Alcohol Help

Working as a bartender in the cocktail bar of a cruise ship proved too much of a temptation for Matthew Bristal( the name Matthew Bristal is fictitious, to respect the anonymity of the real person, all other details are correct. ) of Solihull who is paying a heavy price for those drinks being alcoholic.

Matthew joined the crew aged 22 to see the world but for the two years that was a crew member he was drinking wine and taking full advantage of the bar’s generous opening hours. He didn’t heed the warnings of those who knew that even in off-duty moments on board ship there is often little to do but sit drinking in the bar. On days when he was on afternoon or evening duty the bar was still open during his off-duty mornings.

Any port in a storm ?
Once back on dry land Matthew’s life was anything but dry and his habit of drinking wine throughout the day not only continued but he also started to drink port and brandy.

Such is the damage caused by the alcohol abuse over the next 8 years that Matthew is determined to do everything to stop others falling into similar bad ways and he’s backing a Government drive to provide clear messages for parents and teenagers on the health effects and risks of young people drinking alcohol.

Matthew will be adding his first-hand experiences and views to influence the Government’s draft guidance that is now under a 12-week consultation by calling upon parents, young people and carers to give their views online at http://www.dcsf.gov.uk/consultations

Chronic liver failure is not the only problem facing Matthew; he has developed a condition called Portal Hypertension which causes the blood that should be passing through the liver to be re-directed into small veins lining the oesophagus (gullet).

Here surges of blood force veins to swell like balloons (also called varices). When they burst Matthew almost died after he vomited up blood, bile and phlegm and it required emergency surgery to save him.

Although the surgery, via an endoscopy, treated each of the varices by cutting off their blood supply, the technique only dealt with the varices that were present at the time of surgery. The possibility of more varices appearing is a strong one and he has been told that he may not survive a second bleed. Just one more alcoholic drink would almost certainly tip the balance.

Matthew’s own GP and Dr Andrew Holt, a Consultant Physician and Transplant Hepatologist from the Liver Unit at University Hospital Birmingham are continuously monitoring his enlarged liver and other conditions for any tell-tale signs of deterioration and any action that may be needed. Moral support comes from Aquarius (the drugs & alcohol addiction charity), from Matthew’s family and from his girlfriend as he is willing to speak out about his desires not only for his own future but also for the future of others who could head down the same road.

"I just want to be able to earn a living, travel the world and have a happy life with my girlfriend, but I can no longer work as the sort of physical strain involved in my contracting work could easily spark another bleed.

"I wouldn’t want anybody else to end up in the same situation as me, I’m lucky to have made it beyond 30 but from the kids I see drinking before they’re 18-yrs-old I realise that, unless they stop, some of them will be taking my place in Andrew’s clinic before they’re beyond their teens. If I can help to dissuade them, I will.

"Better still that youngsters, too immature to really comprehend the dangers of alcohol, don’t start until they’re old enough to want to plan a future life. Parents who allow their children to experience alcohol should take a very serious look at their actions and ask themselves if there are any other addictive poisons or toxic chemicals that they’d like to feed them."

The harsh reality is that by the age of 15 many young people will have already consumed alcohol, often drinking weekly. Statistics show that: 16% of 11 – 14-year-olds across the region said, in an Ofsted survey, they have been drunk once or twice in their lives. Figures vary little across the West Midlands’ counties participating in the survey, with Shropshire highest at 19%, Solihull at 18%, Staffordshire at 17%, while Birmingham records the lowest figure of 14%. (source: Ofsted Tell Us3 survey 2008).

Across the West Midlands region alone, almost 1,000 under-18s are admitted to hospital each year due to alcohol-specific conditions, 150 of those are in Birmingham and a further 40 in Solihull.

Matthew continued: "During visits to the hospital I’ve seen fellow addicts who look 70 and I’m shocked when I hear their date of birth confirmed – and they’re not much older than me – yet they can’t even tell you the day, month or year. Like me, their condition and the side-effects of the medication mean that their skin is thin and their blood is thin – so a small puncture can produce heavy bleeding and takes an age to heal. It’s not just the patient who suffers, the strain on my parents is colossal so they need all the professional help, guidance and counselling that is available to them in order to cope with my self-administered illness.

