Testing It Up

Several big name players in global alcohol policy gathered in Washington DC recently to talk about the legal drug and how best to regulate it to avoid exacerbating further problems related to alcohol abuse. 

Health risk factors, the global threat of alcohol abuse, alcohol pricing and ways to diminish the health risks of alcohol and its abuse were all on the agenda for the conference, which took place April 3 – 5. The conference featured many experts in the field of alcohol research and policy from around the world, allowing attendees to contrast and compare how different countries handle the constant threat of alcohol abuse.

For a summary of what happened at the conference, see my Twitter summary of the event.

Don’t rely on coffee to clear your mind after a night of drinking!

Recent research has proven that while caffeine reduces the tranquilizing effects of alcohol it doesn’t improve your concentration so decision-making processes will remain as limited as they were without the caffeine. You may assume you’re not as intoxicated as you are and the impaired thinking that remains may lead to poorly thought out choices and decision-making. Caffeine doesn’t change bac levels and it doesn’t help improve your ability to make proper choices. The result is that you can find yourself doing things you wouldn’t have if you were truly sober. This assumption about caffeine affects younger people (26% of whom according to the FDA are regular consumers) even more strongly as they’re prone to combining the two.

The FDA has plans to look into the risks of combining the two and has asked companies who produce the drinks to explain how they’ve determined their safety and reasoned that they’re safe to sell.

Researchers studied the effects of ethanol and caffeine on mice, both separately and together. When given together, ethanol interfered with caffeine’s anxiety-producing effect, but caffeine could not restore ethanol’s positive effects on learning. The result was a relaxed mouse prone to taking risks without being aware of those risks.

This adds to the growing body of evidence that individuals who combine caffeinated energy drinks with alcohol may be inadvertently putting themselves at greater risk due to poor decision-making and the misperception that their judgment is intact,” said Jeffrey T. Parsons, chairman of psychology at Hunter College in New York City.

New York Health Screening

Adults who drink large amounts of alcohol are causing serious damage to their health that they could pay for over time. Many of us are aware of the risk of cirrhosis of the liver but many of these other health threats aren’t as well known, take a look.

Cancer

Habitual drinking increases the risk of cancer according to research. Scientists believe the amplified risk is caused when the body converts alcohol into acetaldehyde,  which is a powerful carcinogen. Cancers that are most common in drinkers include the mouth, larynx (voice box), pharynx (throat), liver, esophagus, breasts, and colorectal cancer. The risk for these cancers is multiplied if the drinker is also a smoker.

Anemia

Heavy drinking can cause the number of red blood cells to be unusually low this is called anemia. Anemia can set off a series of symptoms which include shortness of breath, fatigue, and lightheadedness.

Gout

Gout is caused by the development of uric acid crystals in the joints of the body. While some cases are hereditary, alcohol and other dietary factors are beginning to be linked as well. If there is already gout present before the drinking becomes dramatically heavy it can get worse as the consumption level increases.

Cardiovascular Disease

Binge drinking makes platelets more likely to form blood clots, which in turn can lead to heart attack and stroke. In fact binge drinking doubles the risk of death among people who survived an initial heart attack. Cardiomyopathy, a condition in which the heart muscle weakens and eventually fails can also occur.  Ventricular fibrillation, another heart condition can cause muddled twitching in the heart’s main pumping chambers and cause sudden loss of consciousness. If treatment isn’t received soon it can even be fatal.

Nerve Damage

Heavy drinking can result in a form of nerve damage known as alcoholic neuropathy, this produces a painful pins-and-needles feeling in the extremities, constipation, erectile dysfunction muscle weakness, and incontinence, among other problems. Alcoholic neuropathy arises because alcohol is toxic to nerve cells and nutritional deficiencies that come with heavy drinking damage nerve function.

Dementia

As people age, their brains shrink about 1.9% per decade, heavy drinking hastens the shrinkage of certain key regions in the brain, this causes memory loss among other symptoms of dementia. It can also cause slight but potentially weakening deficits in the ability to make judgments, solve problems.

In a bid to deal with violence related to alcohol in the UK a special unit of officers wearing “head cams” will be distributed throughout Northamptonshire’s nightlife areas to monitor such behavior. A new drug detection computer will also be used to test revelers queuing to get into some nightclubs.
These measures are all part of an attempt to reign in drunken troublemakers and pubs operating illegally in a week-long operation dubbed Operation Mortlake.

Trading Standards officials and officers are also conducting test purchase operations at bars, pubs, clubs, off-licences, supermarkets and convenience stores. Police will team up with paramedics to help provide fast response to incidents and firefighters are making sure bars and clubs have the proper safety measures in place to cope with packed rooms during the holidays.
“We want to send a clear message to the licensing community that any offences under the Licensing Act 2003 will not be tolerated. The head cams will help us to record important evidence and reassure the public. Drug testing will be a condition of entry at some of the larger premises. A sample is taken from the hands with a device and the computer can detect the levels of a substance present.”

An Audit Commission report identified alcohol as one of the county’s biggest social troubles.

Evil Eye, Max Fury and Slingshot Party Gel, alcoholic energy drinks have quickly become popular among younger drinkers prompting the Food and Drug Administration ask for proof that the combination of alcohol and caffeine is safe for those who drink it. The combination of the two has never been approved by the FDA and so the organization was asked to check into the products to verify their safety.

