Archive for the ‘health’ Tag

Alcohol – it’s not a drug, it’s a drink

Wednesday, September 25th, 2013

I have had somewhat of an epiphany recently. In light of my self-questioning around the application of morality to the laws of the land – specifically with reference to drug use – I have started to perceive alcohol differently. Anyone who knows me knows that I am a drinker. I always have been, and so has everyone around me. This is despite losing people to alcohol. And yet we all still drink drink drink like it was going out of fashion.

I still told my clients the dangers of drinking, indeed I knew them myself, and to be fair in recent years I have generally drunk within ‘safe’ limits. But that is far as I ever thought about going – after all, it was safe, so why would I question it any further?

Recently, I have pretty much stopped drinking – because after a spell of drinking very little, I realised that, when I do drink, I feel anxious the next day. Not only on the night itself, but the day after, I misjudge things, and my perception of the world and of myself is altered. This has nothing to do with ‘safety’ – but it definitely has a lot to do with health. If, as I am starting to wonder, alcohol can significantly affect mood the day after use – and bearing in mind that many people drink every night – does this not have huge implications for the mental state of the nation?

Then I saw a news report last week about the proposed ‘drunk tanks’. The idea was that people who were incapable of being responsible for their own welfare because of excessive alcohol consumption would be put into a unit overnight and then charged for the care they received – both to protect people and to reclaim some of the money in revenue spent on policing costs. It seemed like quite a good idea for me. But the man representing the alcohol industry gave me an insight into how much they care about the damage done by alcohol consumption and what they want to do to tackle it – which was, in summary, fuck all. The well-groomed young man in expensive glasses had a seemingly endless list about why no national mandates should be passed – why this was about local services making local decisions. Which, as anyone who works in the public sector knows, means doing nothing. Because everyone is too busy, are all praying to keep their heads above water and their jobs, and are not about to stump up the cash and time to commission and implement something so huge without imperative direction from the very top.

And as I sat there, watching this nicely-spoken young gent, something happened. Before my eyes, he morphed into every heroin and crack dealer I had ever met. His shirt was ironed, his face was clean – but his justifications for the continued sale of his product, his reasonings for why the deaths and the violence and the illnesses were not his fault, made him seem to me no different from the many dealers I have challenged about their choice of product and its impacts. The truth was – he didn’t give a shit about the number of young women getting sexually assaulted. He wasn’t the least bit interested in how much use of his product cost the taxpayer each weekend in policing and health interventions. And he certainly wasn’t willing to do anything about it.

Now, fear not – I am not about to go all evangelical about alcohol use and start praying to a higher power for strength to repel the demon drink. I am still going to have a drink when I feel like it and, likely as not, will drink too much on occasions. I suppose I am just realising, for myself, another layer to my indoctrination on the matter of legal and illegal drugs. Alcohol is not ‘bad’ – just like any other drug – and of course alcohol companies are only interested in taking your money, as per the capitalist mantra, or just like any other drug dealer. But where is the logic that most drugs should be illegal while just one remains legal – and what impact does this have on perceived safety and social acceptability?

My brother recently came back to the UK, and commented after a night out, “God, I’d forgotten how the English drink”. Recent reports indicate that, in fact, much like the truth-dodging representative for the licensing industry, we as a nation also forget how we drink. A report published by Alcohol Concern found that, in 2007-8, for Brits to drink within advised limits, alcohol consumption (excluding that brought into the country duty-free and home-brewed) would need to reduce by a third. The report found that if the alcohol bought in shops was divided between every adult, we would all be consuming twenty-six units a week.

However, an even scarier report published this year in the European Journal of Public Health , found that half the alcohol consumed in England was unaccounted for. (Again, this does not include imported of home-brewed alcohol, so the actual consumption is even higher.) The report exposed the discrepancy between self-reports of alcohol consumption, and alcohol sales. So at least three quarters of the population are estimated to drink above recommended limits – and no-one is admitting to it.

Now the alcohol industry clearly know this. If this wasn’t happening, they wouldn’t be eating caviar on their yachts. And yet, despite the serious health problems associated with drinking at these levels, they continue to push the drug. They continue to fight legislation to minimise the harm it causes. And they continue to put their hands up in objection when anyone suggests maybe they could be partly responsible for this problem and, as such, should maybe put their hands in their ever-deepening pockets and contribute towards reducing some of the damage done by their product. No less ruthless that the dealers who keep selling heroin they know contains congealants, or market their stash of PMA as ecstacy.

