Middle class over 45-year-olds now the most frequent drinkers

The middle class people over the age of 45 are now the most frequent drinkers in England, new NHS figures show.

The findings add to growing concern over middle class drinkers and the damage their habits are doing to their bodies.

Earlier this year a report by the National Audit Office, the Government watchdog, warned that 10 million Britons were now drinking to "hazardous" levels.

A survey conducted by the NHS Information Centre shows that 30 per cent of men and 19 per cent of women in the highest earning bracket admitted that they had drunk alcohol five nights or more in the previous week, twice as much as in the lowest wage bracket.

The middle aged were also much more likely than young people or thirtysomethings to drink frequently.

The highest rate was among men aged 55 to 64, 33 per cent of whom said that they had drunk five or more days out of the last seven.

Among women, 19 per cent of 65 to 74-year-olds admitted that they drank that often.

By contrast just 12 per cent of male and 5 per cent of female 16 to 24-year-olds said that they drank that frequently.

And overall 22 per cent of men and 13 per cent of women said that they had gone without alcohol for two days or less in the previous week.

While previous studies have concentrated on younger binge drinkers this is the first to suggest so starkly that middle class over 45-year-olds top the league table for frequent drinking.

The survey also found that levels of obesity have almost doubled in 14 years, from 16 per cent of men and 13 per cent of women in 1993 to 24 per cent of both sexes in 1997.

The breakdown of the figures on alcohol contained in the annual Health Survey for England report also show that almost one third of men and more than one quarter of women admit they drank excessively at least one day in the previous week.

It also discloses that few people know the recommended daily alcohol limits.

Men are advised to drink no more than three to four units a day, the equivalent of two pints of beer, and women two to three glasses of wine, the amount contained in one and a half standard glasses of wine.

Less than a third of people knew their safe limits, the study shows.

The survey also showed that while most knew that they should be eating five portions of fruit and vegetables every day, only 14 per cent of men and 11 per went of women knew how much should be contained in a portion, the survey also found.

Dr Mark Davies, medical director of the NHS Information Centre and a practising GP, said it was of "concern" that messages of safe alcohol intake, as well as those on exercise levels and healthy eating, did not seem to be getting through to all sections of the population.

Andrew Lansley, the shadow health secretary, said: "Labour's neglect over issues like obesity and alcohol abuse will leave a terrible legacy for the next Government to try and fix" and called for urgent action on public health problems.
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source: Telegraph

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Binge Drinking Clogs Arteries With Plaque

The specific pathway through which binge drinking contributes to clogged arteries has been identified by University of Rochester Medical Center researchers.

Alcoholic beverages contain ethanol, which is mostly converted into acetaldehyde. The Rochester team found that binge drinking-related levels of acetaldehyde make immune cells called monocyctes more likely to stick to blood vessel walls and cause inflammation that contributes to blood vessel blockage — atherosclerosis.

The study contributes to a growing body of evidence that drinking patterns have as much, or more, impact on cardiovascular disease risk than the total amount of alcohol consumed. The findings also may help efforts to develop new treatments to counter atherosclerosis, which can lead to heart attack and stroke, the researchers said.

“Factors like binge drinking have been linked to increased risk for heart disease, and the newer inflammatory model is beginning to explain how,” study leader John Cullen, an assistant professor in the department of surgery, said in a medical center news release. “One of our experiments found that acetaldehyde, at levels found in the blood after binge drinking, increased the number of monocytes that can adhere to cells lining blood vessels by 700 percent.”

The study was published in the current issue of the journal Atherosclerosis.

Binge drinking means having five or more drinks for men and four or more drinks for women in two hours, according to the U.S. National Institute on Alcohol Abuse and Alcoholism. Some studies have suggested that an irregular pattern of heavy drinking increases the risk of heart attack about two-fold.

An estimated 65 percent of Americans drink alcohol, and 15 percent reporting binge patterns, the researchers said.
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source: health.com

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Group pursues rules to discourage alcohol abuse

A group that spent 10 months reviewing Wyoming's alcohol laws advocates increasing state alcohol taxes and using the money to fund programs aimed at cutting underage and binge drinking.

The Wyoming Prevention Framework Communities group also recommended to state lawmakers that the state require mandatory training for alcohol servers and ban sales to drunk people.