A task force that asked the FDA to become involved feels that the caffeine masks the presence of alcohol and could make it more difficult to maintain awareness of the level of alcohol that is consumed by those who drink it, giving rise to higher levels of drunk driving and other destructive behavior by users.

When the FDA hasn’t tested the safety of a product it becomes the company that produces the products responsibility to test and verify the safety of that product. The FDA is asking for verification of why the combination is considered safe and how that has been proven by these companies. If the FDA feels that there is anything to indicate the combination could be unsafe they’ll ask the products to be removed from the market. The companies who produce these beverages are being given 30 days to respond the FDA’s request. The combination is thought to have come about because of the popularity of combining Red Bull energy drinks with liquor.

Anheuser-Busch Cos. and MillerCoors stopped making similar products last year after the task force made an investigation. Two of the 27 companies being asked to submit evidence have already written letter to the effect that they’ve ceased making the products.

According to records of calls to UK help line ChildLine last year the rate of children seeking help for parental alcohol abuse is twice as high in Scotland as it is in the rest of the United Kingdom. More than 200 kids called into the help line from Scotland last year with worries about their parents drinking. The majority of these kids talked about physical abuse, drinking problems and other family problems when they called. These numbers only include those who gave a location to the operators so the rate could be even higher.

Children everywhere are severely affected by alcohol abuse and the subsequent damage it causes to the family often meaning physical, verbal and emotional abuse and stress for all the family members. Children, inevitably, take the brunt of the harmful effects and the effects can last a lifetime. Anxiety, fear and worry cause these kids to grow up before their time and can even cause them to have their own drug and alcohol issues.

About .2% of the population of children in Scotland are affected by this compared to about .10% of those in Northern Ireland, Wales, and England. The number of calls from Scotland matches up with alcohol related deaths in the area which are also twice as high in Scotland over the rest of the UK.

Among the many things med students will be learning this year are new regulations and treatment methods for dealing with and caring for patients with substance abuse problems including tobacco, prescription drugs and illicit substances according to NIDA. The current level of education on substance abuse varies drastically and for many isn’t enough to truly handle the expanding problem. The new curriculum promises to be much more effective in training future doctors to effectively handle these patients and their problems. Based on real world scenarios that can be worked with by medical students these lessons offer more consistent training and realistic ideas of what substance abuse and its effects truly look like.

Offering more specific health conditions and information for specific substance abuse problems will also help. For instance with methamphetamine users often deal with chest pain, based on what’s going on at the time and the way the patient interacts the doctor can better treat the symptoms of the addiction. It also means that the doctor can make a more informed decision. NIDA may expend these lessons into s specific course for medical accreditation. This allows educators to teach new doctors and better inform those that came before them.

According to government reports Australia is dealing with children as young as ten reporting for rehabilitation. These pre-teens are seeking rehabilitation for addiction to substances like alcohol, marijuana, amphetamines and heroin and the numbers say that such occurrences are becoming more common. While there are a wide variety of reasons such treatment is sought out most of those seeking treatment are dealing with alcohol problems. At a rate of roughly 44% (up from 38% in 2002/2003) alcohol poses a larger problem for young teens and pre-teens more and more each year.

While it’s not totally unheard of for pre-teens this age to seek treatment from time to time the increase is definitely worth watching since it’s been on the rise over the last few years along with drug abuse (which while remaining lower than alcohol has had a bit more users as well) This increase comes after a steady five year declining period and accounts for about 700 more substance abusers seeking treatment recently. Heroine, while nowhere near as highly available or used as it was during the heroin heavy 90s is making a comeback in the country as well. The Australian Institute of Health and Welfare’s study shows that there is a clear need for some sort of substance abuse management in this age group.

The social and physiological costs for those who binge is already keenly understood but until recently the medical costs incurred weren’t as clear. Apparently over any other group those who are drunk at the time of entrance take up the most time and money in Emergency rooms. According to the study at Rhode Island’s Injury Prevention Center, those with any level of alcohol in their systems were in the ER for more than 3 hours longer and racked up a bill that was roughly $5,000 more expensive than those who were sober. The study focused on minimally injured people between the ages of 18 and 65 who were typically treated and released.

Why the difference?

Those who are inebriated often require more care and delay any testing that is involved with their stay in the ER. This means that it takes longer to treat them than a regular patient and could cause the doctor to need more testing to arrive at the best form of care for that patient.  Time is money and the extra time invested in that patient translates to higher costs of both money and medical professional’s time.

Peer pressure, parental influence and the role they play in the use of multiple drugs was studied by researchers at Weil Cornell Medical College: the research seems to point out that teens’ views on tobacco use could have a link with the decision to use tobacco, alcohol, and marijuana together.

Among girls, friends are more influential. When friends in their inner circle were undecided or accommodating of tobacco use their likelihood of using a combination of these three were much higher. Among boys, the general opinion and practices of their whole age group were more influential than those of friends.  The teen’s views on using these substances are most often dictated by how socially accepted they feel their use is among their peers. This slight difference in the way boys and girls make decisions could affect the way prevention should be brought up among teens.

This study was one of the first to focus on all three gateway drugs at once rather than apart and it could lead to prevention methods that treat all three as a group rather than individually. In this way smoking, marijuana and alcohol use could be reduced among teens by addressing the issue in a way that truly relates to the way they make these decisions. If the decision to smoke is one of the first things that can lead to use of the other two substances it should be addressed as a pathway to them.