Thursday, 15 December 2011

Alcohol kills at least one person in Ireland every seven hours

Reporting on events in India The Irish Times has heard that 'a toxic batch of bootleg alcohol has killed at least 102 people and sent dozens more to hospital in villages outside the eastern Indian city of Kolkata....Cheap bootleg alcohol kills dozens of people every year in India.'   But the tragedy of death from alcohol is not something you have to look abroad to find, or need to buy home-made hooch to be at risk of.  The Irish Examiner's story on the same day (15th December) brings it home.  "Alcohol kills at least one person in Ireland every seven hours".  That's over 1,250 per year according to Dr. Declan Bedford, director of public health in the north east, reporting to an oireachtas committee. 

The committe also heard that the last few years have seen the worst ever figures for alcohol harm in Ireland, including a trebling of liver disease and of alcohol related deaths since 1995.  There were also 7,920 admissions to specialist addiction centres in 2008 and 1,798 admissions to mental hospitals in 2010.  Dr Bedford added that:
most of these harms occur not in alcoholics or people with alcohol dependence but rather among regular drinkers who drink at hazardous or harmful levels — unfortunately over 50% of all drinkers.
An opportunity to save lives and money
Senator John Crown, also a member of the committee, brought the monetary cost of alcohol harm into the equation. If the alcohol factor was removed it would "probably end most of the waiting lists" in hospitals he told the committee.  But the government doesn't seem to be listening.  Alcohol Action Ireland, in its post budget analysis, puts it like this.  "Ireland is currently paying an estimated €3.7 billion a year in alcohol-related harm, ironically almost the equivalent amount we have to pay back to international debtors".  But 'budget 2012 was a false step' and did the cause of alcohol harm reduction no favours.
Minister for Finance Michael Noonan rejected the restoration of excise duty to 2009 levels - a move which has lost the Exchequer a potential €178 million: the same amount that would have headed off the now widely condemned cuts to disabled young people, cuts to lone parents and increase in student fees.
Let's hope for better in 2012.

Read some of the most popular Gargle Nation Posts of 2011.

Sport and Alcohol Sponsorship: winning the hearts and minds of young people

Teenagers in crisis: 150% rise in teenage drinking problems in Ireland 

Fetal Alcohol Syndrome: Facts and analysis from FASD awareness week

Suicide and Alcohol: Special report on how the suicide figures are hidden

How safe are the roads? European Police discover one in eight Irish drivers are drunk

Ireland's first alcohol free comedy club: Booz in the Nooz reports

Butt out Anglea Merkel: Ireland is having another drink

Wednesday, 14 December 2011

Sport and alcohol in Ireland: a 'Victorious Sponsorship Campaign'

In 2004 the Irish government's Strategic Task Force on Alcohol recommended that national sporting bodies find an alternative to alcohol sponsorship.  That didn't happen.  Seven years later the Gaelic Athletics Association (GAA) should be lauded for at least making an attempt to reverse the appalling influence that sports sponsorship has had on young people's drinking habits in Ireland.  In Mayo the club is banning the use of alcohol sponsorship on jerseys intended for teenagers.  During January 2012 all GAA players will be encouraged to stay 'off the booze and on the ball' to increase their own fitness and to set a good example to young people. 

The hard hitting campaign believes that "Drinking alcohol is part of everyday adult life in Ireland. It is used to celebrate, commiserate and to socialise. Used sensibly alcohol is a pleasurable, socially acceptable drug". 


 Advertising is often discreet
While this campaign might give the impression self-regulation is working, in reality it is a very small gesture towards countering the pernicious effect of alcohol sponsorship of sports.  The 2011 UNICEF special report on teenagers and alcohol in Ireland found 'the emergence of a dangerous orthodoxy in which drugs and alcohol are accepted as a normal part of adolescence in Ireland' and that 77% of respondents to their survey reported that they drink.  This is not all down to advertising of course - price and availability are also factors, but the prevalence of sports sponsorship is a major factor.  Who thinks so?  Anti-alcohol campaigners do of course, but so do the alcohol industry and sports organisations, and so does the government.

In 2007 an Oireachtas joint committee investigated the issue of alcohol sponsorship of sport and concluded:
The Joint Committee recommends the sourcing of sponsorship for sport outside of the alcohol industry: the correlation between the onset of drinks sponsorship and the rapid rise in alcohol consumption in this country is too strong to be ignored.
Specialist Professor Joe Barry now believes 'the culture of major sports events ....being heavily sponsored by drinks companies needs to be closely scrutinised if the problem of alcohol abuse is to be adequately tackled'.  The industry itself concurs albeit from the opposite perspective.  In 2000 it was felt by alcohol industry giant Diageo that "in the past sponsorship was often an under-rated element of the marketing communications mix".  That was soon remedied and by 2007 'almost €6 in every €10 spent on sponsorship in Ireland is invested in sports-related sponsorships, such as GAA, rugby and soccer'...of a total of €100m spent overall.  Guinness explains why.  'Sponsorship' it said (in a joint initiative with the GAA  published by the Irish Times called Implementing a Victorius Sponsorship Campaign)
'is an investment in an activity in return for permission to exploit the commercial potential associated with that activity'
And the commercial potential to be exploited in the GAA was huge - a full one third of the Irish population are members of the GAA and the organisation offers 'over 1,000 licensed outlets for the Guinness product'.

GAA meets Guinness: The Victorious Sponsorship Campaign
 Does alcohol sponsorship affect the young?
It is safe to conclude that sponsorship of sport results in sales.   The industry would not be spending millions on it otherwise.  Does it reach young people in particular?  A Dutch University study in 2008 interviewed 1,688 12-15 years old, and found that 'youngsters thought more positively about beer after the massive beer publicity on TV during the 2008 European football championship'.   The 2009 Irish study Get em' Young investigated the link between alcohol consumption and advertising and concluded that 'Alcohol sports sponsorship links masculinity, alcohol and sport and embeds alcoholic products into the every day life of the consumer. It reaches the target audience – young males who are the keenest sports fans and heaviest drinkers'.

This year an Australian study had similar results. 'Figures from marketing analysts suggest that major alcohol companies spend up to 80 per cent of advertising and sponsorship budgets promoting alcohol via sports'. Deakin University scientist Dr Peter Miller said:
This study provides new evidence of the harms associated with alcohol industry sponsorship of sport and we believe that any sporting association serious about the well-being of young people should support calls for governments to provide alternative funding. It's simply not worth gambling with their future for the sake of some easy money.
Will alcohol sponsorship of sport be curbed?
Are young people safe in the hands of these two enormously wealthy and powerful industries?  The topic of regulation is up for discussion again and the loss of all that sponsorship money is causing anxiety in the sporting world. At the moment the situation is just how the industry wants it.  In Ireland, as Alcohol Action Ireland reports,
The codes restricting alcohol marketing to children and young people are voluntary rather than statutory - and they do not cover all aspects of integrated marketing, that is, using the marketing methods of product, price, place and promotion to complement and reinforce each other. Integrated marketing is the approach undertaken by the alcohol industry to sell their products. The current codes are, in effect, limited to advertising which is only one aspect of marketing.
So a re-opening of the sponsorship debate is of concern to industry bodies who are all doing nicely out of the current arrangement. 

'Long reaching and devastating consequences'
As sports reported last year the alcohol and sports industry are ready to defend their position.  'The Irish Rugby Football Union' for example 'believes there is a real danger that 'rash decisions could be made' with “long-reaching and devastating consequences” for organised sport in this country in the absence of proper cost/benefit studies on the issue'.  How rash is it to implement a policy after over a decade of debate and rapidly rising statistics on alcohol abuse amongst young people?  The cost benefit study they are thinking about is perhaps the potential loss of their share of that 100 million plus sponsorship money.