"My next visit to the hospital is yet another endoscopy and, in my condition, the thought of the uncomfortable and excruciatingly painful process of purging my insides, ready for the endoscope, weighs heavily on my mind. Although I haven’t touched alcohol for 16 months, ironically the spray that will be used to numb my throat is alcohol-based and even that is a worry."

Department for Children, Schools and Families

Children and alcoholic parents are a disastrous combination – and the problem is more widespread than you might think. According to the National Association for Children of Alcoholics (NACOA), there are almost one million children living with an alcohol-dependent parent in the UK today, many of them hiding their problems, living in fear and facing an overwhelming lack of support.

Research shows that familial alcoholism can affect all areas of a child’s life, hampering their educational process and often leading to behavioural problems and compulsive disorders. There is much evidence to suggest that the impact of life with an alcoholic parent continues well into adult life, with NACOA estimating that some 3.7 million people in the UK are affected by parental alcoholism in some way. Research shows that the adult children of alcoholic parents are far more likely to experience drinking problems themselves.

The day-to-day problems faced by children with alcoholic parents are frightening. Some children may not experience obvious forms of abuse, but suffer from neglect: missed meals, inadequate clothing, poor school attendance, and a lack of access to medical attention.

Others are regularly exposed to rage, violence and abuse on a daily basis, which become part of the unpredictable and inconsistent environment in which they live. NACOA’s research shows that aggression within the family environment is six times more common where one or both parents suffer from alcohol dependency syndrome.

So what can be done to help such children? Intervention is essential, says Sue Allchurch, research director at Linwood Group. "Having one caring adult in a child’s life can help reduce these problems. Children with alcoholic parents need to understand their parent’s addiction is not their fault and that they can choose other options and change their lives," she says.

Where possible, the alcoholic parent should be urged to seek help with their drinking problem. This can be difficult for their families, says Allchurch, but they need to set clear guidelines. "Non-alcoholic family members must be clear about what they are prepared to accept from the person who’s drinking, and the consequences for them if they overstep these boundaries, so that they know how you are going to react. No-one should ever accept the blame for a family member’s drinking," she says.

"But they should be ready to assist if the problem drinker is prepared to acknowledge their addiction, by putting them in touch with qualified alcohol dependency experts. A good treatment centre will not only help the alcoholic parent beat their addiction, but also provide family counselling, so that the whole family can begin its recovery."

Linwood Manor

Six million women in the U.S. abuse or are dependent on alcohol, according to the National Center on Addiction and Substance Abuse at Columbia University. Frequent binge drinking in women’s colleges increased by 124 percent between 1993 and 2001. Nearly 21.6 million Americans are in need of but have not received treatment for an alcohol problem, according to the Substance Abuse and Mental Health Services Administration (SAMHSA, 2003). April is Alcohol Awareness Month, and Brookhaven Retreat, a multidisciplinary treatment facility that helps women overcome emotional trauma and addiction challenges, is working to raise awareness about the number-one drug problem in the United States: alcohol.

"Alcohol abuse is a tool women use to numb out emotional pain, often not realizing that an addiction has developed because they are doing something perceived as legal and social, and therefore okay," said Jacqueline Dawes, the owner and founder of Brookhaven Retreat. "There are millions of American women trapped by alcohol dependency who, because of fear, shame, and the whole stigma associated with alcohol abuse, feel too afraid to seek help. They need to understand that the addiction is treatable and there is hope."

The highly-trained professionals at Brookhaven Retreat strive to help women understand how their need for a numbing-out escape began. What caused them to start using alcohol as a tool to relax, sleep, and hide, when the stress and fear were mounting? And why can they not find the strength to stop?

According to Dawes, alcohol conceals the real issues these women are facing, including depression, low self-esteem, trauma, and disempowerment.

"The alcohol is the tip of the iceberg, and is only a small part of what is really going on with the person," said Dawes. "At Brookhaven, we offer no judgment. It is overwhelmingly frightening to seek treatment, but that is the first step to recovery and is undoubtedly the most crucial."

Alcohol dependency is shrouded by many myths, one of which is that a person chooses to be an alcoholic. Many times, friends and family members think the person should be able to exert self-control, when in fact, the emotional breakage existing within the person has made it unbearable for them to live without their dependency on alcohol. Dawes says that these women have formed a relationship with the alcohol that makes them feel like they need it to function in society, and that once the dependency has been established, women must undergo residential treatment in order to disengage the dependency.

