Event to Commemorate Gordie Bailey & 1,700 Students Who Die Annually as a Result of Alcohol Misuse
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A Report for ASDA
This report aims to assess the recommendations in the Scottish government in their consultation paper: ‘Changing Scotland’s relationship with alcohol: a discussion paper on our strategic approach’, in particular its recommendation to impose a minimum price for alcohol. We study the responsiveness of demand for alcohol to price and how this may vary between different alcohol users. We also consider the distributional consequences of alcohol taxation and regulation and the evidence on the wider influences on alcohol consumption.
The key findings in this report are:
PRICE rises for junk food, cigarettes and alcohol; a ban on tobacco-vending machines, and tax breaks for gym memberships are among recommendations in a Federal Government report that could change the way we live.
Under the radical proposals, alcohol companies would be banned from sponsoring sporting events such as the AFL grand final, legal blood-alcohol concentration levels for drivers would be lowered and movies featuring smoking would be reclassified with a mature (M) rating.
The National Preventative Health Taskforce's inaugural report revealed that almost a third of all illness was caused by "lifestyle" diseases linked to smoking, drinking, poor diet and lack of exercise.
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Single large document:
Australia: the healthiest country by 2020 (PDF 1026 KB)
The same publication in smaller sections:
Spending on mental health (MH) and substance abuse (SA) treatment is expected to double between 2003 and 2014, to $239 billion, and is anticipated to continue falling as a share of all health spending. By 2014, our projections of SA spending show increasing responsibility for state and local governments (45 percent); deteriorating shares financed by private insurance (7 percent); and 42 percent of SA spending going to specialty SA centers. For MH, Medicaid is forecasted to fund an increasingly larger share of treatment costs (27 percent), and prescription medications are expected to capture 30 percent of MH spending by 2014.
Three of Britain's leading experts in alcohol policy and treatments say that strong public policy measures on price and availability of alcohol would be far more successful than clinical treatments or current Government initiatives in reducing alcohol-related harm. In the same way that doctors use evidence-based medicine to treat individual patients, the Government should use the overwhelming evidence we already have to implement stronger public policy measures on alcohol instead of persisting with measures that have little or no evidence of success.
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Baclofen, either alone or in combination with alcohol, produced only modest increases in heart rate and blood pressure and no adverse effects were reported. Baclofen did not increase positive subjective effects (e.g., Stimulant effects, Drug Liking) but did increase sedation and impair performance. Even though both baclofen and alcohol impaired performance, for the most part performance was not impaired to a greater extent when baclofen was combined with alcohol. Among this population of nondependent drinkers, baclofen did not alter alcohol craving or alcohol-induced positive subjective effects.
Baclofen alone has minimal abuse liability in heavy social drinkers, and baclofen is relatively well tolerated and safe when given in combination with intoxicating doses of alcohol.
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|Alcohol misuse in seniors has been studied in clinical samples and in small communities, but relatively few studies are population-based. Objectives are: (1) to describe the characteristics of seniors who score 1 or more on the CAGE (Cut down; Annoyed; Guilty; Eye-opener) questionnaire of alcohol problems; (2) to determine if depressive symptoms are associated with alcohol misuse after accounting for other factors.|
|Cross-sectional study of community-dwelling older people (65+ years) sampled from a representative population registry in Manitoba, Canada. Participants were initially interviewed in 1991-1992 and reinterviewed in 1996-1997. Data from Time 2 were used; 1,028 persons were included in the analyses. Sociodemographic characteristics, the CAGE questionnaire, Activities of Daily Living (ADLs) and instrumental ADLs (IADLs), the Center for Epidemiologic Studies - Depression (CES-D) scale and the Mini-Mental State Examination (MMSE) were assessed by trained interviewers.|
|Males were more likely to score positive on the CAGE questionnaire. After adjusting for gender, age, and education, there was a strong association between depressive symptoms and alcohol misuse. Poor self-rated health and impairments in IADLs were also associated with alcohol misuse.|
|Male gender, depressive symptoms, and poor functional status were associated with alcohol misuse in this population-based study. Attention to depressive symptoms and functional status may be important in the care of seniors with alcohol misuse. Alternatively, physicians should enquire about alcohol use in seniors with functional impairment or depressive symptoms.|
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An analysis carried out by the drinks industry has reported an accelerating decline in alcohol consumption during the first nine months of 2008.
The Drinks Industry Group of Ireland (DIGI) said excise receipts from Revenue showed that alcohol sales in the first nine months of the year were down 9% on the same period last year.Sales are down a whopping 22% in the month of September alone compared to the same time last year. This compares to a fall of 14% in August.
