Alcohol Help

The All Party Parliamentary Group on Alcohol Misuse today (18/05/09) published its report on the future of alcohol treatment services in England.

The report is the result of an Inquiry launched by the All Party Group in October 2008 in order to investigate the obstacles faced by those working with problem drinkers. The Inquiry heard from treatment service providers, service commissioners, local authorities, Drug & Alcohol Action Teams, Department of Health representatives and experts in the alcohol field.

The Inquiry revealed patchy levels of funding and inconsistencies in the way treatment services are being planned across the country.

The report proposes practical solutions to Government to improve the level of care for people with alcohol misuse problems. These start with clear cross-departmental leadership from Government, right down to recommendations to improve GPs’ understanding of alcohol problems and provide patients with the information and help they need to seek treatment.

Chair of the All Party Group, Lynda Waltho MP, said:

“The scale of the problem we set out to investigate is huge – of the 1.1 million people dependent on alcohol, sadly only 1 in 18 access specialist treatment every year.

“There is still a lot of work to be done to highlight alcohol as a public health concern, while breaking down the stigma and lack of understanding that surround problems with alcohol.

“Clear, joined up thinking is necessary from Government, combined with adequate funding for treatment services so that they can meet the needs of all those affected by alcohol misuse.

“Helping people with alcohol problems to get their lives back on track is an important boost, not just for them but also for their families and wider society.

Alcohol Concern

Alcohol-use disorders (AUDs) can damage the brain, particularly the frontal and parietal cortices, although this damage is at least partially reversible with sustained abstinence from alcohol. Chronic smoking is extremely common among individuals with AUDs. A new study has used longitudinal magnetic resonance imaging (MRI) of brain blood flow to show that smoking makes it harder for brain blood flow to recover from long-term heavy drinking.

"The brain’s frontal lobes are involved in higher-order cognitive function, such as learning, short-term memory, reasoning, planning, problem solving, and emotional control," explained Anderson Mon, senior research fellow in the department of radiology at the University of California, San Francisco and corresponding author for the study. "The parietal lobes are involved in aspects of attentional regulation and visuospatial processing. Chronic and excessive drinking is associated with neurobiological abnormalities in these regions, which contribute to the cognitive dysfunction frequently observed in those with AUDs after detoxification."

Cerebral perfusion is a measure of the amount of blood flow to brain tissue per unit time. A normal, uninterrupted flow of blood through the brain is necessary to supply brain tissue with sufficient essential compounds and oxygen for normal metabolism, and will also carry away metabolic byproducts. The brain is only about 1/50th of total body weight, but it demands about 20 percent of the heart’s oxygen-rich blood.

"In general, AUDs are associated with reduced perfusion," said Mon. "With abstinence from alcohol, brain perfusion abnormalities may recover, but there are several factors that may influence recovery, such as age, diet, exercise, genetic predispositions and – the topic of our research –other substances such as tobacco products."

Mon and his colleagues measured brain perfusion in the frontal and parietal cortices of three groups of study participants: 19 non-smoking alcohol-dependent (ALC) patients, and 22 smoking ALC patients at one and five weeks of abstinence from alcohol; as well as 28 age-matched non-smoking, light-drinking controls.

Results showed that even though cerebral perfusion among the ALC individuals, as a whole, improved with abstinence from alcohol, those ALC who were chronic smokers demonstrated significantly less perfusion recovery, particularly in the frontal lobes.

"At one week of abstinence, both smoking and non-smoking ALC patients had similar frontal and parietal gray matter perfusion; and both groups had lower perfusion than normal controls," said Mon. "However, after five weeks of abstinence, frontal and parietal gray matter perfusion of the non-smoking ALC patients recovered to normal control levels, whereas the smoking ALC group essentially showed no recovery."

Mon added that these findings are consistent with their earlier neuroimaging studies which found chronic smoking in ALC patients was associated with significantly diminished recovery of markers of neuronal, or nerve cell, and cell membrane integrity in multiple brain regions over the same period as this present study.

