and Prevention in a study looking not at alcoholism, but a separate American pandemic, obesity. Pilsener or lager beer usually comes in at around 148 calories in 12 ounces. Drinking light beer, offers about a third fewer. Dry wine contains fewer calories than sweet: 106 calories for five ounces of dry wine and champagnes… double it for sweeter wines. If you drink a glass of wine before dinner, another glass with dinner and one for dessert, that’s more than 400 calories in addition to the meal. Liquor calories depend on the proof for whiskey, tequila, gin, rum and vodka. Eighty proof contains 97 calories per shot. One hundred proof has 124 calories. How you mix the hard liquors will add calories faster. A whiskey sour will have 122 calories and a gin and tonic has 171 calories, a pina colada, 262 calories, and a large margarita can have as many as 400 calories.

The body uses as fuel macronutrients stored from the things you eat. Macronutrients are carbohydrates, fat and protein. Pure alcohol has none of those. It's calorie dense, at seven calories per gram but has no nutrient value. The macronutrients in alcoholic beverages come from what carries the alcohol or the mixer used. These carbs do not get burned and no stored body fat is going to get burned until the body first gets rid of the toxin, alcohol.

Alcohol is the first fuel to get burned in other words. Fat burning is postponed for alcoholics and non-alcoholics alike because fat won't burn when there's alcohol in the body.
Adele. Zack Galifinakis. Megan Fox. Three celebrities who in recent months dropped weight, all three crediting a zero-alcohol diet for the pounds lost. Doesn't matter if they're alcoholic or not, and I would suppose not. They wanted to look and feel better. And who doesn't?

The entire 26 episode HD series is available on disc, along with fact sheets, for helping professions. See the preorder special at tr.im/AFiles

Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness.  Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com 

The A-Files, Alcohol A-Z for Alcohol Awareness Month: Vitamin Deficiency

(See online video and article)

Twenty-six episodes of 'The A-Files' air throughout Alcohol Awareness Month on YouTube, Facebook, LinkedIn, Alcohologist.com and AddictedMinds.com, among other web and social media sites. Episode V returns to the topic of nutrition with Vitamin Deficiency. Even moderate alcohol use destroys vital nutrients –vitamins, minerals, and amino acids – that control mental function, preventing depression, and maintaining physical health. I'll note only two here: It raids the body of B-vitamins and has a dramatic impact on the way vitamin A is handled. A study published in the Federation of American Societies for Experimental Biology (FASEB) Journal gives a little more detail on vitamin A first. 

It suggests long-term alcohol use lowers vitamin A levels in the liver, which is the main site of both, alcohol metabolism and vitamin A storage, while bumping up vitamin A levels in many other tissues. Initially 15 percent of the body's vitamin A migrates out of the liver to other tissues. Ultimately, around 60 percent of the vitamin is lost with heavier or more frequent drinking. So it's a wash if liver vitamin A is low and vitamin A in other tissues is elevated, right? Not exactly.

The liver needs the vitamin A to stave off liver disease. And the other tissues don't feed the A into the bloodstream the way the liver does. You'll know you're deficient in the vitamin if you get night blindness or blotchy rashes or both. If it builds up in other tissues, it can become toxic. Self medicating with vitamin A supplements would worsen it, even if the liver stores are low. Vitamin A toxicity usually reveals itself with headaches, nausea, drowsiness, vomiting… which could be confused with the alcohol itself.

The B-complex vitamins are especially vulnerable and destroyed by alcohol. Specifically, B-vitamin absorption is blocked by alcohol use and vitamin-B stores are drained by the by the process of metabolizing the alcohol and ridding it from the body. These vitamins are essential to mental and emotional well being. Vitamin B1 deficiencies can cause neurological and cardiac disorders among drinkers. B2, B3, B12 and folic acid deficiency are all linked to depression and fatigue because they help control how the body uses energy. Vitamin B-6 deficiency can disrupt the formation of neurotransmitters in the brain, which can have the effect of helping make a moderate drinker alcohol dependent. Introducing a toxin into the body's delicate nutrient balance has yet to be proven to increase wellness or longevity.

The entire 26 episode HD series is available on disc, along with fact sheets, for helping professions. See the preorder special at tr.im/AFiles

Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness.  Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com