The Alcohol Beverage Federation of Ireland is also worried about loss of sales (or is it just committed to making the sports industry rich?)  It claims that there is a lack of “coherent, empirical evidence linking sponsorship by alcohol brands to increased consumption" and is worried that 'any ban on sponsorship would put Irish sporting bodies at a “great disadvantage"...internationally'.

Nice of the ABFI to put its concern about sport first.  But no need.  Australian academic Dr. Miller found that "Norway and France have had longstanding bans in place with little apparent effect on sport, and this year Turkey banned all alcohol advertising and sponsorship of sport. France successfully hosted the 1998 FIFA World Cup with their alcohol sponsorship and advertising ban in place, and currently host the multi-nation Heineken Cup Rugby competition, renamed the H-Cup in France".

Dr Kypri of Manchester University, author of several studies showing the direct link between alcohol sponsorship of sport and binge drinking amongst players and fans, sums it up like this:
The latest moves by the major sporting codes lobby against the regulation of alcohol sponsorship of sport show that these bodies remain in denial of alcohol-related problems in their sports.  It is clear that these organisations have enormous vested interests in continuing to receive alcohol money and government should be careful to act in the public interest rather than to cave in to the sports and Big Booze.
World Health Organisation Charter
As the World Health Organisation’s European Charter on Alcohol states:

‘All children and adolescents have the right to grow up in an environment protected from the negative consequences of alcohol consumption and, to the extent possible, from the promotion of alcoholic beverages'.  Each Member State should ‘Implement strict controls... on direct and indirect advertising of alcoholic beverages and ensure that no form of advertising is specifically addressed to young people, for instance, through the linking of alcohol to sports.’

The WHO Charter has been signed by many countries, including all the Member States of the EU.  Back of the net?

Tuesday, 15 November 2011

Counting the cost of alcohol harm: crunch time for Europe's politicians

In Alcohol Awareness Week the harm caused by alcohol is under scrutiny, being signalled by Global Risks as part of 'a global risk equal in cost to the current global financial crisis'.  But politicians under pressure from vested interests are proving slow to act.  As the architect of Ireland's disastrous deregulation of alcohol (and banking), former Taoiseach Bertie Ahern once said:  "Now what we are endeavouring to do is we know what the outstanding issues are, we know that we could argue forever about the rights and the wrongs".   Where alcohol is concerned, the outstanding issues and the rights and wrongs are very clear, so the time for 'arguing forever' is over.  Bucking the trend, incoming Health Minister Roisin Shortall is courageously promising something different.

Fiona Ryan AAI and Minister Roisin Shortall at the Where's the Harm? conference

We must, she says, tackle the issue of alcohol in Ireland head on "in a real and meaningful way".  In the last month she has promised to address the key issue of minimum pricing, discussed the harm to children of parental drinking, and promised to put alcohol in its rightful place at the heart of a national substance abuse strategy.  This week, Alcohol Awareness Week, the Minister promised to look at “the question of minimum pricing to remove that dirt cheap element from the market.”  On 16th November she supported the Alcohol Action Ireland conference 'Alcohol. Where's the Harm?' by presenting the opening address.

Where's The Harm?

The harm is everywhere, it turns out, and very costly in every sense of the word .  The conference focused on crime in particular.  Academic Sean Byrne, author of the HSE study "Costs to Society of Problem Alcohol Use in Ireland", told delegates that "€319 million is spent by three justice agencies on crime linked to alcohol, €191m is spent by An Garda Síochána, €51m is spent by the Prison Service and €77m is spent by the Courts Service.  Overall "the €319m represents 13% of the total Department of Justice budget", and as The Irish Examiner reported "the cost to the exchequer of responding to and dealing with the consequences of alcohol could be €1.6 billion per year".

60% suffer as a result of someone's drinking

But the personal cost of alcohol crime tells an even sadder story.   Discussing a survey conducted in September by Behaviour and Attitudes and based on interviews with 1,000 people over the age of 16, Alcohol Action Ireland director Fiona Ryan revealed to the conference that 'almost 60 per cent of people had been intimidated, frightened or physically assaulted as a result of someone else’s drinking.. and almost one in ten people had been assaulted or had a family member who had been assaulted by someone under the influence of alcohol'. 
"Some 45 per cent of people said they had gone out of their way to avoid drunk people in a public space, while 22 per cent had felt unsafe in a public space due to someone’s drinking. Some 20 per cent had been kept awake by drunk people outside their home, and 18 per cent had felt unsafe on public transport".
And Sean Ryan's crime figures are an under-reporting of the issue. "When they had been assaulted, 44 per cent said they did not report the assault” Ms Ryan said, blaming a culture that too readily accepts alcohol and its problems as part of 'normal' life.

Suicide is another shocking aspect of alcohol harm.  Minister Shortall told the Irish Times,“we have a serious problem with suicide in this country. It is probably the biggest problem facing our young people.  In over half the cases of suicide, alcohol is a key factor".   Young people are also in danger from other alcohol related harms as shown in the recently released HRB statistics for alcohol abuse, which show a 40% increase in the number of people seeking help for addiction, and a huge rise of 150% amongst young people in particular looking for treatment.

80% of rapists were drunk

Cliona Saidlear of the Rape Crisis Network Ireland  informed delegates that alcohol is also implicated heavily in rape and other acts of sexual violence.  The Rape & Justice in Ireland study of 596 DPP files on adult rape cases found that:
"77% of suspects had consumed alcohol on the date of the offence, 41% of suspects were severely intoxicated, 80% of complainants had consumed alcohol around the time of the offence and 90% of complainants had consumed ‘binge’ levels of 7 standard drinks".
But the danger of being raped by someone is added to by the states failure to prosecute when the victim is also drunk.  One third of those who did not report rape 'did so because they had consumed alcohol at the time (voluntarily and involuntarily)' and of the cases received in 2005 the DPP prosecuted 'only a third' because the ‘reliability of the complainants’ account was 'undermined by high levels of intoxication'. As Ms. Saidlear concluded "Irish drinking culture is one that supports a toxic mix of alcohol and sexual violence".

Equal in cost to the current global financial crisis

Culture aside, the core issues of regulation lie with governments to fix.  While the Irish government ponders the 'reputational damage' done to Ireland by its financial disaster, it is not unique in Europe in facing a major social and economic crisis with alcohol.  The World Economic Forum’s 2010 Global Risks Report identifies alcohol as a prime cause of non-communicable diseases (NCDs), and 'these are the second most severe threat to the global economy in terms of likelihood and potential economic loss.  NCDs are a global risk equal in cost to the current global financial crisis'.

The current EU Alcohol Strategy is due to end in 2012.  This week 72 European NGO's called for a new and 'comprehensive Alcohol Policy Strategy'.   In an open letter to Ministers of Health across Europe they wrote that:
Alcohol is the world’s number one risk factor for ill-health and premature death amongst the 25-59 year old age group, a core of the working age population. Europe is the heaviest drinking region of the world. Consumption levels in some countries are around 2.5 times higher than the global average (WHO 2009). Alarmingly 43% among 15-16 year old European students reported heavy binge drinking during the past 30 days (ESPAD 2007) and alcohol is the single biggest cause of death among young men of age 16 to 24.
The Committee on National Alcohol Policy and Action is meeting on 17th November and signatories urge experts to request the European Commission for a European Alcohol Strategy 2013 – 2020.  As Mariann Skar (European Alcohol Policy Alliance Secretary General) puts it:
"Alcohol use is a problem across Europe which requires a comprehensive, targeted and action oriented response... Europe is still the heaviest drinking region in the world. It is our shared European problem that needs a collective solution"’
Let's hope the time for debate is over, and the time for action has arrived.  The alcohol industry spends 44 million Euro per year on advertising in Ireland alone, which is keeping many recession bitten newspapers and TV stations afloat.  Alcohol industry lobby groups have also infiltrated governments very successfully over the last twenty years, holding back any real debate or legislative change on the issues raised at the AAI conference or by the NGO's.  Will Bertie Ahern be right for once? As he so forgettably said,  "I'm a bit disappointed that so many people have closed up on their barriers, that's why we have been very anxious to keep our position."


