Alcohol Help

Low bone mass, or osteoporosis, is a known consequence of alcoholism, especially in older alcoholics. However, a new study shows that younger male alcoholics are also at increased risk for osteoporosis. People with osteoporosis, no matter what the cause, are at an increased risk for fractures and poor fracture healing.

"Our study indicates malnutrition, little exercise, social withdrawal or little exposure to sunlight can contribute to osteoporosis in young alcohol-dependent patients," said lead investigator Peter Malik, M.D., of the Medical University at Innsbruck, Austria.

The study appears online and in the February 2009 issue of the journal Alcoholism: Clinical and Experimental Research.

Researchers measured the bone mineral density of 37 alcoholic men and 20 alcoholic women ages 27 to 50. All participants were currently inpatients of an alcohol rehabilitation clinic and were not drinking at the time of the examination. Patients with liver cirrhosis or those taking medications known to influence bone health were not included in the study.

Before entering rehabilitation, the men consumed an average of 22 drinks per day and the women consumed an average of 18 drinks per day. Most of the participants smoked.

Almost one-quarter of the men had a bone mineral density that was lower than expected for age. In the women’s group, only 5 percent (1 person) had a low bone mineral density.

"It was surprising to me that although the female patients consumed high amounts of alcohol, there seems to be a protective factor present – probably higher estrogen levels – which cannot be fully explained at the moment," Malik said.

Most of the participants also had low vitamin D levels, likely an indication of poor nutrition and lack of exposure to sunlight. Low vitamin D levels can lead to osteoporosis, but the researchers found no direct relationship to vitamin D levels and decreased bone mineral density.

"One of the significant aspects of Dr. Malik’s paper is that there are very few studies that have looked at osteoporosis in this particular [younger] age group of alcoholics," said U.S. researcher Dennis Chakkalakal, Ph.D.

Osteocalcin, a laboratory marker for new bone formation, was above the normal range in about 38 percent of men and 30 percent of women. This suggests that osteoporosis is at least partially reversible in alcoholics who quit drinking, as these patients did.

"It has been demonstrated very clearly that more than 30 days of abstinence results in increasing osteocalcin," said Chakkalakal, of the Orthopedic Research Laboratory and Alcohol Research Center at the Omaha Veterans Affairs Medical Center.

Malik said that the results of his study and other research indicate a need to screen alcoholic men for osteoporosis. "Medical therapy for osteoporosis, when started early, can improve the long-term outcome."

Alcoholism: Clinical and Experimental Research

Hynotherapists at the international firm JustBeWell are experiencing a signficant increase in the number of women using hypnosis to stop binge drinking.

"We are seeing more and more women coming to us for help," said Steve Tromans. "Five years ago it was quite common for around sixty per cent of our visitors on this subject to be male. Nowadays the balance has shifted and it is sixty per cent women and just forty per cent men who we see wanting to quit alcohol."

While alcoholism is certainly a danger to many people who like drinking, binge drinking is something else altogether. Instead of drinking regularly, a binge drinker may only indulge in the evenings or at the weekend. But when they do, it tends to be in huge and potentially dangerous quantities.

"There is a real push to cut down on the numbers of people who are drinking to excess like this," added Steve Tromans. "This is something that young people in particular are known for in Britain. But fortunately there are ways that women who are affected can get help – as can men."

The solution here lays in hypnotherapy. And women who want to try it have two options – they can either go to see a hypnotherapist to help them stop binge drinking, or they can quit alcohol on their own with the help of a self hypnosis audio recording.

"Hypnosis is a practical and relaxing way to change your drink habit," said Steve. "Bingeing like this can lead to alcoholism later on down the line if you aren’t careful – but making a stand now and using hypnosis to change your habits can make all the difference."

If women aren’t able to visit a hypnotherapist or they simply want a solution to stop binge drinking that will work without them having to leave home, Steve has the solution. And it is an easily accessible one as well.

"A self hypnosis audio recording can be listened to in any quiet moments at home," he advises. "Most people find they can stop binge drinking reasonably quickly and cut right down on their drink without any trouble at all."

While the government is trying to find ways to stop binge drinking among both men and women, it is at least reassuring that women are seeking help. Hypnotherapy has already worked for many people – all that is required is to seek the help of a qualified hypnotherapist or invest in one of the self hypnosis audio programmes that are available on the subject.

Just Be Well

The Drinkaware Trust (Drinkaware), a UK charity which aims to reduce alcohol harm, has compiled some top tips for partygoers to help them have a merry – and memorable – Christmas.

Alcohol consumption in Britain increases by 40% in December*, more than any other country in the world. Most of us have probably experienced some of the short-term effects of ‘over-doing it’ at this time of year, including nausea, dehydration and temporary memory loss.

