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Welcome to SHAAP’s (Scottish Health Action on Alcohol Problems) weekly media monitoring service.

19 May 2016

#MUPsaveslives

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This briefing aims to provide a ‘snap shot’ of latest news on alcohol and health policy. The inclusion of an article in the briefing should not imply that SHAAP approves or condones the content.

SHAAP provides a coordinated, coherent and authoritative medical and clinical voice on the need to reduce the impact of alcohol related harm on the health and wellbeing of the people in Scotland. SHAAP was set up by the Scottish Medical Royal Colleges, through their Scottish Intercollegiate Group (SIGA) and is governed by an Executive Committee made up of members of the Royal Colleges.

Half of middle-aged British men classed as problem drinkers: Average 45 to 65-year-old downs two and a half times the recommended alcohol limit each week

Nearly half of middle-aged British men are problem drinkers, downing an average 16 pints of beer a week, experts warned yesterday.

These 44 per cent of men aged 45 to 65 are risking their health by drinking more than the recommended limit of 14 units a week – about six pints of beer.

Their average consumption of 16 pints is 37 units a week – more than two and a half times the recommended limit.

However, one in ten men, about 800,000, drink at least 50 units – equal to 21 pints.

Overall, 3.5million middle-aged men are regularly drinking too much, according to a report today by the charity Drinkaware.

Hospital admissions linked to drinking are highest among middle-aged men – more than double the under-40s’ figures.

Doctors say men who drink heavily are a health time bomb, facing an increased risk of cancer, obesity, diabetes and dementia, and likely to cost the NHS millions of pounds.

Yet polling reveals that 53 per cent of men do not believe the advice, and say drinking above the cap will not harm their health.

The report shows that of all middle-aged adults, men drink on average 20 units a week, while women drink ten units a week.

One unit is equal to half a pint of 3.6 per cent beer or cider, half a 175ml glass of 12 per cent wine, or a single 25ml glass of 40 per cent spirits such as whisky.

It suggests middle-aged men are Britain’s most problematic drinkers, while younger people are drinking less – although they tend to binge at weekends rather than drink every day. 

The report states: ‘Just under half of 18 to 24-year-olds say they drink at least once a week (48 per cent), this rises to 55 per cent of 25 to 45-year-olds and further still to 60 per cent of 45 to 65-year-olds. 

Wider research shows drinking patterns in the UK are changing slowly, driven by younger age groups drinking less frequently and by an increasing proportion of abstainers in the youngest groups.’ Wealthier, middle-class men and women are drinking more than the poor, the researchers found.

According to the report, based on polling by Ipsos MORI, alcohol is often an emotional ‘crutch’ for middle-aged men, with half drinking at least some of the time to cheer themselves up.

Men within this group are also affected by peer pressure, with 45 per cent admitting they drink to fit in with a group or to be liked.

Elaine Hindal, of Drinkaware, said: ‘For a large number of middle-aged men, drinking is part of their daily routine and often goes unnoticed. As there are often no immediate negative consequences, they are unaware how their drinking may be impacting on their health.

‘Reducing alcohol consumption by just a few drinks each week can make a big difference to their long-term health. This includes reducing blood pressure, improving mental health, losing weight and increasing energy levels.’

Official alcohol guidelines were overhauled in January in the biggest shake-up for 30 years. Limits for men were cut from 21 units to 14 units a week, bringing them in line with those for women.

Some 10 per cent of men drink 14 to 21 units a week, meaning they were drinking safe levels last year but are now drinking too much.

Jackie Ballard, of Alcohol Concern, said drinking continued to be a ‘leading risk factor’ in death statistics, adding: ‘To ensure people make an informed choice about how much they drink, we are calling for mandatory health warnings on alcohol products.’

Source: Daily Mail, 13th May

 

Dads who drink too much alcohol 'risk having children with smaller brains'

Dads who drink too much alcohol risk having lighter children with smaller brains and impaired mental skills - according to scientists.

Researchers claim to have found a link between fathers' ages and lifestyles which can lead to lifelong physical and mental problems in children.

Researchers conducted a review of so-called epigenetic environmental effects that alter the activity of genes passed on by men.

They found a host of examples where a father's age, lifestyle and experience can lead to problems in his children.