"These results suggest that patients who want to stop drinking should be offered an option to stop smoking," said Graeme Mason, associate professor of diagnostic radiology and psychiatry at Yale University. "However, any combined cessation has to be designed carefully."

Study results have been mixed, Mason noted. "One study showed that when patients choose to stop smoking and drinking together, they maintain sobriety longer," he said. "Conversely, another study showed the patients who were required to stop smoking at the same time as they stopped drinking did not stay sober as long as those who were not forced." Free will appears to be an important option, he emphasized.

"Additionally," said Mason, "patients may differ in their abilities to handle abstinence from multiple substances at the same time that they may be dealing with other major events in life, but more successful brain recovery may help make those difficult situations easier to manage appropriately. The work of Mons and colleagues certainly suggests that if a patient wishes to tackle both smoking and drinking at the same time, it will be worth the attempt to that person, helping them recover more complete brain function and stay sober, in addition to other, better known health benefits of smoking cessation."

"In short," said Mon, "prolonged and excessive alcohol consumption is bad for your brain, but a combination of alcohol with smoking is worse."

Alcoholism: Clinical & Experimental Research

Drug Rehab And Alcohol Rehab Admissions By Intervention Increased 38% Year Over Year At Connecticut Treatment Facility Mountainside Drug Rehab

The number of drug rehab admissions that have resulted from professional interventions has increased thirty eight percent on a year over year basis at Mountainside Drug Rehab from 2008 to 2009 respectively. Seventy three percent of these interventions came from more than 500 miles away from the Canaan Connecticut drug rehab facility, with the remaining twenty seven percent occurred within 500 miles.

This evidence is part of a national trend and is representative of how a growing number of people continue to go against the conventional wisdom of many drug rehabs and alcohol rehabs – that have long stated that an addict first needs to hit bottom before they will enter treatment. Professional intervention is the process of presenting reality to such individuals in a receivable way. It usually involves the participation of family and or loved ones, and is an invitation to the suffering addict or alcoholic to accept help. It is believed that interventions have a much higher success rate when done under the guidance and supervision of a professional Intervention Specialist and with the help of other people close to the individual needing the intervention.

It has been the experience of Mountainside Drug Rehab that a stumbling block for many alcoholics and drug addicts is the level of denial that prevents them from acknowledging that a problem beyond their control exists. Largely, and in a relatively recent period of time – before interventionists were practicing in the large numbers they currently practice – conventional wisdom of the drug rehab and alcohol rehab community stated that the only way a person could enter treatment is for they themselves to realize their situation, take action and seek help.

Commonly, active drug addicts and alcoholics are resistant to any approach that is made by family, friends and employers. Mountainside Drug Rehab has been working with numbers of professional interventionists across the country and continues to see the numbers of these practitioners increase. Mountainside Drug Rehab is advocating that a nationally recognized licensure be established to ensure that will ensure quality and professionalism in all said practitioners.

Mountainside Treatment Center

The Culture, Media and Sport Committee, Sixth Report of Session 2008-09 – ‘The Licensing Act’ published 14 May 2009, showed concern that ‘the relaxation of rules on premises’ closing hours have not diminished law and order problems, but have merely moved them on or two hours later than previously’. It also criticised the licensing process as ‘too bureaucratic, complicated and time consuming’.

Commenting on the Report , Alcohol Concern Chief Executive Don Shenker said:

“This damning report shows that the government’s expectation of a cafe-style drinking culture was simply naive. Under the Act, people who visits pubs and bars regularly are still at more risk of violence than those who do not, and about a fifth of all violent incidents are committed in or around pubs and clubs.

“The Committee is right to recommend that the density of venues be considered when licenses are granted, however local authorities should also be required to take local public health into consideration when deciding if another venue should open.

“The high level of crime and disorder related to alcohol needs to be tackled by wider measures as well, such as applying a minimum price to alcohol to crack down on very cheap sales which encourage irresponsible drinking.