It also makes me wonder how much sway the alcohol firms have in the Tories’ drug policies. They bring in billions in revenue – and I am sure they are none-to-happy at the idea of someone muscling in on their market share by selling cannabis or other alternative products. Yet again, I am left questioning how much of our legislation is about the welfare of the population, and how much is about rich people scratching each other’s backs..

Baby wants a double vodka

Saturday, July 20th, 2013

Pregnant women who use methadone are likely to under-report their alcohol and drug use, a piece of research published this month has found. The admittedly small sample of fifty-six opioid-dependent women, prescribed methadone as a substitute for heroin, were found to continue taking illicit drugs and alcohol during their pregnancy, as discovered by testing mothers’ and babies’ urine, and meconium (first stools). The study showed that 91% of women taking part in the study had used illicit drugs – 73% had continued taking opiates, and 70% had used benzodiazepines (which are thought to be linked to birth defects). 47% of the babies had also been exposed to alcohol use at levels of at least 2 units a day or 5 units at once, despite only 5% of the women disclosing this level of alcohol use. The most common combination (drug workers won’t be surprised to hear) was heroin, cannabis and alcohol.

Now this is clearly a highly-contentious area to discuss. On one side of the debate, there are people who acknowledge that women become pregnant for a variety of reasons, not necessarily through choice, and that the lifestyle that comes with heroin addiction may not be the most happy or meaningful existence, or borne from the most stable of upbringings. Once pregnant, drug users typically face extreme feelings of guilt – feelings which they have historically used drugs and alcohol to manage. And then the judgements and processes they are subjected to during pregnancy – safeguarding procedures and meetings, constant monitoring, reports written weekly about them and their parenting capacity, every bad decision they have ever made dragged up and pored over – make pregnancy not a joyful but a very stressful experience.

And then, on the other side of the debate, there are the tabloid readers – and there is so much meat on this bone for them to chew. First of all, of course, all drug users should die. They sacrificed their right to be on this planet the first time they smoked a spliff. Then – it gets worse – they are mothers. Should a woman not cease to exist in her own right the instant she conceives? She is, after all, a vessel. She should be pure and demure and fit all the glowing, maternal images we associate with motherhood. So the lifetime of misery, abuse, ill-treatment and self-deprecation should end the second that sperm hits that egg.

Now, don’t get me wrong, I find it very hard not to judge drug-using mothers-to-be. The unborn child is helpless and dependent on her to meet its every need, and it is heart-wrenching to think that it is disadvantaged before it has even left her womb. I do read the riot-act to these women, making it very clear that they are putting their baby’s welfare at risk, and increasing the chance that, once born, their baby will suffer painful and distressing withdrawal symptoms. What a sad and sorry start to life.

However, one thing is for sure – guilt does not perpetuate healthy behaviour. The fact these women are under-reporting their substance use is a sure sign that they already know all of this. You can bet your bottom dollar that they are beating themselves up more than anyone else ever could. And it is the discrepancy between what is expected of them and what they believe themselves to be capable of that makes burying one’s head in the sand the most realistic option.

I would imagine that most women who have had children would find this research both sickening and saddening. Whilst the idea of doing anything that may put their babies at risk may repulse them, I bet most of them have also felt judged, squeezed by other people’s expectations, desperate not to stand outside the prescriptive maternal mould that is dictated to them. Surely there is no worse judgement than being a bad mother. And not breast-feeding…?!

In the late stages of her pregnancy, I took a good friend of mine out for a drink. She was a single mum with two other kids at home, and she was desperate, for one last time before her baby was born, to just be herself for a night. She hadn’t drunk at all throughout her pregnancy, but on this occasion, I bought her a bottle of Corona, and she savoured it as we sat talking for an hour. We were in Wetherspoon’s – not an establishment known for its distinguished clientele with high moral values – but you should have seen the looks she got that evening. People gathered to bitch and point; judgements were formed, comments were made. At the time, she was drinking within the acceptable limits in pregnancy (guidance has since changed to ‘no alcohol during pregnancy’, although I believe this was mainly due to the fact that people struggle to quantify a unit), and she certainly wasn’t putting her late-stage pregnancy at any risk by her action. But as she sat there, gorgeous and bulbous, trying to enjoy her one night of being a person before months of being a multi-tasking milk machine, she was deemed by the other drinkers gathered that evening as the scourge of the earth.

So I suppose, in conclusion, I just want to say – this piece of research is sad. It is sad for the babies, it is sad for the mothers, it is sad for society. But maybe, maybe, if we saw pregnant women as people first and mothers second, the gap between expectation and reality might not be so great, and the image of the happy, stable, glowing mum-to-be might change into something more achievable for all pregnant women.