Dads who are older when conceiving, for instance, were linked with raised rates of schizophrenia, autism and birth defects.

Paternal obesity was linked to enlarged fat cells, metabolic changes, diabetes and a propensity to put on weight, and an increased risk of brain cancer.

Fathers affected by stress passed on a susceptibility to defective behavioural traits.

US senior investigator Dr Joanna Kitlinska, from Georgetown University Medical Centre in Washington DC, said: "We know the nutritional, hormonal and psychological environment provided by the mother permanently alters organ structure, cellular response and gene expression in her offspring.

"But our study shows the same thing to be true with fathers. His lifestyle, and how old he is, can be reflected in molecules that control gene function.

"In this way, a father can affect not only his immediate offspring, but future generations as well."

She pointed out that newborn babies can be diagnosed with foetal alcohol spectrum disorder (FASD) - a wide range of problems normally associated with drinking during pregnancy - even though their mothers had never touched alcohol.

Dr Kitlinska said: "Up to 75 per cent of children with FASD have biological fathers who are alcoholics, suggesting that pre-conceptual paternal alcohol consumption negatively impacts their offspring."

Epigenetic effects alter DNA activity without rewriting the genetic code. In many cases, genes are "silenced" by subtle molecular changes to DNA components.

There is increasing evidence that such effects can be passed from one generation to another.

The new research, published in the American Journal of Stem Cells, found one advantageous result linked to a father's diet.

A Swedish study found that men whose food intake during their own childhood was restricted had children and grandchildren with a reduced risk of dying from heart disease.

Dr Kitlinska said: "This new field of inherited paternal epigenetics needs to be organised into clinically applicable recommendations and lifestyle alterations.

"And to really understand the epigenetic influences of a child, we need to study the interplay between maternal and paternal effects, as opposed to considering each in isolation."

Source: Daily Mirror, 16th May

 

Hospital is first in country to screen pregnant women for birth defects brought on by drinking alcohol

A hospital has become the first in the country to screen mums-to-be for birth defects brought on by alcohol consumption.

Tameside Hospital is leading the way in pioneering a new approach to highlight the dangers of drinking in pregnancy to unborn babies.

Alcohol consumed by mums-to-be is the nation’s leading preventable cause of birth defects, with an estimated one in 100 babies born with alcohol-related damage according to the World Health Organisation.

Now, Tameside’s HALS (Hospital Alcohol Liaison Service) and the maternity unit have developed a new programme to track the drinking habits of mums-to-be, which includes the use of hard-hitting ‘demonstration dolls’ which show the effects of drink on babies in the womb.

As well as being able to send out a clear ‘no alcohol equals no risk’ message from the beginning of a woman’s pregnancy, the new pathway aims to cut preventable birth defects by recording a woman’s drinking in the child’s medical notes - aiding any future diagnosis.

Staff will use the demonstration dolls, showing the malformation in facial development that can occur during early pregnancy, as a training resource.

Features include small eye openings, a smooth wide philtrum (the vertical groove between the base of the nose and the border of the upper lip) and a thin upper lip.

Kerry Lyons, who heads up the HALS team, said: “When a pregnant woman drinks alcohol, so does her developing baby. Any amount of alcohol, even in one glass of wine, passes through the placenta from the mother to the growing baby.

“Developing babies lack the ability to process, or metabolise alcohol through the liver or other organs. They absorb all of the alcohol and have the same blood alcohol concentration as the mother. It makes no difference if the alcoholic drink consumed is a distilled spirit or beer, or wine.”

Kerry said part of the programme is to dispel myths surrounding drinking in pregnancy, such as the common held view that Guinness gives you iron - when in reality a woman would need 148 pints of the beverage to get her daily requirement.

She added: “Alcohol is toxic to a developing baby and can interfere with healthy development causing brain damage and other birth defects.

“Most babies negatively affected by alcohol exposure have no physical birth defects. These children have subtle behavioural and learning problems that are often not diagnosed at all or misdiagnosed as autism or attention deficit disorder instead of one of the Foetal Alcohol Spectrum Disorders.”

There are no specific figures to show the number of babies affected by FASD in Greater Manchester, but those behind the programme say it’s likely to be higher than the national percentage.

“We suspect in Greater Manchester it’s far greater. The number of people within the adult population drinking harmful levels is significant and that will be transferable to the maternal population.

