SMOKING - Blog

Tuesday 06 November 2007

Health researchers at the University of Otago, Christchurch and the Medical Research Institute in Wellington are arguing that alcohol is a high risk drug according to the national classification regulations. This follows comparative research with another similar, but illegal drug, into its effect on public health.

The results of this study are being presented at the APSAD/Cutting Edge Conference at the Aotea Centre in Auckland on November 7.

“There’s no doubt that alcohol is a potentially dangerous drug when we look at the mayhem it causes in relation to public health, crime, and social disruption,” says principal investigator Professor Doug Sellman, from the University’s National Addiction Centre. “Following this peer-reviewed analysis we think the time has come for a serious reappraisal of the way drugs are classified under the Misuse of Drugs Act (1975)”.

The research consisted of a comparison of alcohol with a similar liquid sedative drug, gamma hydroxybutyric acid (GHB) or ‘Fantasy’, which was scheduled as a Class B1 (high risk) drug under the Act in 2001.

Under the six main criteria for classification under the law they found that the risk to public health from alcohol is at least at the level of GHB, and alcohol could be argued to be a ’somewhat more dangerous drug because of its greater inherent toxicity’. The disinhibited intoxication of alcohol also tends to be of greater duration than GHB.

The researchers point out that the negative influence of alcohol has been recognised for decades, contributing to a significant proportion of the global burden of disease. Alcohol has been linked to more than 60 medical conditions, with half the alcohol-related deaths in New Zealand attributable to chronic diseases, especially cancers. The other half are due to injuries while under the influence, especially amongst young people.

Most studies have concluded that there are no health benefits from alcohol before middle age, and the much publicised cardio-protective effect of drinking only occurs in men over 40 and women post-menopause.

“Despite this we’re not saying that alcohol should be prohibited. We simply want its dangerousness better publicised” says Professor Sellman. “What the results of our analysis can contribute is a more objective perspective on alcohol, especially in relation to other recreational drugs”.

The researchers say that this study highlights the limitations of drug classification in New Zealand and other western countries when alcohol and tobacco, the two drugs we know most about, are excluded from consideration. This is a situation which has been described in one UK report as an ‘un-evidence-based mess’.

Professor Sellman argues that including tobacco and alcohol in the evaluation of drugs and their risks to public health, would hopefully result in a more rational discussion about recreational drug use in general, leading to more effective public policy.

Source of press release

Aims: To evaluate whether rivastigmine, an achetylcholinesteraseinhibitor (AChEl), may be effective in restoring memory in Wernicke-Korsakoff’ssyndrome (WKS). Methods: Five patients treated with rivastigminefor a period of 6 months were compared with five matched controlpatients, who received 6 months’ conventional treatment, butwithout rivastigmine. Memory tests were administered at baselineand after 6 months. Results: Slight improvements were observedin both rivastigmine and control patients, but no significantdifferences in improvements were found between the study groups.Conclusion: Treatment with rivastigmine may not be effectivein restoring memory in WKS patients.

Be More Than a Blip in the Blogosphere

The Washington Post has come up with a list of Blogger tips that I can use to increase traffic and appeal of my blogs.

These tips are;

• Tell stories rather than sticking solely to links or photos.
• Create a voice for yourself.
• Make everything easy to read and access.
• Sift through blogrolls and create your own.
• Widget your page.
• Comment early and often.
• Pray for a link from the big boys.
• Nominate yourself for awards.
• Post with verve and consistency.
• Join the crowd.

Full story at the Washington Post.

Alcoholism in Australia: The wives who said time, gentlemen…

The story of Fitzroy Crossing is a tragically common one among Australia’s Aborigines: rampant binge-drinking and the appalling social problems that go with it. But then the town’s women set about turning off the taps. Kathy Marks reports

On the banks of the Fitzroy river, in the remote Kimberley region of north-west Australia, stands the century-old Crossing Inn, a squat brick building with a facade adorned with paintings by local schoolchildren.

The Crossing Inn is a local landmark. It operates the only off-licence in the town, and is the source of most of the alcohol blamed for the appalling social problems that have ravaged the largely Aboriginal town of Fitzroy Crossing: domestic violence, child abuse, disease, dysfunction, premature death and suicide.

Indigenous communities across Australia suffer from such problems, indeed a recent official report blamed “rivers of grog” for a host of interconnected social ills. But few places suffer to the same extent as Fitzroy, a “forgotten” outback town of 1,500 people that barely figures on the national radar. Despite hand-wringing by politicians and media commentators, life rarely seems to gets better in such places.

But now Fitzroy may be proving the exception, thanks to the efforts of a group of local women. They decided that drastic action was needed and lobbied the state government for a 12-month ban on all takeaway alcohol sales from the Crossing Inn.

