Week 5 Reading: If alcohol were discovered today, would it be legal? Flashcards
What’s the psychoactive part of alcohol
= Methylcarbonol – the psychoactive part of alcohol
*
Recent harms of alcohol
- The harms caused by alcohol over the last 50years in the UK is comparable to the Gin Craze in the early 18th century – when the urban poor of London were consuming a pint of gin a day per head on average
o 40% of domestic violence cases involve alcohol and 50% of child protection cases
o 40,000 alcohol related deaths annually being reported, cinluding 350 from acute alcohol poisoning, 8,000 from cirrhosis of the liver
o I think this is just in the UK
the European Centre for Monitoring Alcohol Marketing recently publishing a report called The Seven Key Messages of the Alcohol Industry which gave the following 7 points to contradict the idea that alcohol is harmful
- Consuming alcohol is normal common healthy and very responsible
- The damage done by alcohol is caused by a small group of deviants who cannot handle alcohol
- Normal adult non-drinkers do not, in fact, exist
- Ignore the fact that alcohol is harmful and addictive chemical substance (ethanol) for the body
- Alcohol problems can be solved when all parties work together
- Alcohol marketing is not harmful. It is simply intended to assist the consumer in selecting a certain product of brain
- Education about responsible use is the best method to protect society from alcohol problems
What was the intention with these 7 principles being published?
- The intention of these policies is to misdirect policymakers away from measures that will actually reduce harm to continue an industry with big profits.
1a. Consuming alcohol is normal
Most societies through history have drunk and we’ve done this for so long many of us are genetically adapted to consume alcohol
When ethanol breaks down in the body It produces acetaldehyde, a toxic substance which needs to be oxidised to avoid dangerous effect. People from groups like native americans or inuit and many Chinese don’t have the ALDH2 enzyme to break this down – making them allergic to alcohol causing facial flushing, nausea headaches and general discomfort
* Whereas euopeans, African and south americans have a more active version of this enzyme, suffer less alcohol addiction and liver disease
In the history of drinking people have often consumed, low strength wine and beer with ritual religion etc. However, now we drink in a completely different way
* Eg. the Gin Graze in britian in the 18th century. Or huge rates of alcoholism on Native American reserves in the US.
The binge drinking we see today as a result of cheap and strong alcohol is something our ancestors couldn’t have indulged in even if they wanted to
1b. Consuming alcohol is healthy
Alcohol has some positive psychological effects
* Calms people with anxiety disorders
o Although with heavy use the effects of withdrawal will worsen the anxiety
Alcohol’s physiological benefits have never been proven
* The idea that drinking at low levels is protective is a myth
* Men who drink low levels of alcohol (like red wine) have slightly lower levels of heart disease than someone who is sober – however, this may be due to healthy lifestyle factors or the sick teetotaller effect – where many people give up alcohol because they’re ill – therefore the health outcome has nothing to do with alcohol
Alcohol is a toxin that kill cells and organisms – therefore it is toxic
Moreso, is the toxicity of acetaldehyde
1c Consuming alcohol is responsible
Alcohol is a depressant (similar to GHB, Benzodiazapines and Valium) which if taken at high enough doses will cause amnesia, sedation and eventually dealth. It stimulates GABA receptors in the brain, reducing anxiety, motor coordination and blocks specific glutamate receptors to switch off the parts of your brain keeping you alert and awake – switchin on the parts that make you drowsy and tired
* Alcohol also indirectly stimulates the noradrenaline circuit producing stimulating effects. This is what creates the noisy energy we associate with drunkenness
* The overall effects of GABA and noradrenaline increases in the brain are disinhibition, decreased concern for social codes and standard of behavour, an increase in risk taking and disregard for long-term consequences.
- The damage done by alcohol is caused by a small group of deviants who cannot handle alcohol
Millions of people suffer harm from alcohol consumption
Alcohol dependence is on the rise with the attendant social damage and ruined lives and binge drinking killing hundreds of people a year as well as causing cirrhosis in patients as young as their early 20s.
But often these harms (cancer and stomach problems) are seen in the everyday drinker – rather than people who drink on the rare occasion
This daily drinking has become possible as booze is a third of the cost it was in the 1950s
- Normal adult non-drinkers do not, in fact, exist
There’s many resons not to drink eg.