“This does rely on women being honest with us but it’s about them deserving the right information at the right time and I’m not sure that’s always been the case.”

Monthly education programmes will be available within the hospital and the community midwifery team will be performing the screening and giving advice

Karen James, Tameside Hospital’s chief executive believes the initiative will influence public health messages on drinking while pregnant and mirror the approach taken on smoking in pregnancy.

She said: “Drinking during pregnancy causes more harm to the unborn child than tobacco smoke according to many senior doctors.

“The release of this pathway is the culmination of nearly 18 months of hard work by this talented team.

“It ensures that there will be a seamless approach to both the identification of alcohol consumption in pregnancy and subsequent education offered to pregnant women around preventing developmental disability associated with low-level alcohol consumption."

Mags Deakin, specialist midwife at Tameside, added: “Tameside is an area with higher than average hospital admissions though alcohol harm so we know that this is an area of high risk.

“Our maternity unit has around 2,800 births per year as well as providing antenatal and postnatal support for women who reside in this area but may have their babies in other units but will still receive support via our pathway.”

 

Source: Manchester Evening News, 12th May

 

Teen drinking: Researchers find genes linked to impulsivity and alcohol abuse in adolescents

Most of us are guilty of having snuck a beer or two in our best friend’s basement during high school. But some teens take this to the limit and engage in extremely risky behaviour like binge drinking and illicit drug use. Although certain environmental factors, such as where children live and what kind of household they grow up in, can have an affect on their likeliness to act out, a new study may have also identified a genetic aspect of impulsivity.

For the study, now published online in the open-access journal Frontiers in Genetics, researchers from the University of Sussex in England used mice to link impulsive behavior to certain genes. Under controlled conditions, the mice were assessed for their ability to wait to obtain a reward, and then scored on their scale of “impulsivity.” The team then correlated the impulsive rating into a mouse genomic database to find specific genes responsible for the behaviour.

After identifying the mouse gene linked to impulsivity, the researchers looked for the human equivalent of the mouse gene. Then, they observed 423 teenagers (average age 14) who had this human impulsivity gene. The teens were asked to answer a questionnaire on their drinking and drug use habits during the previous month. Just as the mice, the teen participants were also evaluated for their ability to wait to obtain a reward and underwent an fMRI while these tests were conducted.

Results from both the mouse and human studies showed one gene, KALRN, to be associated with impulsivity and the tendency to binge drink in adolescence. This gene contains a protein called kalirin, which is essential for the development of the nervous systems, especially the formation of nerves associated with impulsivity related disorders such as ADHD. Although past research has found a genetic component to substance abuse, this is the first to find a gene responsible for impulsive behaviour.

“Our findings are important because we show that certain variations in the KALRN gene are associated both with alcohol binge drinking and with brain activation during impulsive responding in adolescents," said lead researcher Dr. Yolanda Peña-Oliver in a recent statement.

According to Peña-Oliver, these results will hopefully provide insight into discovering biomarkers for impulsivity and alcohol abuse. This could be used to predict which individuals may be most vulnerable to conditions such as ADHD and drug addiction, and could serve as a pathway for early intervention.

A 2015 study published in the journal Neurobiology of Diseases found that binge drinking is especially worrisome in teens because it can not only lead to brain changes but also increases the likelihood teens will develop substance abuse problems as an adult. Seeing as a recent Centers for Disease Control and Prevention report found that 21 percent of high school students admitted to binge drinking, a way to identify those most at risk could have important implication.

Source: Medical Daily, 13th May
 

 

Teenage poisonings rise amid surge in girls' alcohol cases

Alcohol poisoning amoung girls is contributing to a rise in teenage toxic incidents, research suggests.

Experts analysed GP records and found a 27% rise in such cases - including accidental, deliberate self-harming and alcohol poisoning - between 1992 and 2012.

There were 17,862 cases of poisoning among UK teenagers between 1992 and 2012, the data, published in the journal Injury Prevention, showed.

Looking at the number of poisonings occurring in 100,000 young people year terms, experts found a rise from 264.1 new cases per 100,000 person years to 346.8 per 100,000.

The largest increases were for intentional poisonings among 16- to 17-year-old-girls and for alcohol-related poisonings among 15- to 16-year-old girls, both of which roughly doubled.

