Week 5 Reading: If alcohol were discovered today, would it be legal?

Question 1

What’s the psychoactive part of alcohol

Answer 1

= Methylcarbonol – the psychoactive part of alcohol
*

Question 2

Recent harms of alcohol

Answer 2

• 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

Question 3

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

Answer 3

1. Consuming alcohol is normal common healthy and very responsible
2. The damage done by alcohol is caused by a small group of deviants who cannot handle alcohol
3. Normal adult non-drinkers do not, in fact, exist
4. Ignore the fact that alcohol is harmful and addictive chemical substance (ethanol) for the body
5. Alcohol problems can be solved when all parties work together
6. Alcohol marketing is not harmful. It is simply intended to assist the consumer in selecting a certain product of brain
7. Education about responsible use is the best method to protect society from alcohol problems

Question 4

What was the intention with these 7 principles being published?

Answer 4

• The intention of these policies is to misdirect policymakers away from measures that will actually reduce harm to continue an industry with big profits.

Question 5

1a. Consuming alcohol is normal

Answer 5

 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

Question 6

1b. Consuming alcohol is healthy

Answer 6

 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

Question 7

1c Consuming alcohol is responsible

Answer 7

 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.

Question 8

2. The damage done by alcohol is caused by a small group of deviants who cannot handle alcohol

Answer 8

 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

Question 9

3. Normal adult non-drinkers do not, in fact, exist

Answer 9

 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

Question 10

4. Ignore the fact that alcohol is a harmful substance for the body

Answer 10

 There is no other drug as damaging as alcohol to so many different organ systems in the body

Question 11

Effect of alcohol on the heart

Answer 11

• Increases risk of irregular heartbeat, heart attacks and heart failure

Question 12

Effect of alcohol on the head

Answer 12

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

Question 13

Effect of alcohol on the liver

Answer 13

• Increase risk of hepatitis, fatty liver, cirrhosis, cancer

Question 14

Effect of alcohol on the liver

Answer 14

• Increased risk of pancreatitus

Question 15

Effect of lacohol on the repro system

Answer 15

• Foetal alcohol syndrome
• Increase risk of miscarriage
• Decreased fertility

Question 16

Effect of alcohol on the body

Answer 16

• Increased wasting of limb muscles and nerve death (neuropathy)

Question 17

4b. Ignore the fact that alcohol is addictive

Answer 17

 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

Question 18

5Alcohol problems can be solved when all parties work together

Answer 18

 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

Question 19

6 o Alcohol marketing is not harmful. It is simply intended to assist the consumer in selecting a certain product of brain

Answer 19

 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.

Question 20

7. Education about responsible use is the best method to protect society from alcohol problems

Answer 20

 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

Question 21

o How can we reduce the harm done by alcohol?

Answer 21

 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

Question 22

o Increase the price

Answer 22

 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

Question 23

o Restrict availability

Answer 23

 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

Question 24

o Make alcohol a national health priority

Answer 24

 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

Question 25

o Make alcohol dependence a priority for the national treatment agency

Answer 25

 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

Question 26

o Stop binge drinking

Answer 26

 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

Question 27

o Save lives on the road

Answer 27

 Decrease the driving limit
 Worsen punishments when people are caught drink driving
 Raise the drinking age etc

Question 28

o Provide alternatives

Answer 28

 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