A Night of Serious Drinking: The Results

"A systematic review of the next‐day effects of heavy alcohol consumption on cognitive performance"

The latest scientific rundown on the ramifications of hangovers, in the journal Addiction, can be found HERE.

 

Cancer: Alcohol’s Dirty Little Secret?

What Doctors Don’t Tell You

It is, in fact, no secret at all that alcohol causes cancer.  Rather than conferring any demonstrable metabolic benefit, alcohol is more likely to damage your health in a variety of ways. The body converts alcohol (ethanol) into acetaldehyde as part of the metabolic process, and acetaldehyde is carcinogenic in sufficient quantities. Drinkers are particularly susceptible to cancers of the head and neck, as well as the liver, breast, and bowel.

However, you wouldn’t know this if you only talked to doctors. In a commentary written for the journal Addiction, Terry Slevin and Tanya Chikritzhs of Curtin University in Perth, Australia, suggest that health professionals may be consciously or unconsciously in denial.

A 2015 survey taken in the UK demonstrated that only about 13% of the population was aware of a link between alcohol and cancer. Moreover, surveys of physicians show that “significant proportions are not aware of or resist the notion that alcohol causes cancer and do not advise their patients of the relationship. This is compounded by the fact that many physicians are reluctant to ask about patient alcohol use, particularly when drinking does not appear to have a direct impact upon their health.” (98% of medical students in a survey from Saudi Arabia, where drinking is rare, said that alcohol causes cancer.)

The authors raise the following question: Could individual alcohol use among doctors be part of the problem? Some studies have shown that physicians drink more than average, other studies conclude that they drink about the same as everybody else. As for attitudes about drinking, the authors reference a U.S. study showing that 24% of doctors admitted to having imbibed alcohol while on call. 64% reported witnessing colleagues who appeared to be under the influence of alcohol while on call.

Given that most doctors probably drink socially at about the levels one would expect of the general population, the authors point up the possibility that a form of cognitive dissonance might be behind an apparent, perhaps unconscious reluctance to discuss the alcohol/cancer link. If true, “an important source of health information for members of the public may not be communicating the alcohol-causes-cancer message consistently or effectively.”

The alcohol industry itself has always viewed the alcohol/cancer question primarily as a threat to sales. These powerful companies exhibit “a vested interest in maintaining the status quo of relative ignorance, uncertainty and denial among the general population and their trusted health advisors. In the face of this, it is time that health professionals set aside any leanings that might stem from their own drinking—good or bad—and convey unreservedly to their patients and the communities they serve that alcohol causes cancer.”

Graphics: http://www.alcoholandcancer.eu/risks/

Binge Drinking in America

And the numbers are… fuzzy.

Public health officials in the UK have been wringing their hands for some time now over perceived rates of binge drinking among the populace. In a 2010 survey of 27,000 Europeans by the official polling agency of the EU, binge drinking in the UK—defined as five or more drinks in one, er, binge—clocked in at a rate of 34%, compared to an EU average of 29%. Predictably, the highest rate of UK binge drinking was found in people between the ages of 15 and 24. This still lagged well behind the Irish (44%) and the Romanians (39%). Scant comfort, perhaps, given the historical role drinking has played in those two cultures, but still, clearly, the British and the rest of the UK are above-average drinkers.

Or are they? And what about the U.S. How do we rank? For comparative purposes, we can use the “Vital Signs” survey in the United States from 2010, performed by the Centers for Disease Control and Prevention, and published in CDC’s Morbidity and Mortality Weekly Report, results of which are pictured above. Using almost the same criteria for binge drinking—five drinks at a sitting for men, four drinks for women—the study concludes that the “overall prevalence of binge drinking was 17.1%. Among binge drinkers, the frequency of binge drinking was 4.4 episodes per month, and the intensity was 7.9 drinks on occasion.”

By the CDC’s definition, the heaviest binge drinking in America takes place in the Midwest, parts of New England, D.C., and Alaska. Survey respondents with an income in excess of $75,000 were the most serious bingers (20.2%), but those making under $25,000 binged more often and had more drinks per binge than other groups, the report says. And binge drinking is about twice as prevalent among men. Binge drinking, the survey concludes, is reported by one of every six U.S. adults.

Even so, it appears that the U.S. does not have the same level of binge drinking as the UK. However, astute readers have no doubt noticed that actual binge drinkers in the U.S. were consuming almost 8 drinks per bout, well above the official mark of four or five drinks at one time. The problem is that there is no internationally agreed upon definition of binge drinking. A 2010 fact sheet from the UK’s Institute of Alcohol Studies (IAS) maintains that “drinking surveys normally define binge drinkers as men consuming at least eight, and women at least six standard units of alcohol in a single day, that is, double the maximum recommended ‘safe limit’ for men and women respectively.”

But referring to binge drinking as “high intake of alcohol in a single drinking occasion” is misleading, says IAS. The problem is biological: “Because of individual variations in, for example, body weight and alcohol tolerance, as well as factors such as speed of consumption, there is not a simple, consistent correlation between the number of units consumed, their resulting blood alcohol level and the subjective effects on the drinker.”

Furthermore, the report charges that “researchers have criticized the term ‘binge drinking’ as unclear, politically charged and therefore, unhelpful in that many (young) people do not identify themselves as binge drinkers because, despite exceeding the number of drinks officially used to define bingeing, they drink at a slow enough pace to avoid getting seriously drunk.”