Alcohol Concern

Problem drinking in Western societies contributes to disease and death as well as social and economic woes. Yet only a small number of people with alcohol problems – 10 to 20 percent – ever seek and participate in treatment. This study examined the real-world effectiveness of a 24/7 free-access, anonymous, interactive, and Web-based self-help intervention called Drinking Less (DL) at http://www.minderdrinken.nl. Findings show that DL can help problem drinkers in the privacy of their own homes.

"We were concerned that so few problem drinkers access the help they need," said Heleen Riper, a senior scientist at the Trimbos Institute and the Vrije Universiteit in the Netherlands, as well as corresponding author for the study.

"This may not come as a surprise, given that addiction services predominantly focus on severely dependent people."

"Web-based interventions can provide a cheap and easily accessible intervention for the large majority of problem drinkers who are not treated," noted Reinout W. Wiers, professor of developmental psychopathology at the University of Amsterdam.

Riper and her colleagues wanted to expand the use of DL – a self-help intervention for adults without therapeutic guidance – from a clinical trial to the community. "DL consists of motivational, cognitive-behavioral, and self-control information and exercises," she said. "It helps problem drinkers decide if they really want to change their problem drinking and, if so, helps them set realistic goals for achieving a change in their drinking behavior, providing tools and exercises to maintain these changes, or deal with relapse if it occurs."

The study authors recruited 378 (199 females, 179 males) of the 1,625 community-based people who used DL from May to November 2007 to complete an online survey six months later. All lived in the Netherlands; the vast majority, 91.5 percent, was of Dutch origin. Outcome measures included alcohol consumption during the preceding four weeks, and mean weekly alcohol consumption. The collected data were then compared with those from the previous trial of DL.

"The observed effectiveness of DL in a randomized, controlled trial setting was maintained when we offered the intervention to the general population in a real-world setting," said Riper. "After six months, participants decreased their mean weekly alcohol consumption, and 18.8 percent changed their drinking patterns to ‘low risk drinking.’ For 84 percent of the participants, this was their first professional contact for problem drinking. Furthermore, more than half was female, indicating that this form of help is highly acceptable for female problem drinkers."

Dutch guidelines for "low-risk drinking" are: for men, drinking less than 21 standard units per week, or six or more units at least one day per week; and for women, drinking less than 14 standard units per week, or four or more units at least one day a week. One standard unit contains 10 g of ethanol. In contrast, American standard drinks contain more alcohol, about 14 g. Thus, Dutch guidelines in terms of American drinks would mean: less than 15 drinks per week and no more than five in a row for men; and for women, no more than 10 drinks per week and no more than three in a row.

Both Riper and Wiers believe these findings from the Netherlands could easily be applied to a North American population. "This research is all about real world applications," said Wiers. "Similar websites could easily be translated and/or developed in other countries."

"While Web-based and digital interventions might not be effective for everyone," added Riper, "almost 20 percent of our participants were able to change their problem drinking to low-risk, while others became aware of their problems and were more willing to seek professional guidance. Our study also indicated that Web-based treatment like this is effective for people with different educational backgrounds."

Riper recommended that interventions such as DL become the "first step" to a collective approach to problem drinking in which online and offline services become integrated. "Web-based self-help … should be seen as an additional form of service next to existing services," she said. "It could be used as a stand-alone intervention, expanded with therapeutic guidance for those who are ready for it, or used to mitigate waiting times. It also provides accessibility for populations who live in low-density areas where professional services are scarce. Alone it cannot change the world, but it could help to make a difference once integrated."

Wiers agreed. "I think that this is an important first step in internet-delivered interventions for alcohol abuse and dependence," he said. "I foresee that in the future these cognitive motivational approaches could be augmented by other approaches that can be delivered over the internet, such as interventions that directly interfere with cognitive processes in alcohol problems. In addition, internet-based treatments can become part of the aftercare of regular treatment, helping to prevent relapse back home, one of the major challenges in treating alcohol-use disorders."

Alcoholism Clinical and Experimental Research

A ban on irresponsible drinks promotions including "all you can drink for £10", speed drinking competitions and "dentist’s chairs" – pouring alcohol directly into people’s mouths – are among the conditions of a proposed new mandatory code on alcohol sales launched for consultation by Home Secretary Jacqui Smith today.