Full story at; The Independent

Study reveals ‘huffing’ household chemicals connected to teen suicide

Girls who ‘huff’ are at higher risk of suicidal thoughts and behaviors

With suicide as the third leading cause of death among adolescents in the United States, a new University of Denver (DU) study reveals inhaling or “huffing” vapors of common household goods, such as glue or nail polish, are associated with increased suicidal thoughts and attempts.

Of the study’s participants,

• 33 percent reported having inhaled volatile solvents,
• 25 percent had attempted suicide, and
• 58 percent reported suicidal thoughts.

Stacey Freedenthal and Jeffrey M. Jenson of DU’s Graduate School of Social Work joined researchers from Chapel Hill and the University of Pittsburgh in a study of 723 incarcerated youth. “Inhalant Use and Suicidality among Incarcerated Youth” appeared in the September 2007 issue of the academic journal Drug and Alcohol Dependence. The study was the first work to categorize both levels of severity of inhalant use and gender in relation to suicidal ideas and suicide attempts.

The investigators found a significant increase in suicidal thoughts and attempts with higher use of volatile solvents.

Researchers did not determine which problem came first, the huffing or the suicidal behavior, but showed that the two are undeniably connected, even when accounting for numerous other factors.

Freedenthal warns parents to be aware of the possibility of suicidal thoughts in children who have been caught inhaling household chemicals.

“Inhalant use has many serious, physiological consequences, including death,” says Freedenthal. “Now we are learning ever more strongly that they are also linked to suicidal thoughts and behaviors.”

The study found the correlation between huffing and suicidality greater in girls than boys. More than 80 percent of girls who abused inhalants revealed a history of suicide attempts, while less than 60 percent of boys showed the same history. The study also indicated that suicidal thoughts were much higher for girls than boys. Suicidal thoughts and attempts were considered two separate issues, since thoughts do not always lead to attempts, and attempts are not always preceded by much thought.

The study involved 723 participants incarcerated by the Missouri Division of Youth Services, 629 boys and 94 girls at an average age of 15. Participants were asked if they huffed any of the 35 common household substances, such as;

• paint,
• paint thinner,
• shoe polish,
• spot remover,
• floor polish,
• kerosene,
• gasoline,
• antifreeze,
• permanent markers,
• nail polish remover,
• mothballs,
• waxes,
• lighter fluid, and others.

Harmful effects of alcohol on sexual behaviour in a New Zealand university community.

The prevalence of hazardous drinking among university students in New Zealand is very high, but the impacts on sexual behaviour are largely unknown.

The aim of this study was to estimate the prevalence of alcohol-related risky and unwanted sexual experiences.

We conducted a web-based survey of a random sample of university students, asking about specific experiences resulting from their own drinking or the drinking of others, and some beliefs about drinking.

A total of 1564 students responded (82%) and the following were reported as the result of drinking, by women and men, in the last 3 months:

• unprotected sex, women 11% and men 15%;
• sex they were not happy with at the time, women 6% and men 7%;
• sex later regretted, women 16% and men 19%.
• Also, 34% of women and 25% of men reported unwanted sexual advances in the past 4 weeks as a result of other people’s drinking.

These experiences were all associated positively with Alcohol Use Disorders Identification Test (AUDIT) scores of the respondents, certain types of living arrangements and specific attitudes to drinking.

In addition, 1% of women and 0.5% of men reported sexual assault in the past 4 weeks.

Cashell-Smith ML, Connor JL, Kypri K. Harmful effects of alcohol on sexual behaviour in a New Zealand university community. Drug Alcohol Rev 2007; 26(6): 645-51.

Drug and alcohol nurses are to be stationed at two of New Zealand’s busiest police stations by January in a bid to help addicts before their offending reaches the point where they have to be jailed [New Zealand Herald]

Aim: To compare the effects in alcohol-dependent patients ofthree pharmacotherapies, disulfiram (DIS), naltrexone (NTX),and acamprosate (ACA), when used with a brief manual-based cognitive-behaviouralintervention. Method: We conducted a randomized, open label,multicentre naturalistic study in two phases; first, a 12-weekcontinuously supervised medication, followed by targeted medication(TM) up to 52 weeks in addition to a 67-week follow-up period;altogether 119 weeks (2.5 years), in 243 voluntary treatment-seekingalcohol-dependent adult outpatients. Subjects were randomized1:1:1 to receive supervised NTX, ACA or DIS, 50, 1998, or 200mg, respectively, per day, plus a brief manual-based cognitive-behaviouralintervention. The patients were met in the second and sixthweeks, and then after 3, 6, and 12 months. The primary outcomemeasures were the time (days) to first heavy drinking day (HDD),and time during the first 3 months to the first drinking dayafter medication started. Secondary variables were abstinentdays/week (0 drinks/day), average weekly alcohol intake, AlcoholUse Disorder Identification Test (AUDIT), Severity of AlcoholDependence Data (SADD), and quality of life (QL) measures. Results:All three study groups showed marked reduction in drinking,from baseline to the end of the study. During the continuousmedication phase, treatment with DIS was more effective in reducingHDDs and average weekly alcohol consumption, and increasingtime to the first drink, as well as the number of abstinentdays. During the TM period, there were no significant differencesbetween the groups in time to first HDD and days to first drinking,but the abstinence days were significantly more frequent inthe DIS group than ACA and NTX. There were no differences betweenthe NTX and ACA groups in either phase of the study of drinkingoutcomes. However, SADD scores improved more in the NTX groupthan the ACA group. Conclusions: Patients allocated to ACA,NTX and DIS combined with brief manual-based cognitive behaviouralintervention significantly reduce their alcohol consumptionand report improved QL. Supervised DIS appeared superior, especiallyduring the continuous medication period, to NTX and ACA.