For all the presentations at the Alcohol Where's the Harm Conference follow the link.

Wednesday, 9 November 2011

150% rise in teenage drinking problems: Alcoholism in Ireland hits new crisis

The Irish Independent has been critical of Minister Shortall's attempts to start a much needed debate on minimum pricing of alcohol.  "Anyone expecting minimum alcohol pricing to solve the problem of alcohol abuse overnight is likely to be disappointed.  Believe it or not, overall Irish levels of alcohol consumption, while still relatively high, have been falling since the turn of the century".  That certainly is hard to believe, particularly when the HSE has published a report this month (based on National Drug Treatment Reporting System (NDTRS) returns) which indicates the exact opposite, showing a steep rise in drinking amongst the growing number of unemployed people, and a 150% rise in the numbers of teenagers seeking help for their drinking. 

Dr Suzi Lyons, senior HRB researcher with the HSE, speaking to the Irish Examiner on Wednesday 9th November revealed that "the effects of the recession are biting hard, with a massive jump in unemployment among people seeking treatment for alcohol".  The report published by the Health Research Board found 76% of people in alcohol treatment in 2010 were out of work — up from 60% in 2005.  "This suggests that prolonged problem alcohol use may lead to loss of employment, or alternatively, the factors associated with failed treatment (or chronic addiction) are similar to those associated with failure to secure or retain employment."

Youth drinking problems up by more than 150%

But the real shock comes in the HSE figures on young people and drinking.  Reported in The Examiner on 9th November the report shows "a 150% jump in the number of juveniles seeking treatment for alcohol in the last six years - over three times the increase among all age groups".  And this, said Dr Suzi Lyons, was an "underestimate" of the true figure, as they only had data for a "fair majority", but not all, treatment centres.  The rise for other age groups is equally alarming, with a 29% increase in new cases and a 42% rise overall, and "the total number of cases increased from 5,525 in 2005 to 7,866".

The Independent is still not having it, arguing that drugs, and not alcohol, are the real problem.  The paper believes that "the fact that a fifth of all those being treated also abused other, illegal, drugs points to another possible explanation.  In modern Ireland alcohol isn't the only drug to be abused by large numbers of people. There are few people under 30 who haven't at least experimented with illegal drugs".

On the contrary, as Dr Lyons' study shows, "40% of clients were drinking daily, with a further 34% consuming alcohol two to six times a week. The majority (81%) of cases reported problem use of alcohol only".   Similarly, while fewer than 1% of drivers were stoned, over 13% were drunk at the wheel as revealed by a recent Tispol survey - seven times the European average.  Alcohol, not drugs, is the cental issue.

Alcohol industry and Government take the issue by storm

Also shocked by the findings is Katryn D’Arcy of the Alcohol Beverage Federation of Ireland, who will obviously 'be reviewing the report in detail'.  Her initial reaction as reported in the Irish Examiner is to repeat the increasingly unconvincing mantra that
"overall alcohol consumption has been declining steadily in Ireland since its peak in 2001.  Consumption declined dramatically between 2008 and 2010 and ...Irish consumption is approaching European norms". 
Is it?  The facts tell the opposite story, and this head-in-the-sand approach is not only wrong but is now proving to be positively dangerous.

The HRB report sums up very neatly what is needed to tackle the problem.  'Effective policies include: increasing the price of alcohol; restrictions on alcohol sales; minimum legal purchase age and low legal blood alcohol concentrations for drivers'.  But the government still seems unable to respond without a bit more time to ponder what it all means.  Answering questions from frustrated backbenchers on 4th November last year on the subject of rising alcoholism, Minister Aine Brady quite reasonably put the blame squarely on "The Minister for Enterprise, Trade and Employment [who] revoked the Restrictive Practices (Groceries) Order 1987 with effect from March 2006".  And that, as part of a continuing programme of deregulation begun in 1992,  is certainly the reason why Ireland has made such steady progress from being a relatively sober country in 1990 to its current position as booze-capital of the western world. 

But that hardly explains why the government has spent 20 years avoiding a reversal of those policies and hiding behind 'reports' and'consultations' to put off any defninitive action on the issue.  Instead Ministers choose to put the whole debate on the long finger, sending the house to sleep with the same long-winded responses.  Giving an identical  response to that of Minister James Reilly this summer, Minister Brady presciently described a year ago the exact situation which still pertains today:
"A Steering Group has been established to develop proposals on the alcohol element of the  NSMS. The NSMS Steering Group is examining a wide range of issues in relation to alcohol policy such as pricing (including minimum pricing), availability, treatment, prevention and marketing. The NSMS Steering Group is due to report on its findings by the end of the year. I look forward to receiving the Report from the Steering Group and considering the recommendations around the price at which alcoholic drinks are sold. My Department is continuing to monitor developments on alcohol policy in Scotland and in Northern Ireland particularly in relation to any proposals on the pricing of alcohol products".

Sunday, 6 November 2011 praised at European Health Forum: satire dies again

As Tom Lehrer famously said, while he wasn't poisoning pigeons, 'Political satire became obsolete when Henry Kissinger was awarded the Nobel Peace Prize'.  In the same spirit, though rightly without the same fuss, was recognised for its 2011 student film competition as a 'model of best practice' at the European Alcohol and Health Forum in Brussels this month., it should be remembered, is the education wing of MEAS, an organisation funded by the alcohol industry for the Mature Enjoyment of Alcohol in Society .  MEAS's modest aim is that "we must respect alcohol when we consume it" which it promotes "with no commercial purpose". itself has another aim - to educate the public about the dangers of alcohol so the government doesn't have to.  In this role as an educator the alcohol industry infact has greater access to the press, to universities and teenagers to promote more of what it has cleverly renamed "responsibility when drinking". 

Bulls - eye

The competition which earned them praise asked students to make a film about home drinking.  Incase its benefits were missed, reminded participants that 'Home drinking ranges from people enjoying a couple of drinks in their family home to house parties with large numbers of guests in attendance. In recent years, drinking in home settings has become increasingly popular: more than half of the alcohol consumed in Ireland is now purchased in the off-licence trade, rather than in pub settings'.

"Specifically targeting 18- to 24-year-olds, with a bulls-eye of 22-year-olds" the campaign placed "a stronger emphasis on the use of social media as a promotional and communications tool".  Said  Fionnuala Sheehan, Chief Executive, “The way we see it, the competition not only gets students thinking about drinking, but also offers them a valuable opportunity to meet people working in their chosen careers; to network with them; and to develop contacts and skills that will stand to them in the future.”  A good job this is education and not advertising, because the industry's own code on advertising prohibits associating drinking with social success or targetting the young.  A bulls-eye indeed.  