Between 2007 and 2012 almost two-thirds (64%) of poisonings were recorded as intentional, and 16% were related to alcohol.

Girls were significantly more likely to suffer from poisoning, the study found, with the rate of poisoning in boys and young men less than half of that in girls and young women. Intentional poisonings were 80% lower in boys and young men than girls.

And alcohol-related poisonings were 10% lower in boys and young men.

The research, from the University of Nottingham, also found that youngsters living in the most economically deprived regions were two to three times more likely to poison themselves than those in the least deprived.

Poisoning is one of the most common causes of death among teenagers worldwide, with much of it related to self-harm.

The authors said: "One potential explanation for the increase in alcohol poisonings over time is increased availability, with the relative affordability of alcohol in the UK increasing steadily between 1980 and 2012, licensing hours having increased since 2003, and numbers of outlets increasing alongside alcohol harm."

But they urged caution over the interpretation of their findings too, adding: "We must consider whether this (the increasing rates seen among young women) reflects real changes, increased health-seeking behaviour or changes in GP coding practices, or popular trends, such as clinicians perceiving intentional poisonings as more frequent and therefore recording events as such."

A second study published in the Archives of Disease in Childhood found that more than half of UK toddler deaths from unintentional drug poisoning are due to methadone.

Experts looked at data on childhood poisonings and admissions to intensive care for unintentional poisoning between 2001 and 2013.

During this period, 28 children under the age of four died in England and Wales as a result of unintentional poisoning with a prescribed drug. Methadone, which is used by heroin addicts to help kick their drug habit, was responsible in 57% of these cases.

Between 2002 and 2012, 201 toddlers were admitted to intensive care as a result of unintentional poisoning with prescribed drugs.

Sedatives accounted for nearly one in five (19% or 22 cases), while methadone accounted for 17% or 20 cases.

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Source: Belfast Telegraph, 17th May
 

The end of fake ID? Major retailers adopt electronic age-checks to stop kids buying booze

The days of using fake ID to buy alcohol and cigarettes are coming to an end as Britain's biggest retailers are adopting new technology which checks people's age in real-time.

A national "electronic token" system could eliminate the need for adults to carry passports and driving licenses to prove their age within a year, as retailers will instead verify it with their bank or a credit agency when they pay.

According to Trust Elevate, the firm that designed the system, it will be rolled out online and at self-service check-outs first but could also become commonplace in pubs and clubs, meaning bar staff would no longer have to ask customers to present physical ID.  

Today supermarkets including Sainsbury's, Waitrose and Morrison's are meeting to discuss the move at a conference hosted by the British Retail Consortium, a trade body which represents large shops.

The move will also address the Government's concerns over minors buying age restricted items - including knives - through online shopping websites, where the only form of age verification is often just a simple tick-box.

David Wilson, head of public affairs at the British Beer and Pub Association, said: "Anything that makes age verification at point of sale easier will help retailers to be responsible when selling alcohol. We are not very keen on the idea of young people taking their passports out with them, and this could help eradicate the need for them to do so."

But Alan Miller, chairman at the Nightlife association, which represents nightclubs and bars, predicted the technology would fail to stop teenagers drinking. "As soon as something new comes out, people find a way of getting around it," he said. 

Graham Wynn, assistant director for consumer competition and regulatory affairs at the British Retail Consortium, said: “Retailers have long recognised the need for age verification online, and the British Retail Consortium is happy to work with Trust Elevate to ensure the success of this initiative that will explore how best to meet retailers need for friction-less and affordable age-related eligibility checks when customers wish to purchase age-restricted products.”

Source: Telegraph, 16th May
 

Study explains links between heavy alcohol use and suicides during economic downturns

While economic downturns have been linked previously to increased suicide risk in the United States, new research from the UCLA Luskin School of Public Affairs sheds light on the role alcohol use may play in the complex relationship between economic conditions and suicide.

UCLA Social Welfare professor Mark Kaplan is lead author and principal investigator of a new study funded by the National Institutes of Health (NIH) and released online today. The report, "Heavy Alcohol Use Among Suicide Decedents Relative to a Nonsuicide Comparison Group: Gender Specific Effects of Economic Contraction," will be published in the July issue of the journal Alcoholism: Clinical and Experimental Research.

