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Alcohol Awareness Fraser Hoggan, Stephen Hounsom

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Title: Alcohol Awareness Fraser Hoggan, Stephen Hounsom


1
Alcohol Awareness Fraser Hoggan, Stephen
Hounsom Neil Strachan May 2007
2
Aim of Session
  • To raise awareness of the Health Social
    Implications of alcohol use and types of harm
    associated with alcohol

3
Objectives
  • Discuss cultural relationship with alcohol
  • Explore the effects of alcohol
  • Explore the harms caused by varying nature of
    alcohol use
  • Identify harmful drinking patterns
  • Increase awareness of sensible drinking messages

4
Accepted part of our culture?
  • Weve been brewing alcohol since before the
    Romans arrived
  • Alcohol is deeply rooted in our culture and
    national identity
  • Used to celebrate, commiserate ....
  • Most people who drink alcohol do so without
    experiencing serious problems
  • Binge drinking and drunkenness have become much
    more common over the last decade particularly
    among young people

5
Accepted part of our culture?
  • In 2006, Scottish Exec research showed that
  • 1 in 5 Scots lie to avoid drinking
  • 1 in 3 Scots drinking more than they want
  • 1 in 2 young Scots have no idea how much they
    drink
  • Evidence would suggest that Scots are more
    concerned about how they are perceived by their
    peers, than they are by the effects of excessive
    alcohol intake.

6
Alcohol is it a problem?
  • Health
  • Alcohol related liver disease has increased 100
    in the last 10 years.
  • Emergency admission rates for people with primary
    secondary diagnoses of acute intoxication and
    harmful use (associated with binge drinking)
    shows admission rates for Grampian are
    significantly higher than rest of Scotland.
  • Other health harm can be related to risk-taking
    behaviours, for example unprotected sex,
    transmission of STI and unwanted pregnancy

7
Alcohol is it a problem?
  • Alcohol Related Deaths
  • In 2004 Grampian had 107 alcohol related deaths
    (from 2052 reported in Scotland).
  • There has been a 21 rise in such deaths in
    Scotland in only FIVE years.
  • In 1990 alcohol related deaths accounted for 1 in
    100 deaths in Scotland. In less than 10 years
    this had risen to 1 in 40.
  • It is accepted that such figures are often
    incomplete given miscoding of deaths or lack of
    recognition of alcohol as a contributing factor.

8
Alcohol - Social harm
  • In Scotland the economic cost of alcohol related
    harm was estimated at over 1.1 billion in
    2002/03
  • Personal - impact on relationships,
    employability, confidence, finances
  • Alcohol is a contributory factor in
  • 40 of violent crimes
  • 39 of deaths in fires
  • 15 of drownings
  • 17 of road traffic deaths

9
Alcohol -short term physical effects
  • Nausea and vomiting
  • Slowed heart rate
  • Coma
  • Death
  • Uncoordinated muscle movements
  • Slurred speech
  • Drowsy/sleepy
  • Increased sexual arousal
  • Decreased sexual performance
  • Sensory impairment
  • Headache
  • Sweating

10
Alcohol - long term physical effects
  • Brain shrinkage
  • Oesophageal varicies
  • Liver damage hepatitis, cirrhosis
  • Skin dehydration
  • Impotence
  • Reduced kidney function
  • Cancers breast, throat, mouth, stomach, colon
  • Pancreatitis

11
Long term physical effects (continued)
  • Fatty deposits on the heart
  • Gastritis, stomach ulcers
  • Inflammation of intestines, reduced ability to
    absorb nutrients
  • Peripheral neuropathy
  • Foetal Alcohol Syndrome (FAS)
  • Alcohol Related Brain Damage (ARBD)
  • Physical dependency
  • Alcohol tolerance

12
Alcohol - mental/emotional effects
  • Short term
  • Lower reasoning ability
  • Exaggerated state of emotions
  • False self confidence
  • Long term
  • Depression
  • Anxiety
  • Phobias
  • Paranoia
  • Psychological dependency
  • Suicidal thoughts

13
Harmful drinking patterns
  • Chronic drinking drinking large amounts of
    alcohol regularly, often associated with alcohol
    dependence
  • Binge drinking drinking excessive amounts of
    alcohol in a short period of time with the
    specific objective of getting drunk. Some may do
    this regularly or it may be occasional