"Mortifying memories" and "slippery nipples" is not new to advising students on how and when to drink.  Its website offers 'myth busting' messages in which 'we don’t set out to lecture to students, or to patronise them. Instead, we aim to engage with them as equals'.  An essential part of the message is to play down the effects of drinking by being funny about them. For example:
"For those with something better to do, remember that just one drinking session can result in the most embarrassing and mortifying memories. For each pint you drink, you have more of a chance of falling victim to the beer goggles effect. Add a slippery nipple or two and you'll be waking up next to a face you will try to spend the next few years forgetting".
According to another myth to bust is that drinking impairs your abilities.  In fact it just promotes a carefree attitude, they say. 
"Canadian volunteers were asked to press a button when prompted by a computer screen but told not to press it if a red light also appeared. Those drinking were more likely to press the button when the red light was shown. However, when drinkers were offered a small reward they performed just as well as sober volunteers. Funny that".
Does think alcohol causes you to do to things you wouldn't have done sober?  No.
"The alcohol made you do it? Oh purrr-leease. The lamest excuse in the book. Its up there with the dog ate my homework. Researchers around the world have proved that it is possible for people who have been drinking to control their behaviour if they want to.  No matter how hard you might convince yourself otherwise".
The "dangers" of drinking too little

And the most dangerous myth is apparently that it is important to cut down the number of times we drink.  Far from it, we should be careful to drink more often.  If you only drink at the weekend
"You are flooding the brain with large amounts of alcohol, then subjecting it to a sudden cold turkey withdrawal, then doing the same again next weekend, which seriously messes with your brain cells.  So think ahead. [Instead, just] have a couple of alcohol free days during the week"
And on the five nights a week you are drinking simply "Pace yourself with water or a soft drink after every alcoholic drink and you’ll sparkle all night long". ads left on the toilet floor

This is apparently the message that the students want to hear. "What they want are the facts on how to ensure they don’t miss the best part of the night, avoid hangovers and fall victim to the beer goggles effect. The Booze Myths campaign is a fun way to deliver these facts."

Another campaign familiarised students with the effects of drink by placing 'images of drunk students sprawled on the ground pasted to the floors of college toilets as part of a hard-hitting campaign on the dangers of alcohol'.  Against research which shows that single issue shock tactics are ineffective and in-fact tend to reinforce drinking norms, claims that the images were 'designed to warn third level students enjoying RAG Week events of how their night could end if they abuse alcohol'.

Jessie J without beer goggles

Sadly you no longer need to go to the toilet to see drunk students on the floor, as singer Jessie J found at her Trinity Ball gig this year.   "Just came off stage at trinity ball" she tweeted . "Probably one of the hardest gigs to date. To see so many people so drunk they couldn't even stand. Girls unconscious and literally trampling on each other. It wasn't easy."

The singer, who has risen to fame over the past year, later posted: "I'm not upset they weren't all listening. It upset me to see so many young people so not with it. I'm not used to it. It's hard to sing when I just wanted to go into the crowd and help all the crying girls who were being squashed." 

Drinkaware's university campaign obviously isn't working, or is it?

Sunday, 16 October 2011

From Mad Men 'glamour puss' to grave: the cost of alcohol advertising to teens

As Einstein said, 'Insanity is doing the same thing over and over, and expecting different results'. Unfortunately alcohol researchers seem doomed to repeat themselves while nobody is listening.

The case in question is the role of regulation in alcohol advertising, which has come up again in a new study by consultant psychiatrist Bobby Smyth reported in the Irish Examiner this week.  The study tells us two things: that 'Teens abusing alcohol are more likely to buy leading brands rather than the cheapest or strongest drinks', and 'that alcohol advertising and sponsorship should be "seriously restricted" by law'. 

This echoes Smyth's 2010 study which found that 'as teenagers view drinking as increasingly pervasive and normalized, they are more likely to commence drinking themselves'.  Both studies also provide further evidence of a steady decline in the age of first drinking, with 13 years now being a common starting age.

Ten years ago the Health Research dept of NUI Galway trod similar ground. Their study The Impact of Advertising on Teenagers in Ireland  demonstrated 'the inadequacy of the current codes' and 'a compelling case for an overhaul of alcohol advertising".  But as reported before on Gargle Nation, neither the UK nor Irish governments have listened to these and many other similar findings, and the revolving door of the 'failure of self regulation' by the alcohol industry continues.

The Galway report explains how the advertising works.
'Alcohol advertising has a strong attraction for Irish teenagers as it ... reinforces the use of alcohol with a range of activities that teenagers aspire to, engage in and enjoy. ...It is likely to have a greater impact among the younger age groups and the 15-17 year old girls than the older boys, given that they perceive the advertising messages as saying that alcohol can help them have fun, make friends and become popular and those that don’t drink are missing out. ...for most of the girls, alcohol use is seen as a way to increase self confidence".

"Releasing my Super me"

Last year a report to the UK parliament showed who is actually reading the research. It is the alcohol industry itself, and more specifically the Mad Men employed to run their advertising campaigns for them.  How the advertising industry set about exploiting these policy weaknesses and reaching a teenage audience makes chilling reading.  Produced by Professor Gerard Hastings the report analyses internal emails and advertising planning materials obtained from the industry.  Presenting the findings to the UK parliament, Professor Hastings asks again 'whether the current regulatory environment affords youth sufficient protection from alcohol marketing'?  Specifically the
'documents we analysed show that attempts to control the content of alcohol advertising have two systemic failings. Firstly, the sophisticated communications and subtle emotional concepts such as sociability and masculinity that comprise modern advertising (and sponsorship) often defy intelligent analysis by the regulator, especially when the thinking and strategising that underpins them remain hidden. Secondly, producers and agencies can exploit the ambiguities in the codes and push the boundaries of both acceptability and adjudication.

"Delivering masculinity"

Carling advertisers, for example, discuss how Carling Weekend can reach young pop concert goers effectively, and be “the first choice for the festival virgin,” The plan includes offering free branded tents and a breakfast can of beer as 'a refreshing start to the day'.  The advertisers also understand how young men 'think about 4 things, we brew 1 and sponsor 2 of them.” “Ultimately" they advise, "the band are the heroes at the venue and Carling should use them to ‘piggy back’ and engage customers emotions".

Remembering 'the Carling commandments' “Thou shalt never desert thy mates in drunken distress” and “Thou shalt never miss a round" and that “potency is a key area to delivering masculinity” Carling’s planning documents reveal that its aim is to position the brand as a "social glue" and that it "celebrates, initiates and promotes the togetherness of the pack, their passions and their pint because Carling understands that things are better together".

 Diageo is also in on the act, highlighting the brand values and personality of Smirnoff Black as “urbane,” “masculine,” and “charismatic”. Penka vodka on the other hand "releases my Super Me. Why?  Because when I drink it, I feel I am in the know and part of an elite group".  Sidekick meanwhile can help you “Kick starting the night" and exploit your "macho competitiveness".  But to be a real man you need to know "how much can you take?”

The advertising executives are bang up to date with social media too.  Alcohol companies should exploit the opportunity to connect with "‘Young and Energised" consumers who engage in "new technologies and gadgets, always looking for the new things to tell their mates about and share on their Facebook/Twitter".  So how to reach them?  Set up 'facebook pages' and produce 'cool ads' that offer "routes to magic". It should look like it’s come from your mate, but is infact Carling branded”.

"Do the Lambrini"

The special prize goes though to Lambrini.  Lambrini looks like a 'sparkling wine' marketed to young women but is in fact referred to by the marketing people more truthfully as 'the kids drink'.  Lambrini can apparently "make you and the girls forget your dull working week" and "transform you into the glamour pusses you know you should be". Extensive television advertising ran together with a competition to  find the “Lambrini girl” with “the UK’s sexiest legs".