In conducting the study, specifically on the contribution of alcohol to suicide during the 2008-09 recession period, Kaplan and colleagues used data from the U.S. National Violent Death Reporting System from 16 participating states and supplemented with data from the Behaviour Risk Factors Surveillance System for the same states, which was used as the nonsuicide comparison group. Blood-alcohol levels in suicide decedents were compared to heavy alcohol use in the nonsuicide comparison group in the years 2005-07 (before), 2008-09 (during), and 2010-11 (after the recession).

Kaplan and colleagues noted that, in general, economic recessions have been associated with declines in overall alcohol consumption but at the same time with increases in heavy alcohol use, particularly among those directly affected by the contraction. In their current work, Kaplan and colleagues showed that the percentages of suicide decedents who were intoxicated at the time of death increased during the recent economic recession. What is unknown is whether this change in alcohol use prior to suicide mirrored patterns of heavy drinking in the general population. 

In this new study, Kaplan's findings show that, for men, alcohol involvement increased among decedents beyond what was observed in the general population, emphasizing the "heightened importance" of acute alcohol use as a risk factor for suicide among men during times of severe economic hardship. "Surprisingly, there is evidence that individuals intoxicated at the time of death did not necessarily have a history of alcohol abuse prior to suicide," said Kaplan.

But similar results were not found for women who died by suicide. Kaplan suggests women may show resilience to the interaction of alcohol and financial crises, reporting that heavy alcohol use by women mirrored consumption in the general population.

He further explains how creative control policies have been shown to reduce the risk. Among those policies, Kaplan cites research on pricing strategies, including raising taxes and pricing beverages according to alcohol content. Also, easy access to alcohol—longer hours for alcohol sale or high density of alcohol outlets—may create more opportunity for impulse buying and thus contribute to suicide during economic downturns, Kaplan concluded.

And, citing recent research, Kaplan explains, "Not only are alcohol control policies important, but equally so is investing in the public health and social welfare infrastructure to minimize the adverse effects of future economic downturns, such as high unemployment and associated material deprivation."

Source: Medical Express, 18th May
 

Buckfast Day celebrations 'bizarre' says former MSP who led failed alcohol crackdown

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A FORMER MSP whose rejected alcohol bill would have cracked down on caffeinated alcoholic beverages said it was "bizarre" to celebrate a Buckfast Day.

Dr Richard Simpson, a former GP and psychiatrist who stood down as Labour MSP for Mid-Scotland and Fife at the end of the last parliament, hit out at plans to celebrate the cult tonic wine with a second 'National Buckfast Day' tomorrow [sat].

Dr Simpson said: "To have an international Buckfast day is bizarre. It is irresponsible and there is no reason to do it.

"It is a drink primarily used by young men n who want to get completely out of their minds drunk. But they become wide awake drunks and that can lead to problems.

"Research in US colleges on similar drinks found people were more likely to drive when drunk and young women more likely to get involved in sexual activity which they later regretted. Men were likely to be more aggressive.

“Buckfast is very much a West of Scotland problem of course. In the East and North East people don’t consume it in the way they do in the west so it is basically a social thing."

Dr Simpson had proposed an Alcohol Bill including specific restrictions on alcoholic drinks, including Buckfast, which are fortified with caffeine. The beverage has long been associated with aggressive and antisocial behaviour in the west of Scotland, but the Bill was rejected by the Scottish Government and Holyrood's health committee amid concerns it would be unworkable.

Dr Simpson said he was concerned that minimum pricing legislation will not impact on Buckfast.

He said: "It won’t be affected by minimum pricing, so I was proposing a limitation on the amount of caffeine in alcoholic drinks.

"American research led to the FDA demanding producers prove it is safe, but producers all stopped producing such drinks, effectively.

"Denmark has limited them to 150mg a litre –about a third of the caffeine content Buckfast currently has."

Buckfast Day organiser, Mark Onk, is urging fans of the drink around the world to enjoy it tomorrow.

Around 25,000 took part in Buckfast Day celebrations last year.

Mr Onk said: “Some Scottish politicians wanted to ban Bucky blaming it on anti-social behaviour. This clearly shows how Buckfast can bring people together."

Source: Herald Scotland, 13th May

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