* Religion
* Alcoholism – recovery via sobriety
* Experience – family experience with alcoholism
* Health choices
* Althetes choices
Non-drinkers are often heavily pressures to drink to fit in with others – reinforced via the press, TV, Alcohol advertising etc
- Ignore the fact that alcohol is a harmful substance for the body
There is no other drug as damaging as alcohol to so many different organ systems in the body
Effect of alcohol on the heart
- Increases risk of irregular heartbeat, heart attacks and heart failure
Effect of alcohol on the head
alcohol; head
* increases risk of heat injury from accident or fight
* Increases risk of brain damage from repeated withdrawal
* Increased risk of stroke
* Increased risk of cognitive decline
Effect of alcohol on the liver
- Increase risk of hepatitis, fatty liver, cirrhosis, cancer
Effect of alcohol on the liver
- Increased risk of pancreatitus
Effect of lacohol on the repro system
- Foetal alcohol syndrome
- Increase risk of miscarriage
- Decreased fertility
Effect of alcohol on the body
- Increased wasting of limb muscles and nerve death (neuropathy)
4b. Ignore the fact that alcohol is addictive
Alcohol is not the most addictive drug but it’s availability and social acceptability makes becoming dependent more likely
This also increases the risk of relapse
About a quarter of the adult population in the UK drink more than recommended; 6% in men and 2% of women are harmful drinkers where damage to health is likely and levels are higher in Scotland
Alcohol withdrawal is characterised by tremors, nausea, extreme irritability and sometimes fits/delirium and it can be life threatening
5Alcohol problems can be solved when all parties work together
The harms of alcohol can’t be reduced unless we reduce the number of people drinking or the amount being consumed – which is against what the alcohol industry wants
The drinks industry relies on hazardous drinking for it’s income. If everyone who drinks more than recommended, went back to drinking moderately there’d be a 40% drop in alcohol consumption overall
In practise, what the industry means by working together – is bringing in voluntary codes rather than statuory regulation – solving problems through rules that the industry chooses to comply with rather than laws they must abide by
However, evidence shows voluntary codes are pretty ineffective in reucing alcohol harms as they tend to focus on the wrong sorts of interventions
6 o Alcohol marketing is not harmful. It is simply intended to assist the consumer in selecting a certain product of brain
Whilst the important factors determining consumption are price and availability, marketing does have a demonstratable impact on levels of drinking, not just the brands people choose to drink
The BMA (British Medical Association) published many of the techniques in the drinks industry used to target a younger audience including email campaigns, embedded film clips, facebook links etc
There’s a lot of evidence that more common and acceptable consuming alcohol is seen to be the more people with drink – which is influential particularly for young people.
- Education about responsible use is the best method to protect society from alcohol problems
It is useful for the drinks industry to emphasise the value of education, because it takes the focus off regulation, if how much a person drinks is just their individual choice, then there’s no need to control how much alcohol they have access to
However, WHO showed that merely providing info and education without bringing in other policy measures, doesn’t change drinking behaviour – at best they’re a waste of money. At worst, these programmes are funded by the industry and can reinforce heavy drinking
Informing people about the harms of drugs likela cohol is important but it isn’t the be all and end all – we need other measures too
o How can we reduce the harm done by alcohol?
Prohibition (eg. in the US from 1920 to 1933) has been shown to be not great as the bootleg alcohol market lead to lack of regulation and a lot of alcohol related death.
Other options include
* Increase the price
* Restrict availability
* Make alcohol a national health priority
* Make alcohol dependence a priority for the national treatment agency
* Stop people binge drinking
* Save lives on the road
* Provide alternatives
o Increase the price
In the 50s alcohol was three times the price than it is now.
Alcohol price determine use for nearly everyone – with the exception of severely dependant drinkers
This is already used when pricing say super strength ciders etc
Another option is to remove happy hours and subsidised for bars etc
This could lead to a higher level of alcohol smuggling – but effective border control could be effective against this
o Restrict availability
The availability of a drug has a strong relationship with the number of people who become addicted to it
Changing the opening hours of liquor stores so it’s not 24 hours etc could be helpful in this
Removing alcohol over a certain percentage from supermarkets – so it’s only in liquor stores could help
o Make alcohol a national health priority
We know that public health campaigns really do work – eg. against smoking
These capmagins could help make drinking alcohol unfashionable
Education should degin in primary school
Educating teenagers on the harms of alcohol is largely ineffective but what can be effective is teaching them about the shady acts of the alcohol industry
o Make alcohol dependence a priority for the national treatment agency
There’s a number of promising lines of research into pharmacological substitutes and therapies for alcohol which work well with psychological treatments like CBT, and AA
The pleasant effects of alcohol are caused by the release of natural opoids – substances lik acamprosate and naltrexone block these making drinking less pleasurable and could help with treatment
Some research has found that building up tolerance results in an increase to GHB; where an alcholic might be able to take three times as mucha s a non-aclohol without overdosing – although the mechanism is unclear. Therefore GHB could be a safer alternative for those severely dependant on alcohol and they’re less likely to kill themselves. But for people who aren’t tolerant like this, would face huge negative effects from GHP – so not recommendended especially taken alongside alcohol
GHB is used in Italy and Austria to treat alcoholism – the potential as an alcohol treatment of another drug, baclofen that acts on GABA receptors has alco been discussed
o Stop binge drinking
We need cultural change
It’s hard to do this with regulation
Could help by banning known to be toxic drinking events – eg. uni type events
There are other simple steps like wine should be sold in smaller glasses – this is especially important for women who drink wine womens higher body fat percentage means they experience about twice the effect per unit of alcohol compared to men
o Save lives on the road
Decrease the driving limit
Worsen punishments when people are caught drink driving
Raise the drinking age etc
o Provide alternatives
Make sure liquor stores are selling non-alcoholic drinks too
Non-alcoholic drinks should be cheaper
Another route is looking at less dangerous alternatives like benzodiazapines – so you get a buss without getting pizzed. It could also come with a sober pill for at the end of the night to reverse the effects of the drug