As Hastings writes in the BMJ, 'the cynicism is palpable'. 
'Lambrini’s tenacious attempt to retain the strapline ‘Girls Just Wanna Have Fun’ in the face of repeated advice from the regulator that it is "targeting young girls, and promotes getting pissed", was unacceptable. Only when a young woman died after a Lambrini drinking binge and the strapline appeared in newspaper coverage of the death did Lambrini feel there might be benefits in relinquishing it'.

But the tragic effects of marketing alcohol to vulnerable young women didn't end there. In the pages of British newspapers are three more tales of some 'Lambrini girls'.  The Telegraph reports how a 14 yr old babysitter drank three bottles of Lambrini before filming herself killing the owner's rabbit by repeatedly throwing it against a wall.   The Mail Online carries the story of a vicar's 19 year old daughter who drank Lambrini with a 17 yr old and 13 yr old friend before getting into an argument that led to her jumping to her death from a window.  And the Daily Mail reports the unprovoked rage of the Lambrini fuelled teenage girls who senselessly and without motive kicked an elderly man to his death as he walked past them in a park.

As Einstein also said.  'Only two thing are infinite, the universe and human stupidity. But I'm not sure about the former'.

Thursday, 22 September 2011

Is the alcohol industry taking over the world?

A major survey of teenage drinking was published in June by the usually trusty and worthy Joseph Rowntree Foundation as part of its three year project on young people and alcohol.  It concludes with the astounding 'policy' advice that there is 'little benefit' in aiming to prevent young people from drinking alcohol. How did we get to this point?

'Doubt is their Product' is an excellent analysis by David Michaels of how the American tobacco (and asbestos) industry managed to stave off restrictions to sales and marketing that would naturally have followed from the alarming discovery that their product kills you.  The facts were known in the early part of the last century, a good 50 years before the courts and government took action.  Why were governments so slow to act?

As Michaels shows, the manufacturers created phony science to counter the good science.  As a tobacco company executive put it, they 'manufactured doubt' by flooding the market with 'studies' putting the emphasis away from the health disbenefits of tobacco and onto, for example, the genetic predisposition of some smokers to get cancer, or the social failings of addictive smokers, or the benefits of relaxing with a cigarette.  'The Orwellian strategy of dismissing research conducted by the scientific community as "junk science" and elevating science conducted by product defense specialists to "sound science" status also creates confusion about the very nature of scientific inquiry and undermines the public's confidence in science's ability to address public health and environmental concerns'.

Looking at the research flooding the journals it is clear that the alcohol industry, with the benefit of hindsight, is playing the same game, but better. The 'world's largest alcohol research organisation' the Foundation for Alcohol Research, for example, is funded by the alcohol industry to the tune of over 2,000,000 per year. It boasts the top alcohol manufacturers on its board, but also has a host of  academics from many leading universities rubbing shoulders with them.   Fine you say, but its output is very clearly stated: 'your donation will support our mission to discover the benefits and risks of alcohol consumption'.  And so it does. As the Public Library of Science editors wrote in May:
"The crisis of confidence that surrounds the behavior and practices of Big Tobacco and Big Pharma bias in funded research, unsupported claims of benefit, and inappropriate promotion and marketing, among others—should be enough to provoke in us all a high degree of skepticism with any industry involvement in health research and policy. But the evidence and critical voices highlighting the practices of the alcohol industry—a massive and growing US$150 billion global business—have not yet received adequate prominence in medical journals. Indeed, attention to and scientific research on the alcohol industry have not kept pace with the industry's ability to grow and evolve its markets and influence in the health arena"
“Powerful sway” of industry ahead of UN health summit

The influence doesn't end with research.  Big Alcohol is also infiltrating governments, and at very senior levels.  Astoundingly, the UK governments 'independent' health advisory panel on alcohol has been reconstituted in order to make way for a 50% alcohol industry representation (see the Guardian report on advisory panel 'heavily stacked' with industry insiders).  Worse, the British Medical Journal last month published details of how the world health agenda itself has been hijacked in advance of the world summit on non-communicable disease in New York this September.  The BMJ has evidence that alcohol industry representatives in several nations have used influence to change or delete aspects of the agenda.  'Indeed, draft documents show that effective, evidence-based measures on alcohol (controlling price, availability and marketing) are being deleted, and industry favoured measures (partnership working, community actions and health promotion) being substituted... with Japan, the EU, US and Canada resisting all language on taxation'.

Parents take the blame

Following the once-succcesful route taken by tobacco manufacturers, Big Alcohol has looked for scapegoats for the massive rise in alcoholism in the past decade, much of which is attracting negative publicity. In the UK and US and Australia the chosen soft targets are parents, deflecting attention away from the vacillations of government and a persistent failure to regulate an increasingly powerful industry. Led by the alcohol industry's 'responsibility' wing drinkaware in the UK, and the PDFA (outed as alcohol and pharamceutical industry funded) in the USA, a number of 'help' websites and 'research' papers have sprung up examining and advising on the role of parents who fail to manage teenage drinking. Of course parents have a role, and an important one, but the new 'research' serves to deflect or counter the many studies showing that the real drivers of our new drinking cultures are the massive advertising and marketing campaigns funded at enormous cost by the alcohol industry itself.  Western alcoholism is consequently flying under the radar as 'normal healthy drinking'.  As the JRF itself has noted in its pursuit of the cause of drinking cultures, 'international research, as well as research conducted in the UK, has led to debates regarding the emergence of a youth drinking culture which transcends gender, socio-economic differences, nationality and locality differences and is breaking away from traditional drinking cultures of older generations'.  Exactly - advertising and marketing reaches everyone.

Following on from the recent Drinkaware campaign advising 'when to talk to my children about alcohol' the Joseph Rowntree Foundation has published a series of studies into drinking amongst teens.  Its' September study of celebrity culture was preceeded in June 2011 by a 'major survey of early teen drinking patterns in England' conducted not by independent researchers but by the political census for hire group Ipsos MORI.  The report claims that
"For the first time in the UK, this study ranks what most influences young people’s drinking behaviour. It found that the behaviour of friends and family is a strong influential factor in determining a young person’s relationship with alcohol.... and are stronger influences than some other factors – such as individual well-being, celebrity figures and the media".
This would be valuable information if the report had evidence for this comparison, but it doesn't.   The study asked 5,700 teenagers to self-complete a survey which records their drinking habits, but doesn't attempt to assess or survey the effects of advertising and media.  It has many interesting findings - 'the odds of a teenager having ever had an alcoholic drink are greater if their parents allow their child to watch 18-rated films unsupervised...or if they have seen their parents drunk'.  Useful to know, but there is a slight of hand in concluding that the blame for our drinking culture must therefore fall solely on parents, and away from alcohol marketing and advertising. The report itself, effectively in an aside, acknowledges the power of marketing.
Young people are likely to say that adverts make alcohol look appealing and will encourage people to drink (Ipsos MORI, 2007). A review of seven international studies (Smith and Foxcroft, 2007) demonstrated an association between exposure to alcohol advertising and marketing and drinking behaviour in young people. Young people are influenced by television and magazine commercials, films, music videos and celebrities who explicitly or implicitly convey positive associations with alcohol (Christenson, et al., 2000; Roberts, et al., 1999, 2002).et al., 2000; Roberts, et al., 1999, 2002).
Having got that off their chest though, the surveyors ignore the whole issue of advertising and sponsorship until it comes to boldly making 'policy' recommendations.  Much like the Ipsos MORI report in 2007 which, against the findings of its own very loaded poll, claimed that there was 'no clear support for minmum pricing of alcohol in Scotland', the new report has no modesty about making strong recommendations not remotely supported by the survey itself.  Unlike the specific and tentative recommendations usual in research, this report confidently advises that 'there appears to be little benefit at this point in time in policy aiming to prevent young people from trying alcohol or encouraging an alcohol-free childhood'. Excuse me? Instead, it continues, policy should only target and 'set clear messages to parents, local policy-makers and front line services. National policy must focus on the strongest predictors that can be influenced - parental influence".  No minimum pricing, no regulation, no legislation.