Brookhaven Retreat’s philosophy is that each person must receive individualized attention, administered by highly-trained staff in order to facilitate long-term recovery. This recovery grows from an introspective journey to define the emotional breakage, followed by the development of life skills that allow lasting maintenance of emotional wellness.

Realizing that you or a loved one has a drinking problem can be a challenge. The following signs may indicate alcohol abuse:

* Feeling guilt about drinking
* Drinking to calm nerves, forget worries or to boost a sad mood
* Unsuccessful attempts to cut down/stop drinking
* Lying about or hiding drinking habits
* Feeling irritable, resentful or unreasonable
* Causing harm to oneself or someone else as a result of drinking
* Needing to drink increasingly greater amounts in order to achieve desired effect
* Identifying medical, social, family or financial problems caused by drinking

About Brookhaven Retreat

Brookhaven Retreat is a unique, voluntary residential treatment facility specially designed to help women overcome emotional trauma or addiction challenges. The fully accredited and certified dual-diagnosis center is America’s premier treatment center for emotional trauma and addiction and offers female-specific treatment. Located on 48 beautiful acres in the foothills of the Great Smoky Mountains, it offers modern, holistic care with compassion and respect from a highly trained expert staff of licensed therapists, physicians, registered nurses, nurse practitioners and licensed practical nurses.

Brookhaven Retreat

A new groundbreaking study by the drugs and alcohol treatment charity Addaction has found that young people respond well to treatment when it is carefully tailored to their needs, and the results when families are also included in treatment is even more positive.

The results of a three-year pilot project into young people and substance misuse, funded by the Big Lottery, are set out in a report entitled ‘Closing the Gaps’ to be launched next week (Tuesday March 24th).

Following their involvement in the Young Addaction Plus (YAP) project, 91% of the young people made positive changes to their lives, 96% tried to keep out of crime, and 82% either reduced or stabilised their substance misuse.

The findings were particularly striking given the severity of the problems the young people suffered when they first entered the project. The ages of the young people ranged between 10 and 19; they had complex drug and alcohol problems and their needs could not be met within mainstream services.

As a result of its findings, Addaction is calling for changes to the way young people are treated for drug and alcohol addiction problems. The charity calls for treatment to be tailored to take account of specific needs, and for services to be flexible enough to respond quickly to young people in vulnerable positions. It argues for more money to be spent on early interventions, to prevent the need for more costly interventions such as residential rehabilitation later on. Addaction wants to see dedicated family support becoming integrated into drug and alcohol treatment services, because of the improvement in results when families are included in treatment.

Commenting on the report, Adrian Auer, Chair of Addaction, said:

“Young people sometimes have major problems with their misuse of drink and drugs, but it is possible with commitment and an informed approach to change things for the better. I hope lessons from this report will inform policy and actions across our society.”

Addaction

A community artist who educates young people about the dangers of alcohol is urging everyone to give their views on the Government’s drive to provide clear messages for parents and teenagers on the health effects and risks of drinking.

Kim Wiltshire, from Trafford, works with young people across Greater Manchester to hammer home the potential social and psychological impacts of drinking alcohol through the mediums of writing, art and drama.

She recently helped young people to create their own feature film about the hazards of drinking, called "The Amazing Doctor Sober". The film received its world premiere at Manchester’s Printworks and was so successful that young people involved were invited to London to meet the Prime Minister to discuss their work.

Kim, who works for the Manchester-based arts and health charity Lime Art, said: "Young people drinking alcohol is hugely problematic, booze is so cheap to buy and children see their parents drinking so assume it is ok for them to drink too. I would back any public consultation that highlights this important issue, and would encourage young people to take part and make sure they have their say."

The Government’s five-point guidance document was launched last month in response to calls from parents for clear messages on the health effects and risks of young people drinking alcohol.

Most parents may see the unconscious, drunken 11-year-old in the park as a long way from the experience of their own children, yet an introduction to alcohol too young can store up problems for the future. Just under a quarter of children aged 11 to 15 said they get alcohol from their parents (source: NHS Information Centre).

The Chief Medical Officers’ Guidance on the Consumption of Alcohol by Children and Young People advises:

1. Children and their parents and carers are advised that an alcohol-free childhood is the healthiest and best option. However, if children drink alcohol, it should not be until at least the age of 15 years.