To make this Christmas one to remember, Drinkaware’s suggests the following tips:

* Avoid drinking on an empty stomach – food slows down the absorption of alcohol
* Pace yourself, there’s no rush – drink slowly
* Include soft drinks in your celebration
* Don’t leave yourself vulnerable – plan your journey home

The morning after:

* Drink plenty of water to rehydrate
* Avoid ‘hair of the dog’ – it doesn’t work!
* Over-done it? Have two alcohol-free days

Up to a million business-card size Christmas ‘tip cards’ have been distributed to over 2000 pubs across the UK, containing tips, unit guidelines, and links to a 24 hour helpline and drinkaware.co.uk. A further 10,000 tip cards will be given to taxi passengers in London, with 300 black cabs’ supersides and tip seats displaying advice to partygoers.

Drinkaware’s new CEO, Chris Sorek, said: “It’s all too easy to drink too much during the festive season. By distributing tip cards in pubs and licensed taxis, we hope to offer practical guidance to consumers who want to enjoy Christmas without experiencing the negative effects of over-doing it.”

To find out more about how to survive the Christmas party season, visit drinkaware.co.uk, which includes a unit calculator, drinks diary, health fact sheets, lifestyle features, short films and more.

Drinkaware

If you or someone you love has recently decided to seek treatment for a drinking problem, then as bad as things may seem, congratulations are in order. This is a courageous step to take and it’s one that offers the best chance of giving up drinking and staying alcohol free.

The next decision is not an easy one, either: is an outpatient or residential rehabilitation programme the best choice?

For some people, outpatient care offers a flexible approach and the opportunity to maintain links with family, home and work. But research conducted over the last few decades shows a clear link between positive outcomes in giving up drinking and longer, more intense treatment programmes.

In this respect, a residential rehabilitation programme has much to offer. In order to stop drinking, most people with alcohol dependence problems need to change both their behaviour and their surroundings. Going into a residential programme assists in removing an individual from the influences that led them to drink in the first place.

In addition, they will also find themselves in the company of people pursuing the same goal — a powerful incentive to make the necessary changes. Backed up by counselling and one-to-one therapy, this can provide the basis for healthy living in future.

"We like to see ourselves as providing a retreat," says Sue Allchurch, research director at Linwood Manor. "We offer clients an escape for a short time from outside pressures to allow time for reflection and re-grouping. For many, the relief of slowly unwinding in a peaceful, supportive atmosphere has a very beneficial effect in helping them to achieve their goal of recovery."

In fact, she says, there are many situations where residential rehabilitation is strongly recommended over an outpatient alternative. It should be strongly encouraged if:

- the individual needs to undergo a period of medically supervised detoxification prior to embarking on a period of intense therapy;

- the individual has previously tried outpatient care and found that they could not maintain sobriety;

- the home environment offers too much temptation or insufficient support to enable the individual to maintain their commitment to not drinking;

- the individual is in danger of losing their house, job or spouse as a result of their drinking;

- the drinking has started to have serious health consequences and the individual cannot afford to waste any time in getting well.

If you or your loved one are ready to experience life without the daily grind of having to drink, effective help is available at reasonable cost.

Linwood Manor

A ban on ‘all you can drink’ promotions in pubs and bars is among a range of new measures announced on Wednesday 3 December 2008 by Home Secretary Jacqui Smith and Health Secretary Alan Johnson, supported by a new £4.5 million crackdown on alcohol fuelled crime and disorder.

Following an independent review, which found that many retailers are not abiding by their own voluntary standards for responsible selling and marketing of alcohol, The Government now intends to introduce a new mandatory code of practice to target the most irresponsible retail practices. This will set out compulsory licensing conditions for all alcohol retailers and will give licensing authorities new powers to clampdown on specific problems in their areas. Licensing authorities will also be able to impose these new powers on several premises at once.

The Government will shortly consult on a range of compulsory conditions including:

- banning offers like ‘all you can drink for £10′;
– outlawing pubs and bars offering promotions to certain groups, such as women only;
– ensuring that customers in supermarkets are not required to buy very large amounts of a product to take advantage of price discounts;
– ensuring staff selling alcohol are properly trained;
– requiring that consumers are able to see unit content of all alcohol when they buy it; and
– requiring bars and pubs to have the minimum sized glasses available for customers who want them.

Crime and Disorder Reduction Partnerships are being awarded a £3 million cash injection to target enforcement activities on specific alcohol-related problems in 190 areas across all police forces. In addition, £1.5 million will be given to a number of priority areas to strengthen their ability to tackle underage sales, confiscate alcohol from under 18s and run communications campaigns to tell people what action is being taken to successfully reduce alcohol related crime and disorder in their local area.