Alcohol is no ordinary commodity. It is a legal drug which brings health, personal, cultural and social benefits for many people around the world – yet causes significant mental, physical and social harms for many others. To effectively tackle this dilemma, the alcohol field in general needs to generate and embrace new ideas and more practical approaches.

Alcohol harm reduction can be broadly defined as measures that aim to reduce the negative consequences of drinking.

A comprehensive alcohol policy needs population-level interventions, which focus on the availability and accessibility of alcohol (such as taxation and restricted licensing hours). But it needs more than this - such measures alone will not reduce alcohol related harms. In the last 20 years there has also developed an increasing (but less promoted) interest in alcohol harm reduction interventions. These tend to focus on particular risk behaviours (such as drinking and driving, binge drinking), particular risk groups (such as pregnant women, young people) and particular drinking contexts (such as bars and clubs). These approaches have broadened the sphere of interest in alcohol related harms to include social nuisance and public order problems. Very often (but not exclusively) such interventions operate at the community level.

Examples of this approach in practice are:

• Campaigns against drinking and driving (including designated driver schemes and improved public transport in the evenings)
• Serving alcohol in shatter-proof glass to prevent injuries
• Training bar staff to serve alcohol responsibly
• Promoting the safer design of drinking environments (such as bars)
• Managing the ‘night-time economy’ and the ‘drinking environment’ in order to maximise pleasure and minimise violence and anti-social behaviour
• Brief interventions advising people on moderate or controlled drinking
• Education in schools and universities advising people on moderate or controlled drinking
• Providing shelters for homeless drinkers (known as ‘Wet Centres’)
• Providing shelters for heavily intoxicated individuals (known as ‘Sobering-Up Centres’)
• They do not exclude abstinence based programs.

The benefits of alcohol harm reduction approaches are as follows:

• They are practical approaches (so much so that many people deliver alcohol harm reduction on a regular basis without realising it)
• They are realistic approaches in that they (often) do not rely upon national consensus, funding, policies or legislation
• They can be designed and delivered by local communities and stakeholders to address specific local needs and contexts
• Their short-term aim is to minimise the impacts of drinking alcohol
• Their longer-term aim is to change drinking cultures – encouraging the benefits of responsible drinking and discouraging harmful drinking

http://www.ihra.net/alcohol

The International Harm Reduction Association (IHRA)

New report highlights impact of heavy cannabis use on vulnerable young people

Heavy cannabis use among vulnerable young people can exacerbate existing social problems, such as low educational achievement, homelessness and unemployment, according to a new report for the Joseph Rowntree Foundation (JRF) from the University of Bedfordshire. However, for others, particularly those in higher or further education, the effects appear to be relatively benign.

The impact of heavy cannabis use on young people, drew on 100 interviews with 16 to 25 year-olds selected because they had been using cannabis on a daily basis for the past six months. Most were smoking ’skunk’.

When asked about the positive and negative consequences of taking the drug, the young people initially only listed what they felt to be positive: relaxation, socialising, and the feeling of being ’stoned’.

It was only when various aspects of their lives were probed in more detail that associations between their use and problems such as unemployment, educational under-achievement and homelessness became apparent – particularly for those with less structured lives. Moreover, those with the greatest number of social problems tended to use most heavily.

The report also found that some of the 30 professionals working with young people (such as youth workers and hostel workers) interviewed as part of this research saw cannabis as less harmful than the young people in the study did. This may be because of their differing experiences of cannabis use in previous decades, when high-strength herbal cannabis was less widely available. However, it raises questions about professionals’ awareness of the potentially compounding effect of heavy cannabis use on the problems experienced by vulnerable or excluded young people – particularly if young people are unlikely to identify these problems themselves.

The report’s author, Dr Margaret Melrose, said, “Young people may not be aware of the extent to which cannabis use might exacerbate their existing social problems, and professionals who have had experience of cannabis users in the past may assume the effects are relatively harmless if they take young people’s assessment of the impact of cannabis use in their lives at face value. More probing may be required in order to explore the level and nature of cannabis use and how this may be adding to a young person’s problems.”