The group, which is made up of representatives from all 23 Wyoming counties and the Wind River Indian Reservation, released its report Thursday.

Binge and underage drinking are two of the state's top health issues, according to Ernie Johnson, a University of Wyoming criminal justice instructor who managed the review effort.

"We have minimized the concerns for too long," he said.

The report recommends "substantially" increasing the tax on all alcohol products to equal the national average, with top priority going to a beer tax hike. Beer in Wyoming is now taxed at 2 cents a gallon - the lowest in the nation. The national average is 26 cents a gallon.

The group acknowledged that the tax hike is the most controversial recommendation in the report.

"It also has the greatest potential for generating and providing much-needed resources for Wyoming communities," the report states.

In advocating for the higher tax, the report notes that Wyoming's current tax rate hasn't changed since it was set in 1935.

The report recommends creating a system for providing local governments with the tax money in order to address binge and underage drinking. However, there wasn't consensus among the review group on the best way to achieve those ends.

Mike Moser, executive director of the Wyoming State Liquor Association, opposed raising alcohol taxes when he met with the group in May. Doing so would punish responsible drinkers along with people who abuse alcohol, he told the group.

The report suggests mandatory server and owner training as ways to cut down on the sale of alcohol to underage drinkers and people who have already had too much to drink.

Liquor retailers, working with the state's Liquor Distribution Division, already offer a training program on serving alcohol responsibly. However, Wyoming law does not require servers, managers or owners to participate.

The report offered statistics showing that most of the citations and infractions handed out during alcohol stings went to people who hadn't received server training.

The review group also recommended legislation that would ban alcohol sales to drunk people and prohibit drink specials that promote excessive drinking. The report cited research showing such laws can reduce alcohol-related problems, like car crashes, if they are adequately enforced.

Wyoming is one of three states that doesn't have a law prohibiting alcohol sales to drunk people.
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source: Billings Gazette

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Half of Young Adults Have Mental Disorder

Nearly half of young adults may suffer from a mental disorder such as alcohol abuse, depression and anxiety, and nearly one in five suffer from a serious personality disorder.

But according to new research published yesterday, fewer than a quarter of those young adults who do have mental concerns seek treatment for them.

And to check on whether such mental health concerns
might be triggered by attending college or not, the researchers compared those attending and not attending college and found similar rates of psychiatric illnesses among the two groups. This suggests that the transition from adolescence to adulthood can trigger the onset of a mental health problem regardless of setting.

The researchers analyzed data from over 5,000 young adults aged 19 to 25 years old from the
National Epidemiologic Survey on Alcohol and Related Conditions. Carlos Blanco, M.D., Ph.D., of the New York State Psychiatric Institute and Columbia University, and his colleagues analyzed the data to compare the mental health of those enrolled in college at least part-time with those not attending college during the previous year.

The researchers interviewed and assessed for psychiatric disorders those attending (2,188) or not attending (2,904) college during the previous year.

A total of 45.8 percent of college students and 47.7 percent of young adults not in college met the criteria for at least one psychiatric disorder.

The most common disorders in college students
were alcohol use disorders (20.4 percent) and personality disorders (17.7 percent), whereas those not in college most frequently met criteria for personality disorders (21.6 percent) and nicotine dependence (20.7 percent).

College students were less likely to have a diagnosis of drug use disorder, nicotine dependence or bipolar disorder and were less likely to have used tobacco. However, their risk of alcohol use disorders was significantly greater.

Treatment rates were low for all psychiatric disorders. College students were significantly less likely to receive treatment for alcohol or drug use disorders than those not in college.

“In view of the high prevalence and low rate of treatment of alcohol use disorders in college students, greater efforts to implement screening and intervention programs on college and university campuses are warranted,” the authors write. “The centralized delivery of campus student health services might offer an advantageous structure for carrying out such screening and interventions.”

Overall, the authors note, the rate of psychiatric disorders is high among young adults, who are at a vulnerable stage of development.

“The vast majority of disorders in this population can be effectively treated with evidence-based psychosocial and pharmacological approaches,” they conclude.