* JOWITT MBONGWE
An extra-ordinary public debate has been unleashed by the policy activism of the current national political leadership towards dealing with the challenges of alcohol abuse in the country.
Many perspectives are being offered with multivalent arguments coloured by economic, health, political, cultural and moral world views. As the debate rages and gains momentum, it is critical that the lessons on both democratic intentions and processes are learned.
Let me state at the outset that it is the responsibility of every accountable Government to seek strategic interventions to solving what cannot simply be brushed aside as matters of personal choice. Alcohol is not simply another economic commodity whose trade should be left to forces of supply and demand in a free market playground, it is destructive and addictive.
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In a desperate effort to win the liquor war, the Office of the President (OP) has reportedly ordered the state media to run stories and programmes emphasising the negative effects of alcohol.
The directive orders the state electronic and print media to depict alcohol as socially unacceptable and destructive to society.
Reliable sources say the anti-alcohol directive was issued this week. Government attempts to introduce a punitive 70 percent levy on the sale of alcohol to control excessive drinking has been hobbled after a strong resistance from brewers and other stakeholders in the industry. Even after the levy was reduced to 30 percent, the government found no respite after a court stopped the introduction of the tax pending the outcome of a case filed by stakeholders.
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9 October, 2008
By James Wilmore
Pressure for the government to act is building, but where will it lead?
In the government’s attempts to tackle the problems around alcohol, one solution has provoked more reaction than most. Minimum pricing.
A significant number of people, inside and outside of Westminster, now believe introducing a minimum price on a unit of alcohol will help curb some of the problems associated with booze.
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They believe Government and industry measures to tackle binge drinking are failing, and that more needs to be done to reduce the toll of alcohol-related deaths.
More people die annually from alcohol-related causes than from breast cancer, cervical cancer and MRSA infection combined.
The deaths of around one in four young men and 10 per cent of young women in Europe are alcohol-related.
Doctors writing in the British Medical Journal publication Gut say that tough measures such as increasing the cost of alcohol, banning advertising and reducing its availability will work.
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Asda is charging just 90p for the four pack of 440ml Skol lager, at 3.2 per cent strength, which works out at 51p a litre.
In comparison, a pack of four 750ml bottles of Evian water costs £2.91, or 97p a litre.
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The drinks industry is bracing itself for a "damning report" on the way alcohol is promoted on price. The Sheffield University report is expected to present the first evidence linking cheap booze to binge drinking.
Its imminent release will follow the launch this summer of the Department of Health’s “Safe, Sensible, Social” consultation on alcohol strategy.
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In a press release 2 October the World Health Organization (WHO) invites all interested parties to participate in a web-based public hearing to present their views on effective strategies to reduce the burden resulting from the harmful use of alcohol. WHO was asked by its Member States in May at the World Health Assembly to develop a global strategy to combat the harmful use of alcohol. The hearing is a part of this work. Submissions must be given before 31 October.
We appeal to all interested civil society organizations, in particular NGOs in the South, to contribute to the hearing. It is important that the development dimensions of the global alcohol problem become a priority issue in the WHO global strategy in 2010. A submission does not have to be very comprehensive. The most important is that key issues are raised and that many organizations demonstrate their interest and commitment.
Each year, more than two million people die from alcohol-related causes. "The harmful use of alcohol is a leading risk factor for premature death and disability in the world. Every year at least 2.3 million people die from alcohol-related causes," says Dr Ala Alwan, Assistant Director-General of WHO's Non-communicable Diseases and Mental Health Cluster. "This web-based public hearing is broad and inclusive and will provide an opportunity for everyone, including the public, to present their views on effective strategies to reduce the burden resulting from the harmful use of alcohol."
Dedicated web site for the hearing
Contributions shall be posted on a WHO web site dedicated to the hearing. The submissions can form a part of the documentation to be considered and discussed at the round table meetings with economic operators from the alcohol industry (planned for 6 November 2008), and NGOs and health professionals (planned for 24-25 November 2008), as well as at regional technical consultations with Member States (planned to take place between January and April 2009).
"We encourage our Member States and other governmental institutions, as well as civil society groups, academic and research institutions, private companies, individuals and other interested parties to participate," says Dr Benedetto Saraceno, Director of WHO's Department of Mental Health and Substance Abuse. "We are particularly interested in getting views on integrated approaches that can protect at-risk populations, young people and those affected by harmful drinking by others."
Six alternative languages
Contributions can be submitted to the public hearing via the web site in any of the six official UN languages (Arabic, Chinese, English, French, Russian and Spanish) beginning 12:00 noon Geneva time on 3 October. Submissions should not exceed five A4 pages or 2000 words. Contributors are encouraged to provide a summary of their views, which should not exceed 500 words.