There you have it. As currently defined and measured, binge drinking is a relatively useless metric for assessing a population’s alcohol habits. “The different definitions employed need to be taken into account in understanding surveys of drinking behavior and calculations of how many binge drinkers there are in the population,” as the UK report wisely puts it. Take the above chart with a few grains of salt.

Photo Credit: CDC

The Economic Cost of Heavy Drinking

Some food, or rather, some drink for thought.

A recently released study conducted for the CDC Foundation estimates that the economic costs of excessive drinking in American totaled $223.5 billion in 2006.  Binge drinking accounted for 76.4%, or $170.7 billion of the total costs, according to the report. Binge drinking is defined as 4 or more drinks for women and 5 or more drinks for men within a two-hour period.

The report estimates that the per capita cost of excessive drinking was approximately $746 for every man, woman, and child in the United States in 2006. 

Here is a breakdown of the cost of excessive drinking:

·         72.2% ($161.3 billion) - Lost productivity
·         11% ($24.6 billion) - Healthcare
·         9.4% ($21.0 billion) - Criminal Justice
·         7.5% ($16.7 billion) - Other costs (e.g., property damage)

(The study was conducted for the CDC Foundation, a nonprofit enterprise that creates programs with the Centers for Disease Control for fighting threats to health. The study analyzed 2006 costs obtained from national databases.)

Graphics Credit: http://cdc.gov

Rules for a Night of Serious Drinking

Simple moves to dodge a hangover.

Let's face it: Despite all the folk remedies--ginseng, prickly pear extract, peanut butter, miso soup, and Vitamin B6, there really is no cure for a hangover except more alcohol.

However, there are things you can keep in mind when contemplating a night of serious drinking. What you do while you are drinking can mitigate or exacerbate the effects of the Day After. The following list was adapted from a post by the folks over at the Nursing Schools Network and Directory and used with their kind permission.

--If you're in it for the long haul, consider alternating an alcoholic beverage with a non-alcoholic drink. The reward for this is continual hydration, which helps offset the tendency of alcohol molecules to replace water molecules in the cells.

--Choose your liquor carefully. Red wine and cheap dark booze have more congeners, which are organic molecules that can contribute to a hangover. ML01, a genetically-modified yeast, is being touted as a way of cutting back on the headaches commonly associated with a night of red wine.

--Keep Count. When you lose count, it's time to stop. Know your measure.

--Skip the Sugar. Sweet drinks mess with your blood sugar level even more than regular drinks.

--Keep the smoking to a minimum. You'll need your oxygen come morning.

--Don't diss the bar and cocktail snacks. Foods high in fat well help absorb excess alcohol.

--Skip the Tylenol and Ibuprofen before going out. They probably won't help, and the combination with alcohol taxes the liver.

--Drink water. And keep drinking water. Morning-after dehydration causes many of a hangover's lingering effects.

--Stop drinking an hour before you go to bed. Better to nod off than to pass out, and you will have a better chance of sleeping through the night.

Picture Credit: www.ehow.com

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What Type of Drinker Are You?

U.K health officials classify problem drinkers.

In an effort to combat problem drinking with “social marketing techniques,” the British Department of Health has released a study purporting to break down heavy drinkers into 9 distinct personality types, according to the U.K. Guardian.

British Department of Health researchers performed the studies at the behest of the National Health Service, which says that alcohol-related illnesses cost England almost $5 billion each year. It was unclear what criteria were used to identify and define the nine types.

BBC news quoted Health Minister Dawn Primarolo on the findings: "This will be a tough one to crack. Research found many positive associations with alcohol among the general public - even more so among those drinking at higher-risk levels. For these people alcohol is embedded in their identity and lifestyle: so much so that challenging this behaviour results in high levels of defensiveness, rejection or even outright denial."

The idea behind the investigation is to identify the social and psychological characteristics of problem drinkers “in an attempt to devise more effective public health campaigns to encourage safer use of alcohol.”

THE NINE TYPES OF DRINKER

1) Depressed drinker:
Life in a state of crisis. Alcohol as self-medication, comforter. Any sex, all age groups.

2) De-stress drinker:
Stressful job and/or home life. Alcohol as relaxation, dividing line between work and personal life. Middle class men and women.

3) Re-bonding drinker:
People with a crammed calendar. Alcohol as “shared connector,” a means of keeping close to others.

4) Conformist drinker:
Traditonalist drinker. Alcohol as “me time,” the pub as second home, a sense of belonging. Typically middle-aged men in blue-collar or clerical jobs.

5) Community drinker:
Alcohol as social network, a sense of safety and security. Lower middle class men and women who drink in large social groups.

6) Boredom drinker:
Alcohol as stimulation, comfort in isolation. Often single moms or recent divorcees.

7) Macho drinker:
Alpha males, drinking as an assertion of masculinity, alcohol as a competition.

8) Hedonistic drinker:
Excessive drinking as an assertion of independence, freedom, release from inhibitions. Often single or divorced men or women, or older drinkers with grown children.

9) Border dependents:
Alcohol as a defense against the need to conform, and a general sense of malaise. Typically men for whom the pub is “home.”

The research was done as part of a renewed effort to to crack down on heavy drinkers. A pilot program will be undertaken over the coming months to target heavy drinkers. More than 900,000 households will be mailed information highlighting the link between drinking and conditions such as cancer and liver disease.


photo credit: http://www.ulv.edu

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