So a study which has found that far too many teenagers drink far too much is letting the government and the alcohol industry completely off the hook.  In opposition to evidence-based recommendations worldwide from Alcohol Concern up to the World Health Organisation, the report  fails to recommend curbing sales, price, marketing or even drinking itself in favour of a few wise words to parents.  If you didn't know better, you might think it was written by the alcohol industry itself.

Demos shares the credits

No need to ask the same question of a remarkably similar study by the Demos think-tank 'focused on power and politics'. Publishing their report in August 2011 Demos trumpets unequivocally that 'poor parenting increases likelihood of binge drinking at ages 16 and 34'.  More than that, this study 'shows parenting style is one of the most important and statistically reliable influences on whether a child will drink responsibly in adolescence and adulthood'.  And policy implications?  “While levels of binge drinking have fallen for five years running, there is a minority of extreme, publically visible, drinkers. No matter how high minimum pricing on alcohol is, there will be a hardcore of binge drinkers who will find a way to pay for it'.   So again, no need for governments to act.  Its the parents and its the hardcore drinkers at fault, and nothing we can do about it.  No, what we should look to are “very practical measures like spreading the school summer holiday throughout the year which will go some way to preventing boredom and avoiding risky behaviour like under-age drinking.”

For goodness sake.

Two things undermine this very famiilar sounding report. Firstly the reliability of the data.  Demos claims to have reached its conclusion by categorising the families of 15,000 children into good and bad parents. How exactly, by looking through the window?  Not really. Actually they 'ran logistical regressions' on data from the 1970 British Cohort Study'.  No explanation of how.  Not what you might call good science.

And secondly, who actually paid for this logistical regression analysis of 40 year old data?  Step forward SABMiller.  'We're one of the world's leading brewers, operating across six continents, making a difference through beer'. 

I rest my case.

Wednesday, 14 September 2011

Booz in the Nooz

Live footage from Ireland's First Alcohol Free Comedy Club

'Ireland's First Alternative Alcohol Free Comedy Club was full to the rafters and a roaring success!' tweeted Dil Wickremasinghe, founder of Dublin's new club.  We had 'great acts, great audience & a great venue, plus a full house'.  Hosting Ireland's first alternative alcohol-free comedy club, Accents Lounge Dublin offered 'the most fun you can have with your clothes on' at the opening night, Monday 5th September.

As Dil writes about the new club, 'In addition to being Ireland’s first alcohol-free comedy club we hope to showcase the true diversity of new talent that often does not feature on the main stages. So not only are we going to help change the Irish drink culture but we are also going to break down barriers through humour – which incidentally was the reason why I got into comedy in the first place!"

The opening night featured comedian Steve Cummins, who has performed in every major venue throughout Ireland and at the Edinburgh festival.  He is also a regular contributor to Hot Press magazine and other publications.  Prior to turning professional, Steve worked with the homeless, juvenile offenders and adolescent gang members from the Projects in Chicago.  Be warned, 'some of what he says is contentious, some offensive but it’s nearly always funny. Except when he’s trying to be sexy. Then it’s borderline creepy'. 

Dil also blogs about the serious side of alcohol, a drug which has burrowed deep into the Irish culture.  'As a new comer to Ireland I wanted to learn about Irish culture but little did I know I had to learn about Irish drink culture as well! During the promotion of the gig we have come across polar opposite opinions about the concept of an alcohol-free comedy club. Some actually think it’s completely preposterous and will not work as I was told by one individual “this is Ireland, we need our drink to have a good time”.  Fortunately the many established alcohol free pubs, clubs and night -clubs of Dublin have already show that's not the case.

Back to the comedy.  The club meets on the first Monday of each month, and the second night is set for Monday 3rd October at 7.00 pm at  Accents Lounge at 23 Stephen Street Lower Dublin 2.  The first night 'even had people sitting on the floor' so 'be early or you might be disappointed'.


Thursday, 1 September 2011

Fetal Alcohol Spectrum Disorders: UK & Ireland's 'hidden disability'

Ireland and the UK are facing a major crisis with Fetal Alcohol Spectrum Disorders (FASD), a crisis fuelled by high rates of  drinking by mothers and a poor response by government.  To coincide with FASD Awareness Day on September 9th, a special conference on 'protecting the unborn baby from alcohol' takes place in the European Parliament.  As the organisers say, 'throughout pregnancy, even at low levels of exposure, alcohol interferes with the normal development and can seriously damage the unborn child.  Case studies across Europe show there are a substantial number of women who continue to drink during pregnancy, it ranges from 25% in Spain to 35%-50% in the Netherlands and even higher rates in the UK or Ireland at 79%'.

The more commonly known Fetal Alcohol Syndrome is a growing problem worldwide, affecting between 1 and 4 births per thousand.  But Fetal Alcohol Spectrum Disorders covers a wider range of problems associated with drinking during pregnancy.  Evidence Based Mental Health estimates that in Europe between 2–4% of all live births are affected.  'The majority of these children are described as having an alcohol-related neurodevelopmental disorder (ARND), manifesting in terms of problems with overactivity, inattention, behaviour or learning'.  The problems caused to babies and children by drinking during pregnancy are the leading known cause of intellectual learning disabilities. Not only are there physical signs and growth problems, but as FASD Ireland notes, there are 'central nervous system abnormalities such as poor fine motor skills, poor eye-hand coordination; hearing loss which is not related to injury or illness and poor gait when walking'. Alcohol Action Ireland also warns that 'more than three drinks a day increases the risk of miscarriage, 12 drinks a week increases the risk of premature birth and sudden high levels of drinking damage the developing brain'. 

The effects are long term and far reaching. The University of Pittsburgh 2010 study followed 592 people up to the age of sixteen. They found 'a range of behavioural problems' amongst those born to 'mothers who had at least one drink per day in the first trimester of pregnancy', and nearly '60 percent of the male affected patients' were found to have 'conduct disorder as adolescents'.  The narrow definition of FASD is clearly inadequate to describe the full scale of potential problems caused to infants by alcohol intake during pregnancy.

Counting the cost

Ireland is at crisis point with the problem.  As Fiona Gartland wrote in the Irish Times this week 'In a study in Dublin’s Coombe Hospital published in 2006, 82 per cent of women continued drinking while pregnant – almost eight times as many as women in the US, where FASDs are notifiable and drinks carry a warning label'.  This was confirmed in a British Journal of Midwifery study in 2009 which found that 'women in Ireland drink the most alcohol in pregnancy', and the government's own 2009 study which found that 26% of educated Irish women continued drinking while pregnant. Given that more women now drink in Ireland than ever before, with four in ten drinking to harmful levels and an increase of 29% in the proportion of Irish teenage girls hospitalised for alcohol related conditions, the problem of FASD must be reaching epidemic proportions.