The proposed mandatory code of practice for pubs, clubs, off-licences and supermarkets is the latest step in the Government’s plans to tackle alcohol-related crime and disorder and harm to health which costs the UK up to £13 billion every year.

The proposals take a two-tiered approach with a small number of mandatory conditions for all alcohol retailers, which will ensure consistent good practice alongside new discretionary powers for local authorities to tackle problem premises where irresponsible drinking could put individuals at risk and lead to crime and anti-social behaviour.

Any premises that breach the mandatory code or local discretionary conditions that have been imposed will face a range of possible sanctions including losing their licence, having additional tough conditions imposed on their licence or, on summary conviction, a maximum £20,000 fine and/or six months imprisonment.

The proposed mandatory code of practice includes;
* banning promotions such as "all you can drink for £10", speed drinking competitions and "dentist’s chairs" where alcohol is dispensed directly into the mouth of any customer. These promotions encourage people to drink quickly or irresponsibly, can lead to crime or antisocial behaviour and make it impossible for people to keep track of the units consumed;

* ensuring all bars, pubs and clubs offer alcohol in both measures so customers have the choice between a single or double measure of spirits and a large or small glass of wine; and

* requiring alcohol retailers to display information about the alcohol unit content of drinks and for supermarkets and convenience stores, the health impacts of alcohol under powers from the Food Safety Act. This allows customers to make an informed decision about how much they drink and the effects on their own health.

Home Secretary Jacqui Smith said:
"Alcohol-related crime and disorder costs the UK billions every year in police and hospital resources, not to mention the effect it has on the lives of the millions of decent people who want to enjoy a night out.

"We do not want to stop the vast majority of people who enjoy a drink responsibly from doing so but this code will crack down on the minority of businesses whose irresponsible promotions fuel the excessive drinking that can lead people into crime and disorder or to risk their own or other’s safety. It is not about penalising the majority who trade responsibly but the Government has a duty to tackle this issue which affects us all.

"We have consulted with the alcohol industry to ensure the conditions in the proposed code target the irresponsible practices that most people agree should not be allowed."

Secretary of State for Health, Alan Johnson said:
"The alcohol industry has a responsibility to help reduce harm from alcohol. This code will give them the framework in which to live up to that responsibility.

"People must also be able to make informed choices about their drinking habits. Our Units campaign is already giving the facts about alcohol units. Today’s proposals would see all alcohol retailers reinforcing this with information for their customers on the number of units in their drinks and the health risks of drinking too much."

Alcohol Concern Chief Executive Don Shenker said:

"A mandatory code is a necessary step in the right direction towards cutting crime and health problems caused by alcohol.

"These measures are long overdue – for too long, the industry has failed to regulate itself. This new code will help people make healthy choices while further protecting communities from crime."

As well as the mandatory conditions there are also a flexible secondary set of conditions that can be imposed by licensing authorities on two or more premises in one area where they are clearly associated with alcohol-related nuisance and disorder.

These conditions will enable local councils to take tough action in areas experiencing particularly high levels of alcohol-related disorder by imposing strict conditions to stop irresponsible promotions or practices and to ensure that premises are responsibly run.

Additional conditions for alcohol crime hotspots include;
* restricting happy hours or "pub crawl" promotions at particular times most associated with alcohol-related crime and disorder;

* banning irresponsible bulk buy promotions where for example a consumer must buy more than one 24 pack of lager to obtain a discount to reduce the risk or people drinking excessive amounts of alcohol at home then going out already drunk and causing crime and disorder;

* requiring staff to operate a Challenge 21 policy where anyone who may look under 21 must produce proof of age to buy alcohol;

* requiring licensed door staff to conduct checks for weapons and drugs at times most associated with alcohol-related crime and disorder;

* banning glass containers or ensuring glasses are collected at regular intervals to reduce the risk of violent incidents;

* ensuring that CCTV is in operation at times most associated with alcohol-related crime and disorder; and

* display information on the location of public transport links and taxi numbers to help people get home safely.