To make a submission, please go to one of these web pages:
People without access to the Internet can send their submissions by fax to: +41 22 791 48 51
Published 07.10.2008 by
FORUT – Campaign for Development and Solidarity
Data Access Policy, Application and Agreement
A Multisite Trial of Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence
The COMBINE Study (often times referred to as COMBINE) is the largest pharmacotherapy trial conducted for alcoholism in the
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To evaluate the costs and cost-effectiveness of the COMBINE Study interventions after 16 weeks of treatment.
The study included 9 treatment groups; 4 groups received medical management for 16 weeks with naltrexone, 100 mg/d, acamprosate, 3 g/d, or both, and/or placebo; 4 groups received the same therapy as mentioned earlier with combined behavioral intervention; and 1 group received combined behavioral intervention only.
Incremental cost per percentage point increase in percentage of days abstinent, incremental cost per patient of avoiding heavy drinking, and incremental cost per patient of achieving a good clinical outcome.
On the basis of the mean values of cost and effectiveness, 3 interventions are cost-effective options relative to the other interventions for all 3 outcomes: medical management (MM) with placebo ($409 per patient), MM plus naltrexone therapy ($671 per patient), and MM plus combined naltrexone and acamprosate therapy ($1003 per patient).
To our knowledge, this is only the second prospective cost-effectiveness study with a randomized controlled clinical trial design that has been performed for the treatment of alcohol dependence. Focusing only on effectiveness, MM-naltrexone-acamprosate therapy is not significantly better than MM-naltrexone therapy. However, considering cost and cost-effectiveness, MM-naltrexone-acamprosate therapy may be a better choice, depending on whether the cost of the incremental increase in effectiveness is justified by the decision maker
This study examined whether the experiences of childhood or adolescent parental divorce/separation and parental alcohol problems affected the likelihood of offspring DSM-IV lifetime alcohol dependence, controlling for parental history of drug, depression, and antisocial behavior problems.
Childhood or adolescent parental divorce/separation and parental history of alcohol problems were significantly related to offspring lifetime alcohol dependence, after adjusting for parental history of drug, depression, and antisocial behavior problems. Experiencing parental divorce/separation during childhood, even in the absence of parental history of alcohol problems, remained a significant predictor of lifetime alcohol dependence. Experiencing both childhood or adolescent parental divorce/separation and parental alcohol problems had a significantly stronger impact on the risk for DSM-IV alcohol dependence than the risk incurred by either parental risk factor alone.
Further research is needed to better identify the factors that increase the risk for lifetime alcohol dependence among those who experience childhood or adolescent parental divorce/separation.
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To examine key individual- and community-level correlates of regular very high-risk drinking (more than 20 drinks at least 12 times a year for males and more than 11 drinks at least 12 times a year for females) among young (16–24) drinkers in Victoria.
One-fifth of the sample reported regular (at least monthly) very high-risk drinking. Significant individual-level correlates of very high-risk drinking included age, gender, cultural background, recreational spending money, life stage, living situation, family conflict and age at first drink. Significant community-level correlates included remoteness (living in a rural area) and packaged liquor outlet density.The study highlights a range of important factors relating to regular drinking of dangerous amounts of alcohol by youth. Interventions aimed at preventing early initiation or managing recreational spending should be explored. Further, regulatory management of packaged liquor outlets and or remote rural communities in Victoria with high levels of dangerous drinking should be a priority.
A quick method of assessing readiness to change was needed for a major study of implementing screening and alcohol brief intervention in England. For this purpose, a Readiness Ruler that had been validated among a sample of male college students in the USA was adapted and applied to a sample of excessive drinkers in a general medical practice located in a deprived area of Gateshead, England..
In terms of concurrent validity, the relationships between the Readiness Ruler, on the one hand, and either stage of change allocation or a dimensional score derived from the RCQ, on the other hand, were highly significant but weaker than expected. When patients who endorsed the “maintenance” point on the Readiness Ruler were excluded from the analysis, the above relationships were considerably strengthened for reasons that are discussed. On this basis and with another small change, a final Readiness Ruler was developed.
If the validity of the Readiness Ruler is confirmed in subsequent research, a quick and simple way of measuring readiness to change will be available for research or clinical work with alcohol brief interventions.
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Britain is to become the only European country that allows motorists to have at least one alcoholic drink and still be legally fit to drive.
The Times has learnt that the Government has changed its mind about reducing the limit from 80 to 50 milligrams of alcohol per 100 millilitres of blood, despite evidence that a lower limit would save 65 lives a year.
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