Currently, according to Inclusion Ireland,  there are 'just under 27,000 people with intellectual disability registered on the National Intellectual Disability Database in Ireland. That is a prevalence rate of 7.38 per 1,000 of the total population'.  Of course there is no suggestion that these figures relate to FASD alone, but given the potential rise in FASD, is the total number of children with diabilites now set to rise?  And how is the country to cope given that 7,000,000 Euro in cuts to social welfare are expected in 2011 on top of the 6,000,000 Euro already cut in 2010?  To do the sums, the 2008 general survey revealed that Ireland has the highest birth rate in Europe with an average of 6.000 babies born every month.   If four out of ten women are drinking to excess, and 80% of those are still drinking during pregnancy, then potentially the well being of 1,920 babies per month is threatened. 

Government doesn't know

Astoundingly though, thanks to government policy, we don't actually know what the FASD figures for Ireland are.  Like many problems the government chooses to avoid rather than deal with, the issue is buried by a failure to register it.  Asked in the Dail this May about FASD, Dr. James Reilly Minister for Health confessed that
'although FAS is a specific diagnosis...only infectious diseases are notifiable under ...legislation. Therefore Foetal Alcohol Spectrum Disorder (FASD) does not fall within the scope of this legislation. There is no National Register for Foetal Alcohol Spectrum Disorder (FASD). Therefore, the numbers of cases of Foetal Alcohol Syndrome (FAS), Foetal Alcohol Spectrum Disorder (FASD) and Alcohol Related Neurodevelopmental Disorder (ARND) in Ireland are unknown'.

You would think this a matter for shame, or at least for a change in the legislation, but the Minister ducked out with the crumb that the Coombe Women’s Hospital, partnered by the HSE, is 'running a project' on FASD. Although a welcome move, the Coombe study has so far failed to identify many cases of FASD for two obvious reasons.  Firstly it relied on self reporting to assess drinking levels, and so 'only 2 in 1,000 admitted to be heavy drinkers'.  Secondly the babies were only studied for the few days or hours that they were in the hospital. As researcher Deirdre Murphy concedes, 'it is likely that some of the women were underestimating (or under reporting) the amount they drank. In general, fetal alcohol syndrome occurred less frequently than expected in this study, suggesting that it is either not recognized by medical staff, or only becomes apparent after the mother and baby have left the hospital'.  The Coombe project is clearly not even going to scratch the surface of the problem.

In the UK 'we are doing nothing'

The situation in Ireland's drinking neighbour the UK is similar. As the Guardian reported last year 'FASD have so far failed to register on the government's radar, suggesting a pressing need for more integrated working between health and social care. Dr Mary Mather, medical adviser to Tact's foetally affected children's service, says: "Here we are doing nothing, and we suspect we have a bigger problem than other countries because we have one of the highest rates of teenage pregnancy and binge drinking in Europe."

So, abandoned by politicians we must turn to the medical experts.  Dr Kieran O’Malley, consultant psychiatrist at Our Lady’s Hospital for Sick Children in Crumlin is an expert, having worked in the US and Canada and opened the first foetal alcohol clinic in Ireland in 2009. Speaking to the Irish Times he said that
'Because FASDs are not notifiable, there are problems with how cases are processed. The condition is hidden under a complex of ADHD and autistic spectrum or Asperger’s disorder to get services. Officially, there are no cases of FASDs in Ireland because they are not notifiable; it is a classic hidden disability. It seems we are 20 years behind North America with FASDs in Ireland, not dissimilar to how we dealt with child abuse. It is a socio-cultural issue. If a foetus is exposed to alcohol, it chemically increases its craving. I have seen six and seven year olds who steal cough medicines because they can smell it. They go to it like bees to honey"

FASD Ireland calls for action

Michele Savage, founder of support organisation FASD Ireland, also wants to see the disorders become notifiable.  Quoted in The Irish Times she says “If you don’t have the statistics, you don’t have epidemiology, and if you don’t have that, you don’t have services.  This is not about policing women’s pregnancy, but we wish women knew that if they are pregnant, alcohol won’t help their baby.”

No services, no plans

Legislation and services aside, even the simple policy of putting health warnings on bottles seems beyond the two governments at the moment.  It is effective.  As Ms. Savage says, 'since 1989, the US has had warning labels on alcohol and there has been a huge drop in alcohol consumption by pregnant women to 10-12 per cent'. The Irish drinks industry is apparently ready and willing to act according to drinks industry ireland.  Quoting the Acting Director of the Alcohol Beverage Federation of Ireland (ABFI), Kathryn D’Arcy it reports that  'the drinks industry had agreed this measure with the previous Government almost four years ago'.  However 'work on the legislative proposals is on hold at present to await the recommendations of the National Substance Misuse Strategy (NSMS) Steering Group'. 

Admittedly it must be hard to report on a problem that the government has decided does not exist.  There may not be much hope though, even if the labels are agreed. A voluntary code in the UK supervised by the alcohol industry's 'responsibility' wing the Portman Group aimed to put  'don't drink if you are pregnant' warning labels on all bottles and cans. It had the agreement of the industry, but after three years they had turned in what an independent assessment rated as only a 15% compliance.  Alcohol Concern's assessement of the same issue was an even more dismal 4%.  As David Norris recently said, quoting from Samuel Beckett, 'Ever failed. No matter. Try again. Fail again. Fail better'. The UK government have given the Portman Group a further two years to do just that.  The second attempt at labelling has until 2013 before the issue of a failure of self-regulation can be discussed.

Until then, with no sign of a government response, no official access to treatment and diminishing resources, Dr Malley's advice must stand. 'The truth is there are no safe amounts of alcohol in pregnancy'.


Link here for further info and research on FASD


Wednesday, 17 August 2011

America redefines alcohol addiction, Ireland redefines denial

Ireland has a lot to teach the world about alcohol, but perhaps not in the way it thinks. Having consulted 80 experts over four years The American Society of Addiction Medicine has published a new definition of addiction.  It confirms what, as the Los Angeles Times puts it, 'neuroscientists have been saying for years- that addiction is a chronic disease of the brain. There are stacks of studies to back up the chronic-disease theory – changes in brain circuitry, changes in the way that genes in the brain are turned on or turned off ...even after a person has given up a habit'. The new definition acknowledges the behavioral aspects of addiction, but concludes that “addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry”.  In other words addiction is not a matter of predisposition but is a condition caused by the consumption of addictive substances.

Professor Patricia Casey disagrees

 'But just because something’s widely accepted professionally doesn’t mean it’s widely accepted out there in the world', the Los Angeles Times continues. Sure enough in Ireland, the new home of alcoholism, Professor Patricia Casey is reported in the The Irish Examiner proving just that.  She tells us that the new definition is an "over-simplification" of the problem'. "By speaking of addiction as simply a brain illness we are in danger of being over-simplistic and of removing choice from our understanding," said Prof. Casey.  "It is important that those who are addicted accept that they have a choice and realise that, unlike certain mental illnesses, such as schizophrenia, their behaviour is not in the first instance determined by the neurochemistry," she said.

The personal choice argument suits Prof Casey's views but doesn't answer the facts.  Prof. Casey was criticised for over-extrapolating facts before, but in this instance she seems to be ignoring the research in favour of a message also spun widely by the alcohol industry.  As David Poley of the Portman Trust puts it, 'it is only through education, coupled with targeted interventions against misusers, that we shall ultimately change the drinking culture'. Or as drinkaware advise 'a predisposition towards alcohol can be inherited, or shaped by family attitudes ... occupations, such as high pressure sales jobs or ...people living through stressful events... may find they start to drink more heavily'.  In other words,  the industry want us to believe that the problem with addiction lies not in the substance but in the user.  Alcohol, they imply,  is not really an addictive substance at all, and the 'misusers' who let the side down for the safe-drinking majority are weak minded, emotionally damaged or just having a hard time. 