2. If young people aged 15 to 17 years consume alcohol, it should always be with the guidance of a parent or carer or in a supervised environment.

3. Parents and young people should be aware that drinking, even at age 15 or older, can be hazardous to health and that not drinking is the healthiest option for young people. If 15 to 17 year olds do consume alcohol they should do so infrequently and certainly on no more than one day a week. Young people aged 15 to 17 years should never exceed recommended adult daily limits and on days when they drink, consumption should usually be below such levels.

4. The importance of parental influences on children’s alcohol use should be communicated to parents, carers and professionals. Parents and carers require advice on how to respond to alcohol use and misuse by children.

5. Support services must be available for children and young people who have alcohol related problems and their parents

The harsh reality is that by the age of 15 many young people will have already consumed alcohol, often drinking weekly. Ten per cent of 11 – 14 year olds in both Oldham and Wigan said in an Ofsted survey they have been drunk three or more times in the past four weeks (source: Ofsted Tell Us3 survey 2008).

Aimed at children aged ten to 14, "The Amazing Doctor Sober" follows the story of Curtis, whose mother becomes an alcoholic after his father’s death. While his friends drink alcohol in the park, Curtis retreats into a fantasy world before realising he has to confront his mother about her excess drinking.

Kim has worked on a variety of projects for Lime Art, an arts in health charity within the Central Manchester University Hospitals NHS Foundation Trust, including creating the DVD package "Losing It" which is being distributed to schools across Greater Manchester to teach teenagers aged 14 to 16 about the pitfalls of binge drinking, and the impact it can have on families. She has also helped young people in Salford create their own magazine called FKD on the dangers of alcohol and substance misuse.

She added: "Sometimes I work with 12-year-olds who turn up to workshops drunk. There are a large number of teenagers whose first experience of sex is while they are drunk. It’s a hugely complex issue.

"One major reason is that children are bored and consume alcohol because they don’t have enough to do. Some children even get their parents to buy them alcohol, as their parents view is that they would rather they drink at home where they are safe rather than in a park. More needs to be done to make children aware of the social impact of alcohol, rather than condoning children who drink. Young people need to have a voice and be involved in this consultation."

Sir Liam Donaldson, the Chief Medical Officer for England, led the development of the guidance, following extensive research and work with a panel of experts who reviewed the latest available medical evidence and data from across the UK on the impact of alcohol and young people.

He said: "This guidance aims to support parents, give them the confidence to set boundaries and to help them engage with young people about drinking and risks associated with it.

"More than 10,000 children end up in hospital every year due to drinking and research tells us that 15 per cent of young people think it is normal to get drunk at least once a week. They are putting themselves at risk of liver damage, depression and problems with brain development and memory. Resulting social issues can lead to children doing less well at school and struggling to interact with friends and family."

Department for Children, Schools and Families

Sir Liam Donaldson, Chief Medical Officer, today published his 2008 Annual Report, in which he called for society to recognise the effect of ‘passive drinking’ on society. He wants to see a shift in public opinion on alcohol similar to the move to smoke-free public places, so that being drunk is no longer an aim of drinking nor socially acceptable.

In his 2008 Annual Report, On the State of Public Health, England’s Chief Medical Officer made recommendations to the Government to tackle alcohol harm, and particularly the collateral damage to society, family members, the NHS, and the economy.

Speaking at the launch, Sir Liam said:

"England has a drink problem and the whole of society bears the burden. The passive effects of heavy drinking on innocent parties are easily underestimated and frequently ignored.

"The concept of passive drinking and the devastating collateral effect that alcohol can have on others must be addressed on a national scale. Cheap alcohol is killing us as never before. The quality of life of families and in cities and towns up and down the country is being eroded by the effects of excessive drinking."

Society’s attitudes to passive smoking have shifted, culminating in the landmark smoke-free legislation introduced in July 2007. In comparison, whilst alcohol consumption has fallen in many European countries since 1970, England’s consumption has increased by 40 per cent. The average UK adult consumes the equivalent (in units of alcohol) of 120 bottles of wine a year. Sir Liam calls for:

* A national consensus, prompted by government, that as a country we should substantially reduce alcohol consumption.

