Title: Alcohol Awareness Fraser Hoggan, Stephen Hounsom
1Alcohol Awareness Fraser Hoggan, Stephen
Hounsom Neil Strachan May 2007
2Aim of Session
- To raise awareness of the Health Social
Implications of alcohol use and types of harm
associated with alcohol
3Objectives
- 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
4Accepted 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
5Accepted 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.
6Alcohol 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
7Alcohol 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.
8Alcohol - 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
9Alcohol -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
10Alcohol - 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
11Long 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
12Alcohol - 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
13Harmful 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
14Alcohol 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
15Delirium 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
16Korsakoffs 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
17How can people get help?
- Prescribing Antabuse, Acamprosate, Naltrexone
- Talking based treatments Cognitive Behavioural
Therapy (CBT), Motivational Interviewing,
Counselling - Range of voluntary and statutory services
18Confusion 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
19Sensible 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
20How 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
21Alcohol pregnancy - new recommendations from
CMO
- Avoid alcohol if pregnant or trying to conceive
22Foetal 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
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24ABV Unit labelling
25Responsible 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
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27Source of further information
- www.infoscotland.com/alcohol
28Thank You
- fraser.hoggan_at_nhs.net
- neil.strachan_at_nhs.net
- Stephen.hounsom_at_moray.gov.uk
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