Home Secretary Jacqui Smith said:

"I don’t want to stop the vast majority of people who enjoy alcohol and drink responsibly from doing so but we all face a cost from alcohol-related disorder and I have a duty to crack down on irresponsible promotions that can fuel excessive drinking and lead people into crime and disorder. That’s why I will impose new standards on the alcohol industry that everyone will have to meet with tough penalties if they break the rules.

"There is no simple solution to tackling this problem – we all have a responsibility to tackle the binge drinking culture. I look forward to seeing the results of our £4.5 million crackdown on alcohol fuelled crime and disorder."

The Government undertook a public consultation on a mandatory code in July this year. Over 90 per cent of approximately 2,000 respondents supported a mandatory code.

The Government also commissioned an independent review of the effects of price and promotion on alcohol-related harm. These reports are published today. The review findings suggest that changes to how alcohol is priced and promoted could deliver reductions in health harms, crime and absenteeism from work. However, the ScHARR review is a very detailed study examining a wide range of policy options. The Government needs to evaluate these before deciding whether or not to act in this area. Details of how this will be done will follow in due course.

Health Secretary Alan Johnson said:

"The majority of people who drink enjoy alcohol sensibly, but we are determined to take action to reduce the health and social harms caused by those who don’t. We have already invested £10 million in the ‘Know Your Limits’ campaign which launched in May this year and arms people with the facts about what a unit of alcohol is, how many units are in the drinks they consume, and a guide to safe levels of consumption.

"We now have the evidence and public support to take decisive action to reduce harm from excessive drinking. Our consultation results suggest that people want to see Government tackle irresponsible promotions – we can’t justify delaying action here while waiting for further analysis on changes to pricing.

"Low-cost alcohol is clearly linked to increased consumption and harm, so I’m not ruling out taking action on very cheap alcohol, such as alcohol sold below cost price. However, it would be wrong to make sweeping changes without taking account of all the options suggested by our new research. We need to do more work on this to make sure any action we take is appropriate, fair and effective."

Mike Craik, Association of Chief Police Officers (ACPO) lead for Alcohol Licensing, said:

"ACPO welcomes the indication today that the Government is looking at the introduction of a mandatory code of conduct for the licensing industry. For too long, some retailers have been putting profits before responsibility and cutting the price of alcohol until it is cheaper than water.

"There is no doubt that irresponsible drinking leads to alcohol-fuelled violence and suggestions that enforcement alone can provide an answer ignore the obvious. Last year, nearly one fifth of all violent incidents took place in or around pubs and clubs at a cost of £7.3 billion to the UK. While there are many who trade responsibly, there are also, as the KPMG study released earlier this year showed, a great many who do not. So the industry has an important part to play in helping to reduce the excessive drinking that leads to alcohol-fuelled disorder on our streets.

"ACPO has consistently called for end-to-end solutions bringing together the police, local authorities, industry, parents and all those in each neighbourhood who share an interest in tackling alcohol related crime and disorder. We look forward to working with Government and partners on proposals to meet this aim."

Don Shenker, Chief Executive of Alcohol Concern, said:

"A mandatory code of practice for licensed retailers is a very welcome development in the Government’s alcohol policy. Self-regulation from the drinks industry has clearly protected irresponsible licensees, rather than customers and we believe a mandatory code is crucial in tackling poorly run pubs, clubs and off-licenses. Government must ensure however that the new code urgently addresses the issue of irresponsible price promotions in both the on- and off-trade in order to reduce harmful drinking and avoid preventable deaths."

David Poley, chief executive of Portman Group, the social responsibility organisation for drinks producers, said:

"Retailers offering consumers incentives to drink excessively and rapidly can cause harm. This mandatory code would strengthen the existing licensing laws while allowing effective producer self-regulation to flourish. It will stamp out irresponsible promotions without making everyone pay more for a drink. The funding boost for alcohol enforcement activity is to be applauded. We encourage police forces to use the raft of powers at their disposal for tackling alcohol-related disorder. Greater police activity, better education and responsible industry actions will make a bigger dent in our drinking culture."

Home Office

Abstinence is still the best policy

A new study from Mayo Clinic finds the use of the drug therapy etanercept ineffective in treating alcoholic hepatitis, an acute inflammation of the liver caused by excessive consumption of alcohol. The results of the study are published in the December issue of Gastroenterology.

Alcoholic hepatitis is a major cause of morbidity and mortality worldwide. Severe alcohol-related liver disease carries a poor prognosis. Several research studies have worked to find a successful treatment for alcoholic hepatitis, but no consensus has been reached on the most effective treatment regimen.