14
Alcohol dependence
  • Drinking begins to take priority over other
    activities. Becomes a compulsion
  • Tolerance develops, it takes more alcohol to
    produce drunkenness
  • Withdrawal symptoms such as anxiety, tremor
    develop and are reduced by taking more alcohol.
  • Often undetected for years may be masked by
    availability and acceptability
  • May be a genetic component alcohol dependence
    clusters in some families, but its hard to be
    certain this is not learned behaviour

15
Delirium tremens (DTs)
  • Caused by cessation or reduction in alcohol
    intake
  • Usually where prolonged heavy drinking has been a
    feature
  • Effects include, fast heart rate, sweats, high
    blood pressure, marked tremor, vivid
    hallucinations and agitated behaviour
  • Can lead to seizures
  • Can be fatal if untreated

16
Korsakoffs syndrome
  • Caused by lack of Vitamin B1 (Thiamine) which
    affects brain nervous system
  • Alcohol use is often cause of this deficiency
    poor diet in heavy drinkers over longer term.
    Alcohol also affects how well body absorbs key
    vitamins
  • Brain damage can occur if untreated (with Vit B1)
  • Results in severe short term memory loss,
    difficulty acquiring new skills, lack of insight
    into condition, talkative and repetitive
    behaviour
  • Younger cases now being reported

17
How can people get help?
  • Prescribing Antabuse, Acamprosate, Naltrexone
  • Talking based treatments Cognitive Behavioural
    Therapy (CBT), Motivational Interviewing,
    Counselling
  • Range of voluntary and statutory services

18
Confusion about units....
  • Advice has been conflicting
  • Awareness of units concept
  • Interest in units concept
  • In 2006 a Student Survey in Edinburgh concluded
    that only 2 of females and 4 of males
    understood the unit concept.
  • 9 out of 10 did not use units to calculate
    alcohol intake

19
Sensible Drinking Guidelines
  • Women - up to 2-3 units of alcohol a day, not
    exceeding a total of 14 units per week with at
    least 2 alcohol free days per week
  • Men - up to 3-4 units of alcohol a day, not
    exceeding a total of 21 units per week with at
    least 2 alcohol free days per week
  • Young people theres no safe limit for young
    people
  • Takes 1 hour for the body to process 1 unit of
    Alcohol

The emphasis is now on daily units to discourage
heavy binge or weekend drinking
20
How much is too much?
  • Large glass wine (250 ml) at 13 ABV 3 units
  • Average glass wine (175 ml) at 13 ABV 2.3
    units
  • Lager/beer (440 ml can) at 3.5 ABV 1.5 units
  • Lager/beer (440 ml can) at 5 ABV 2.2 units
  • Pint of strong lager (5 ABV) 2.8 units
  • 25 ml measure of spirit (e.g. gin, vodka etc.)
    1 unit
  • 330ml bottle of beer/lager/alcopop at 5 ABV
    1.7 units

21
Alcohol pregnancy - new recommendations from
CMO
  • Avoid alcohol if pregnant or trying to conceive

22
Foetal Alcohol Syndrome (FAS) Foetal Alcohol
Spectrum Disorder (FASD)
  • FAS
  • Characteristic minor abnormalities of the face
  • Growth restriction pre post natal
  • Neurodevelopmental problems
  • Maternal alcohol consumption has been high
  • FASD
  • Studies have shown that elements may be present
    where maternal alcohol consumption has been more
    moderate
  • 1 of 3 FAS features may be present, thought to
    most commonly be neurodevelopmental problems

23
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24
ABV Unit labelling
25
Responsible drinking tips
  • Remember - It is fine not to drink alcohol.
    5-10 of the population choose not to drink
    alcohol
  • Drink water or soft drinks between alcoholic
    drinks
  • Eat before or during drinking
  • Drink tall mixers avoid neat spirits
  • Drink purer drinks. Clearer drinks have less
    congeners
  • Pace yourself, be wary of getting involved in
    rounds
  • Keep an eye on the strength and volumes of drinks
  • Home measures are often larger than pub measures
  • Drink plenty of water before going to bed
  • Plan your night out, think about how you will get
    home etc.
  • Look after your friends, if their in a bad way
    help them out

26
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27
Source of further information
  • www.infoscotland.com/alcohol

28
Thank You
  • fraser.hoggan_at_nhs.net
  • neil.strachan_at_nhs.net
  • Stephen.hounsom_at_moray.gov.uk

29
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