Austerity gives it Greek-style

Tuesday, May 21st, 2013

As most, I fear the fate of our beloved NHS under the Shithead Coalition. I have previously suggested that current Government policy (punish the poor for the mistakes of the minted) may well be leaving the door wide open to another heroin epidemic, and we already see the country flooded with novel psychoactive substances such as MCat. Well it seems that the nightmarish repeat of the 80s unravelling before our eyes in Britain is already taking place in Greece.

A new ‘cocaine of the poor’ is sweeping the poverty-stricken country. At €2 a hit, and reportedly a variant of crystal meth, ‘shisha’ sounds likely to me to be MCat by another name. Similarly, it brings aggression, violence, mental health problems, and burns users from the inside out. And as with MCat, it is cheap, easily accessible, and currently has ripe pickings of the desperate poor.

And who can blame people for wanting some escapism. With Greek youth unemployment apparently at 64% and a total of 400,000 families without any income at all (not to mention those who have jobs but aren’t getting paid, or are earning so little that they are unable to sustain their families), it is no surprise that suicides have increased by over 60%. Prostitution and homelessness have also massively increased – and I don’t know about you, but if I was reduced to living a brutal life on the streets, I think I’d prefer to be the nutter than the nutted, battered than the battered. Shisha use could be seen as a strategic line of defence.

In terms of the back-drop to the growing drug problem in Greece, I have been dipping in and out of an amazing blog (a really excellent example of why the Internet and its self-publishing is a wonderful thing) which challenges pretty much everything written in the mainstream media, and uncovers some fairly scary truths about the state of the world and those running it. The author, John Ward, writes about the ‘Troika’ – European Commission, International Monetary Fund, and European Central Bank – crippling Greece’s economy by forcing austerity measures. His comparisons between the Troika’s policies and those of the Fascists during the Second World War are genuinely frightening. John has exposed the corruption within the capitalist structures of Europe, and warns that, as in the past, ‘austerity’ can be a label given to international looting by those in power. And last time round, he says, when the Nazis stole Greek resources as part of ‘German reconstruction costs’, 40,000 Greeks starved to death.

So what does this mean for the Greek people now, and are there lessons we can learn? A new book, as reported in the Guardian this week, looks specifically at the health impact of austerity measures, and brings the tag line “Recessions can hurt, but austerity kills”. Strong words – but they are backed up with hard facts by this Yale, Oxford and Cambridge-educated expert in health economics, David Stuckler, who says that Greece is facing a public health disaster. With a reduction to the health budget of 40%, he quotes the Greek health minister, “These aren’t cuts with a scalpel, they’re cuts with a butcher’s knife”. And the cuts weren’t made under the guidance of the medical profession but by the financially-motivated Troika. They are not even representative of financial requirements being met by other countries, but are in fact much harsher than the cuts being imposed in other areas of Europe. It seems that John Ward’s shocking comparisons may be more accurate than is comfortable to acknowledge – and that the concepts of public health and indeed humanity appear to have been lost in a calculated move for money and power.

And the results for Greek health provision so far? Hospitals without surgical gloves, pharmacies without necessary medication, and seriously diminished resources to support the ever-increasing population of substance users. Stuckler has spoken to drug services in Athens to see how close they are to meeting World Health Organisation guidance that 200 clean needles should be made available for each IV drug user every year – and the current availability per person is 3. No wonder then that cases of HIV have shown a 200% increase (which is probably a conservative estimate given that testing is no doubt harder to access, and will not be helped by the increasingly desperate prostitution trade), and I dread to think of the rates of hepatitis C, venous damage and bacterial infections as people continue to use drugs without access to harm reduction advice and clean equipment.

As Professor Stuckler points out using multiple examples from history, destroying welfare, healthcare and employment programmes is never a positive move for the economy, aside from the human cost. A country that fails to invest in its people has not the strength to recover – very much like a person, there needs to be belief, hope and investment for recovery to take place. And if austerity was a treatment programme being clinically trialled, “It would have been discontinued” says Stuckler. “The evidence of its deadly side-effects – of the profound effects on economic choices on health – is overwhelming”.

So, just to bring it back home.. Cuts to public services: check. Increase in unemployment: check. Money being taken from the poor and disabled to pay for the rich: check. Increase of depression presentations (especially in the north of England where unemployment is highest and suicide is on the rise): check. Easy access to dangerous, damaging new drugs and a bumper opium crop due in from Afghanistan: check. Right then, we’re all set! Addiction is the new black, I’d get taxing the stuff if I were you, David.

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