"Alcohol usage has long been associated with serious liver diseases such as hepatitis," says Vijay Shah, M.D., a Mayo Clinic hepatologist and lead researcher on the study. "The relationship between drinking and alcoholic hepatitis is complex. Not all heavy drinkers develop alcoholic hepatitis, and the disease can sometimes occur in people who drink only moderately. Though damage from alcoholic hepatitis often can be reversed if patients stop drinking, the disease can progress to cirrhosis and liver failure."

In this placebo-controlled clinical trial, Mayo researchers collaborated with seven other medical centers to enroll 48 patients with moderate to severe alcoholic hepatitis. Patients were either given a placebo or etanercept, a compound which blocks the effects of toxic cytokines. Etanercept is approved for treatment of inflammatory arthritis and is under investigation for effectiveness in treating other inflammatory conditions. Research results found a significantly higher rate of six-month mortality in patients with moderate to severe alcoholic hepatitis who received etanercept. The six-month mortality rate was more than double that of the placebo group. The major cause was an increased rate of infections.

"Etanercept therapy showed promise in our animal models, but was not effective in treatment of patients with alcoholic hepatitis. A few possible causes of increased late mortality rate may relate to impaired liver regeneration, and another is the effects of etanercept on immune function," says Dr. Shah.

Liver disease complications from alcohol are typically severe and difficult to treat, which further emphasizes the importance of not drinking too much.

"Despite awareness of hepatitis C and non-alcoholic fatty liver syndrome, our recent studies show that alcoholic liver disease is still the major cause of liver disease and liver-related death," says Dr. Shah. "Our Mayo Clinic research team will continue to examine other avenues of treatment for alcoholic hepatitis patients — including examining other anti-inflammatory proteins for study purposes."

Complete abstinence from alcohol is the single most important treatment for alcoholic hepatitis. It’s the only way to reverse liver damage or, in more advanced cases, to reduce the chance that thae disease will become worse. Without abstinence, the majority of people with alcoholic hepatitis eventually develop cirrhosis and die, says Dr. Shah.

Mayo Clinic

Drivers are being warned that a festive tipple could see them end up behind bars this Christmas as a new hard-hitting £1.6 million THINK! campaign is launched today by Road Safety Minister Jim Fitzpatrick.

The Government and Police have once again joined forces to urge anyone hitting the party scene to leave their car keys at home and not risk the devastation that drink driving causes. This year the Department for Transport’s THINK! campaign is supported by Coca-Cola, meaning designated drivers will receive free soft drinks at thousands of pubs across Britain.

The THINK! campaign – with brand new radio, Internet and in-pub advertising – was launched today to remind drivers, and young men in particular: If you get caught drink driving you’ll be processed like any other criminal.

Alongside this, the Association of Chief Police Officers (ACPO) will coordinate a nationwide police operation to tackle the menace of drink and drug driving over the festive period – with many forces using new digital breath testing equipment funded by the Department for Transport.

Road Safety Minister Jim Fitzpatrick said:

"Drink driving ruins lives. Last year 460 people died and families across Britain were devastated by the menace of drink driving.

"My message to drivers is clear. If you get behind the wheel after a festive tipple you risk wrecking your own and other people’s lives – don’t do it.

"Drink drivers are treated like any other criminal – they face giving blood and DNA samples and being locked in a police cell. They’ll also get a minimum 12 months driving ban, criminal record and large fine. Don’t ruin Christmas in a moment of selfishness."

More than half a million drivers are stopped and breathalysed each year and with more breath tests carried out in December than other months. This Christmas many police forces will be using digital breath testing equipment, funded by a £2million investment by the Department for Transport, which allows officers to record information about drink driving electronically. As well as providing a much clearer picture about those who drink and drive, the devices will enable police to carry out more enforcement.

Deputy Chief Constable Adam Briggs, Chair of ACPO Roads Policing Operations Forum said:

"This year will see more roadside stop and check operations than ever before, at all times of day and night and on all types of road. We will be stopping a large number of drivers and where appropriate, will arrest and bring offenders before a court.

"Drink and drug drive collisions not only devastate the lives of victims and their families, but they also ruin the lives of the offenders. Those responsible could face a lengthy driving ban, imprisonment and could lose their job, home and livelihood. They will also have to live with the lifelong guilt of having killed or injured somebody through their reckless behaviour."

As well as new radio and Internet adverts, the THINK! Christmas drink drive campaign will include the Moment of Doubt TV advert, cinema and in-pub advertising and partnership marketing.

This includes working with Coca-Cola Great Britain to help tackle drink driving through its ‘Buy one Coca-Cola and get two more free’ deal for designated drivers – which will be running in 2,500 pubs across Britain over the festive season.

Department for Transport