“Early treatment could reduce the persistence of these disorders and their associated functional impairment, loss of productivity and increased health care costs. As these young people represent our nation’s future, urgent action is needed to increase detection and treatment of psychiatric disorders among college students and their non–college-attending peers.”
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source: Psychcentral.com

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Extended-release naltrexone, treatment for alcohol dependence, improves quality-of-life measures

Most studies examining the impact of alcohol-dependence (AD) treatment on quality-of-life (QOL) have looked at psychosocial treatments. This study looked at the impact of pharmacotherapy on QOL, specifically, the effects of extended-release naltrexone (XR-NTX), a once-a-month injectable formulation for the treatment of AD. Results showed significant improvements in the QOL areas of mental health, social functioning, general health, and physical functioning.

Results will be published in the February 2009 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Alcohol dependence is a chronic and disabling disorder," said Helen M. Pettinati, professor of psychology in the department of psychiatry, and director of the division of treatment research at the University of Pennsylvania School of Medicine. "Heavy drinking is associated with broad impairments in health-related QOL, with the largest impact typically found for mental health and social functioning."

XR-NTX (Vivitrol™) is a once-a-month injectable formulation for AD treatment; its 380 mg dose has been FDA-approved since 2006. Daily oral NTX doses are also available, typically at 50 mg or 100 mg a day.

"If naltrexone is taken orally for 30 days, this translates to a total monthly dose of 1,500 mg or 3,000 mg," explained Pettinati, who is also corresponding author for the study. "When compared to the once-a-month 380 mg injectable dose approved by the FDA and the only dose available clinically, we can see what appears to be a hefty difference in the amount of naltrexone given over a month's period to a single individual when dosed daily versus injection. However, this 'lower' injectable dose does not appear to compromise efficacy, likely due to different and more efficient pharmacokinetic properties in the injectable formulation."

"The important issue is that if you can change people's drinking patterns, then you can also change people's QOL," observed Allen Zweben, professor and associate dean for academic affairs and research in the school of social work at Columbia University. "Pharmacotherapy has never really looked at QOL vis-à-vis drinking behavior, but it would seem that the FDA is interested in learning how people's changes in drinking can have an impact on their QOL. There's an implication that QOL changes naturally, but in this study Dr. Pettinati actually looked at and measured QOL as a factor."

The researchers randomly assigned 624 AD patients (423 males, 201 females) to one of three groups during 24 weeks of treatment – XR-NTX at 380 mg (n=205), XR-NTX at 190 mg (n=210), or placebo (n=209) – in conjunction with a standardized psychosocial intervention. QOL was assessed using the Medical Outcomes Study 36-item short-form health survey, administered at baseline and then at four-week intervals during treatment.

"There were three main findings from this study," said Pettinati. "First, the AD sample showed impairments in QOL at pre-treatment compared with population norms, especially in mental-health and social functioning. Second, the XR-NTX 380 mg group showed meaningful and significant improvements compared to the placebo group in the QOL domains of mental health, social functioning, general health, and physical functioning. Third, reductions in drinking from pre-treatment levels were correlated with improvements in QOL."

"These finding reinforce the notion that treatment of alcoholism, whether it's by medication or psychotherapy, does work," said Zweben. "Medication thus becomes another option available to people. These findings also have implications for the issue of compliance, in that high compliance rates might have something to do with the fact that people improve their drinking as well as their QOL."

It is one thing to believe that treatment reduces drinking and that time abstinent from alcohol can lead to increased QOL improvements, said Pettinati. "It is another to show this connection with new pharmacotherapies as they become available to our AD patients."

"In terms of treatment options," said Zweben, "this study shows that pharmacotherapy may be very cost-effective. You don't necessarily have to have a separate intervention to deal with QOL issues – whether more intensive psychotherapy, or family therapy – you may be able to use one intervention to reduce drinking, and improve QOL. This study also has implications for using medication as an option. A lot of people don't believe medication has any basis in alcohol treatment, that 'alcohol is a chemical already so why are you prescribing more chemicals?' It is almost a bias against medications. These results help to reduce some of the stigma attached to using medication in terms of alcohol treatment."

Zweben noted, however, that these findings need to be replicated in future studies, that the patients examined were seeking treatment –differentiating them from the more general population of AD individuals – and that 35 to 37 percent of the patients did not receive all six injections.
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Source: Alcoholism: Clinical & Experimental Research

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