So are people cured of addiction, as Professor Casey is arguing, because they can choose to be unaddicted?  Or are they, as the new American Society definition says, struggling with an 'addiction characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response'?  Science, when not sponsored by the alcohol industry itself, supports the latter view.  Alcohol addiction 'at its core' says leading expert Professsor Nutt, is a 'state of altered brain function that leads to fundamental changes in behavior that are manifest by repeated use of alcohol'. Over time cravings and behaviours over-ride common sense until 'the situation is compounded by the occurrence of withdrawal reactions which motivate desperate attempts to find more of the addictive agent'.

Ireland itself now offers proof that it is wide availability coupled with a general acceptance of the over-consumption of alcohol that primarily drives addiction in society.  The government took the advice of the alcohol industry to heart in 1992 when it began a process of deregulation of sales and marketing restrictions and fell for the charms of 'self-regulation' lobbied for by a strong alcohol producing and publican's sector.  Since then alcohol consumption and alcoholism have rocketed.  In 2007 a European report found that while 19% of Germans, for example, drank too much 36% of Irish people binge every week and 72 % abuse alcohol on a regular basis.  And this year a European police study found that while on average one in fifty drivers across Europe are drunk, Ireland boasts on in eight. Or to take other figures from Europa, abstainers represented 39% of the Irish population in 1992, 17% in 1998 and 16% in 2002, and by 2007 only 11% had not actually binged during the last year.

So does Professor Casey think that this is explained by a collective 'choice' to drink more alcohol by more of the population?  During this time many socal changes have taken place, but nothing in Ireland's history seems to explain our unique and rampant alcoholism more than this deregulation which mirrors Ireland's other world class disaster, the deregulation of the banking sector over the same period.  It looks very much as if  the long term result of unregulated advertising, marketing and availability of alcohol has resulted in widespreaad addiction.  As the new definition puts it 'early exposure to substance use is another significant factor in the development of addiction'. Yes, Ireland has certainly managed that.

Wednesday, 3 August 2011

One in eight drivers in Ireland are drunk. Are the roads safe?

Superficially it seemed like a good year for road safety in Ireland.   The recession and emigration meant that traffic, and therefore road accidents, were down last year by 48% from ten years ago, (though up again in the first half of this year).  New legislation is set to enforce a lower drink drive level at 50mg, down from 80mg, to comply with European recommendations, and random breath tests are also to be implemented, which are known to reduce incidents of drink driving. 

But dig deeper and the story is not good.  There is little evidence that the legislative changes will be enforced.  There is neither the money nor the will to increase garda numbers or to supply gardai with the breath testing equipment that will make the changes possible.  Drink driving is responsible for one in three road accidents, but according to Alcohol Action Ireland 'nine out of ten drivers who survived crashes where someone died were not tested for alcohol while more than a third of drivers killed in crashes were not tested.' 

Even amongst the few drivers actually tested, conviction rates are poor.  As reported last August in the Sunday Independent 'almost one-in-five people arrested and charged with drink driving were not convicted'.  The Cavan/Monaghan district and Waterford city had the lowest conviction rates at 75 per cent, and Donegal, 'regarded as having one of the worst road safety records in the country, also had one of the lowest conviction rates, with only 79 per cent of those charged with drink driving being convicted'.  Of those actually sentenced, only 679 received prison sentences compared with 9,275 being fined or 112 given a community service order.  Amongst those apparently drink-driving were a TD who threatened a Garda for stopping him leaving the Dail, the wife of the current Minister for Justice and the Superintendent in charge of  the Garda Traffic Division who was driving a police car at the time.  Justice was swift and tough.  No action was taken for the TD, the politicians wife was fined and 'the Garda traffic superintendent 'suddenly retired' after his arrest and 'will get a 'golden handshake' of over €138,000 and a pension of more than €46,000 for the rest of his life'.

Seven times the European average for drink driving
The new legislation will actually make penalties much lighter for most drink drivers. 'Drivers caught with between 50mg and 80mg will receive a €200 fine and three penalty points if they do not challenge the penalties in court.  This is the first time in Irish history that a drink-driving conviction will not result in an automatic driving disqualification'.  So with little chance of being caught and a flat €200 fine with no questions asked if you are, it is not surprising to find Susan Grey, spokesperson for road safety group Public Against Road Carnage, saying that 'Ireland is still ambivalent about drink driving. "The drink-driving culture is still here and will remain here until people see a higher enforcement of the law.  We're seeing less and less checkpoints on the road and as well as that people aren't scared of getting caught."

With consequences like these, no wonder that Tispol, the European Police Traffic Network, found shocking evidence in its Europe wide check on drink driving, which saw police conduct 'almost one million breath tests in a seven-day period across 28 countries, of which more than 17,000 were positive'.  Having failed to supply figures for the previous Tispol survey, this time Ireland disgracefully and spectacularly topped the poll.  As reported in The Irish Examiner  'the rate of detection in Ireland for drink-driving was the highest among the states surveyed and more than seven times the European average. More than 13% of motorists tested here during the operation were above the legal drink-driving limit compared to the European average of just under 2%'.  Ireland also had the highest drug-driving rate at three times the European average, with 0.6% of drivers stopped showing positive.

Road safety experts blame 'a core group', and granny
What is equally alarming is the attitude of the Road Safety Authority whose chief executive Noel Brett told the Examiner that he was concerned about 'the high detection rates, particularly given that the drink-driving limit in Ireland is higher than most other EU countries'.  The Irish limit was in fact raised only recently to meet the European norm last year, but has not yet been enforced.  It is not the 'detection rate' that is worrying, it is the drink driving itself.  The detection rate, outside of this special TISPOL operation, is clearly not good and with one in eight drivers now drunk at the wheel word has clearly got round amongst drivers that there is very little chance of prosecution.

Nevertheless Mr Brett thinks that there is just "a core group of motorists who habitually persist in driving after consuming large quantities of alcohol".  How does he know? Are they all personally know to him?  Or is it because he knows that the courts are routinely letting convicted drivers back behind the wheel for another go?  His point seems to be that the hard drinkers are spoiling it for the rest who just like to offend occasionally.  Which fits with the views of a number of TD's who routinely pop up to defend the rural pub, or coroners like Dr Denis McCauley of Donegal, home of unsafe motoring, who argued 'that lowering the limits "would have a very negative affect on social interaction in rural Ireland", and called for further studies and consultation before enacting the measures'.

In fact the RSA itself seems determined to be kind to ordinary, decent drink-drivers. At a TISPOL road safety event hosted in Dublin in October the RSA claimed that the problem is not really the drinkers after all.  It is the 'largely undetected' number of drivers in Ireland with drugs in their system.  These, the RSA says, are 'now almost as big a problem as those engaged in dangerous drink driving'.  And this view was echoed by T.D.'s who raised the issue of drug-driving repeatedly in the Daíl debate on road safety in May, managing to mention drug-driving 65 times, as many times as drink-driving was raised during the same debate.  But despite expert witness Professor Denis Cusack of the Medical Bureau of Road Safety's colourful description of 'the 19-year-old out of his head on speed or doped up granny on medications', it is hard to see how the 0.6 % of drivers on drugs equals the 13% on drink.  Drink-driving is twenty times the problem.  I'll take my chances with granny. 

However, in the interests of fairness, these doped up senior citizens were apparently treated nicely by the authorities too. 'Of 1,500 people tested positive for drug driving last year – just 831 were prosecuted'.  So that's alright then.