* Passive drinking to be acknowledged as a key issue. It should present a consolidated rationale for action and be the basis of national campaigns.

* Licensing laws should reflect the full impact of heavy drinking, making public health considerations central to licensing.

* A minimum pricing of 50p per unit to be introduced to reduce the consumption of alcohol and its associated harms.

If a 50 pence minimum price per unit policy was introduced this year, substantial effects would be seen immediately, with the full effect seen by 2019. Every year there would be 3,393 fewer deaths, 97,900 fewer hospital admissions, 45,800 fewer crimes, 296,900 fewer sick days, and a total benefit of over £1 billion. Research shows that the impact of price would be greater on heavy drinkers.

Department of Health

Professor Chris Hackley, from the School of Management at Royal Holloway, University of London, has raised doubts about the effectiveness of proposals to introduce minimum prices for alcoholic drinks in an effort to curtail ‘binge drinking’ in Britain.

In a report citing research commissioned by the Department of Health at the University of Sheffield, the country’s chief medical officer, Sir Liam Donaldson, has encouraged the British government to set a minimum price for alcoholic drinks. Under this proposal, no drinks could be sold for less than 50 pence per unit of alcohol contained within, in an effort to combat alcohol misuse.

However, Professor Hackley, who has done extensive research into young people and alcohol, has admitted concerns following Sir Donaldson’s proposal. Professor Hackley argues that, ‘The level of pricing would have to be very high indeed to return alcohol’s relative affordability to the level of 20 years ago. This would meet with intense opposition from the powerful alcohol industry who would argue that it would penalise sensible drinkers and seriously undermine the already creaking UK pub industry’.

According to Professor Hackley, although price control might influence consumption levels at the margins, it would be unlikely to address single-handedly the UK’s deep and complex alcohol problem. He warns that this has arisen over many years under conditions of an explosion in the number of high strength branded alcohol products available; a huge increase in alcohol advertising and marketing and a redirection of alcohol marketing towards youth orientation; and a liberalisation of licensing and urban planning laws around drinking venues and alcohol retailing.

Professor Hackley even warned that price control in itself would be difficult to police and could lead to an increase in criminal activity in alcohol supply. He suggests instead that, ‘A long term solution must lie in measures which address the UK’s culture of intoxication, which has arisen under the influence of the alcohol industry and government alcohol policy’.

Royal Holloway, University of London

Researchers at Boston Medical Center (BMC) have found that a single-screening question recommended by the National Institute of Alcohol Abuse and Alcoholism (NIAAA) accurately identifies unhealthy alcohol use in primary-care patients. This research supports the use of the brief screen in the primary-care setting. The BMC study appears online in the Journal of General Internal Medicine.

Unhealthy alcohol use, the spectrum from risky consumption to alcohol use disorders, alcohol abuse and dependence, is prevalent but under-diagnosed in primary-care settings. Commonly used alcohol screening instruments are comprised of multiple questions, often do not cover the full spectrum of unhealthy use, and can be time consuming to administer. Consequently, many patients are not screened.

The NIAAA recommends a single-question screen for unhealthy alcohol use. The recommended question asks, "How many times in the past year have you had X or more drinks in a day?" (where X is 5 for men and 4 for women). While similar single-question screens have been validated in various settings, the NIAAA recommended screening test had not been validated in the primary-care setting. BMC researchers attempted to validate this version of the screening question in a sample of primary-care patients.

Of the 286 study participants reviewed, unhealthy alcohol use was reported by 31 percent of participants. Six percent consumed risky amounts but did not have alcohol-related problems or a disorder, 13 percent consumed risky amounts and had problems but no current disorder and 12 percent had a current alcohol use disorder. The single-question screen was 81.8 percent sensitive and 79.3 percent specific for the detection of unhealthy alcohol use. It was slightly more sensitive and less specific for the detection of a current alcohol use disorder.

"The single-question screening recommended by the NIAAA appears to have favorable characteristics," said lead author Peter Smith, MD, attending physician in the section of General Internal Medicine at Boston Medical Center. "Single-question screening tests for unhealthy alcohol use may help to increase the frequency of screening in primary-care."

Researchers further state that screening and brief intervention by primary-care physicians for those with unhealthy alcohol use reduces risky consumption among those without dependence and improves patient outcomes.

Boston University