The Government has decided not to proceed with any national or local measures around minimum unit price as it would punish unfairly the sensible majority of moderate and responsible drinkers. However the consultation commits to developing further the evidence base in this area.
In addition the consultation asks for views on whether banning retailers from selling alcohol at prices below the level of excise duty paid, plus the VAT due, would further the Government’s objectives in tackling alcohol-related harms in a way that does not unduly affect the majority of responsible drinkers and retailers.

Mike Craik, Association of Chief Police Officers (ACPO) national spokesperson for Alcohol Licensing, said:
"Alcohol misuse impacts on every area of society. But long term sustainable reductions in alcohol misuse can only be delivered by influencing attitudes and behaviour. ACPO welcomes the announcement of the Governments’ consultation today around a mandatory code of conduct for the licensing industry and looks forward to working with Government and industry to develop detailed proposals to address what is a significant issue for our society. We want to see an end to promotions that lead to alcohol-fuelled violence.

"Tackling those retailers who continue to trade without considering the effect of their actions on communities is a step in the right direction. However, just as not all people who drink do so irresponsibly, not all retailers trade irresponsibly and putting an end to irresponsible drinks promotion is not the only solution.

"We need cultural change, properly planned town centres, appropriate licensing decisions, courts handing down appropriate sentences and of course, continued enforcement activity targeted at problem premises and problem individuals."

The consultation invites views from members of the public as well as businesses, industry groups and interested organisations. It will run for 12 weeks and responses will be used to inform and develop the final set of conditions.

In deciding when to implement the Code, we will take full account of the views of the pub and drinks trade and the economic conditions affecting the industry at present. The Government will pay particular attention to minimising the impact on the great majority of responsible pubs, clubs and retailers and giving them enough time to adapt to mandatory provisions in the Code.

Home Office

Commenting on the publication of the Government’s consultation on a code of practice for alcohol sales, Alcohol Concern Chief Executive, Don Shenker said:

“A mandatory code is a necessary step in the right direction towards cutting crime and health problems caused by alcohol.

“These measures are long overdue – for too long, the industry has failed to regulate itself. This new code will help people make healthy choices while further protecting communities from crime.

“While we broadly support the code, we’re concerned that some of the local conditions will be impractical to apply and ineffective. For example, banning bulk buying should be a national requirement, not a local option.

“Many off-trade venues, including supermarkets, still sell alcohol at irresponsibly low prices. Therefore, the Government should not be afraid to consider the Chief Medical Officer’s proposals for a minimum price.

“This will reduce the burden on police and the NHS, and help make town centres safer and more attractive for the majority of responsible drinkers."

Alcohol Concern

Longreach, Plymouth
Our programme is designed to offer a balance between therapeutic groups & individual therapy.

About us:

Longreach operates along the lines of a therapeutic community, offering a person centred approach and specialised evidenced-based individualised treatment plans within a structured programme. Residents are supported in engaging in group therapy and one to one counselling along with a range of activities and optional workshops. It is a safe and friendly environment where women can build confidence and motivation whilst addressing their own particular difficulties, which may co-exist with their dependence.

Residents collaborate with their focal counsellor on their treatment plan, which may include therapeutic sessions for specific issues. We can offer a safe environment to address specific issues such as eating disorders, post traumatic stress disorder, childhood absue and self harm. Women with complex issues may need further medical assessment.

Access to gym, AA/NA Meetings, Arts and Crafts, Tai chi, Karate, Gardening, Health and Nutrition, Cooking, Mediation, and Relaxation

There are facilities are available for children (up to the age of 11) to stay for overnight/weekend visits. Support and advice is available from our dedicated Parenting Worker.
Longreach offers Parenting skills workshops to residents with children from our dedicated Parenting worker.

Contact Details:

Longreach
7 Hartley Road
Mannamead
Plymouth
Devon
PL3 5LW

Telephone: 01752 790 000

* Problem drinking in Western societies leads to disease and death, as well as social and economic problems.
* Few problem drinkers seek treatment help.
* New findings show that a 24/7 free-access, anonymous, interactive, and Web-based self-help intervention can aid problem drinkers in the privacy of their own homes.

Problem drinking in Western societies contributes to disease and death as well as social and economic woes. Yet only a small number of people with alcohol problems – 10 to 20 percent – ever seek and participate in treatment. This study examined the real-world effectiveness of a 24/7 free-access, anonymous, interactive, and Web-based self-help intervention called Drinking Less (DL). Findings show that DL can help problem drinkers in the privacy of their own homes.

Results will be published in the August issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"We were concerned that so few problem drinkers access the help they need," said Heleen Riper, a senior scientist at the Trimbos Institute and the Vrije Universiteit in the Netherlands, as well as corresponding author for the study.

"This may not come as a surprise, given that addiction services predominantly focus on severely dependent people."

"Web-based interventions can provide a cheap and easily accessible intervention for the large majority of problem drinkers who are not treated," noted Reinout W. Wiers, professor of developmental psychopathology at the University of Amsterdam.

Riper and her colleagues wanted to expand the use of DL – a self-help intervention for adults without therapeutic guidance – from a clinical trial to the community. "DL consists of motivational, cognitive-behavioral, and self-control information and exercises," she said. "It helps problem drinkers decide if they really want to change their problem drinking and, if so, helps them set realistic goals for achieving a change in their drinking behavior, providing tools and exercises to maintain these changes, or deal with relapse if it occurs."

The study authors recruited 378 (199 females, 179 males) of the 1,625 community-based people who used DL from May to November 2007 to complete an online survey six months later. All lived in the Netherlands; the vast majority, 91.5 percent, was of Dutch origin. Outcome measures included alcohol consumption during the preceding four weeks, and mean weekly alcohol consumption. The collected data were then compared with those from the previous trial of DL.

"The observed effectiveness of DL in a randomized, controlled trial setting was maintained when we offered the intervention to the general population in a real-world setting," said Riper. "After six months, participants decreased their mean weekly alcohol consumption, and 18.8 percent changed their drinking patterns to ‘low risk drinking.’ For 84 percent of the participants, this was their first professional contact for problem drinking. Furthermore, more than half was female, indicating that this form of help is highly acceptable for female problem drinkers."

Dutch guidelines for "low-risk drinking" are: for men, drinking less than 21 standard units per week, or six or more units at least one day per week; and for women, drinking less than 14 standard units per week, or four or more units at least one day a week. One standard unit contains 10 g of ethanol. In contrast, American standard drinks contain more alcohol, about 14 g. Thus, Dutch guidelines in terms of American drinks would mean: less than 15 drinks per week and no more than five in a row for men; and for women, no more than 10 drinks per week and no more than three in a row.

Both Riper and Wiers believe these findings from the Netherlands could easily be applied to a North American population. "This research is all about real world applications," said Wiers. "Similar websites could easily be translated and/or developed in other countries."

"While Web-based and digital interventions might not be effective for everyone," added Riper, "almost 20 percent of our participants were able to change their problem drinking to low-risk, while others became aware of their problems and were more willing to seek professional guidance. Our study also indicated that Web-based treatment like this is effective for people with different educational backgrounds."

Riper recommended that interventions such as DL become the "first step" to a collective approach to problem drinking in which online and offline services become integrated. "Web-based self-help … should be seen as an additional form of service next to existing services," she said. "It could be used as a stand-alone intervention, expanded with therapeutic guidance for those who are ready for it, or used to mitigate waiting times. It also provides accessibility for populations who live in low-density areas where professional services are scarce. Alone it cannot change the world, but it could help to make a difference once integrated."

Wiers agreed. "I think that this is an important first step in internet-delivered interventions for alcohol abuse and dependence," he said. "I foresee that in the future these cognitive motivational approaches could be augmented by other approaches that can be delivered over the internet, such as interventions that directly interfere with cognitive processes in alcohol problems. In addition, internet-based treatments can become part of the aftercare of regular treatment, helping to prevent relapse back home, one of the major challenges in treating alcohol-use disorders."

Alcoholism: Clinical & Experimental Research