My name is Sally Marlow and I research alcohol problems in women at the Institute of Psychiatry, King’s College London. I started this blog to communicate the science, psychology and culture underlying drinking problems, and to put right some of the misinformation out there about women and how they use alcohol. All views expressed here are my own.
The student version of the BMJ is running a poll today asking medical students to vote on whether minimum unit pricing for alcohol is a good idea. At time of writing, 78% of those voting are in favour. Students are more usually known for embracing alcohol in all its forms, but these students of course see the results of too much alcohol at first hand, as part of their training.
BMJ also featured an article, which I have to declare an interest in as I co-wrote it with Alice Buchan, a fourth-year medical student at Oxford. It’s called A Minimum Price for Alcohol: what you should know and why you should care. I’ll post it up when the electronic version is available.
I was really pleased to be invited to be part of an upcoming feature film, A Royal Hangover, by Arthur Cauty. If this trailer is anything to go by, it should be worth a look.
There’s another story out today about drinking while pregnant, and how it can increase the risk of miscarriage. Read it here http://www.bbc.co.uk/news/health-26239576
It’s an interesting one this, because it opens up the question of whether it’s safe to drink in pregnancy, even a small amount. You may not be surprised to learn that government guidelines are far from helpful: NICE (the body which considers all the evidence and produces government health guidelines) advises alcohol should be avoided in the first three months of pregnancy because of increased risk of miscarriage. However, in the same guidance advice is given that if women choose to drink alcohol during pregnancy then they should drink no more than 1 – 2 units once or twice a week. Contradictory? What the guidelines seem to say is don’t drink, but if you do, drink a little. In the USA they are much more clear, and the National Institute on Alcohol Abuse and Alcoholism has also considered all the evidence, and state “no amount of alcohol is safe for pregnant women to drink”.
The problem with alcohol is that the molecule can and does cross over from the mother into the foetus, and can interfere with developmental processes in the foetus. Also the liver of the foetus is not sufficiently developed to metabolise the alcohol it receives from the mother through the placenta. There are a range of problems found in children whose mothers drank during pregnancy, most of them “neurodevelopmental”, ie to do with the developing brain, and these problems range from mild to severe. Although not all children whose mothers drank will have these, by any stretch of the imagination, some will, and it’s hard to say why some children are affected and others aren’t, which is why in my opinion the advice really does have to be don’t drink at all during pregnancy.
Easy to say, less easy to do….. and if your pregnancy wasn’t planned, how were you supposed to know to stop drinking? As with all things to do with women and alcohol, it’s complicated.
I recently gave a talk to the King’s College London Biomedical Society on the legality of alcohol when compared to other drugs, and one of the topics which came up in questions was that of minimum unit pricing. I said I would post up my thoughts on this blog, along with the evidence we have to date. My thoughts are in these previous posts
This link details the evidence (summarised very comprehensively and helpfully by Dr Margaret McCartney, whose blog and twitter feed I would highly recommend to anyone interested in all aspects of medicine)
And if you want to hear last year’s Radio 4 Inside Health programme where Margaret and I discussed minimum unit pricing and other alcohol issues, there’s a description of it and a link here
Just in case you’ve been treking across the Sahara with no internet, satellite or smoke signals for the past few weeks, let me explain. Neknominate is a drinking game, which involves drinking a glass of something alcoholic down in one (“necking” your drink), in a weird place, whilst being filmed. At the end of the drink you nominate someone else to do the same, then you post the video on Facebook. The more revolting your drink, or the more outrageous the setting, the more likely it is that people will share your video, and hey presto, you get your fifteen minutes of social media fame. I’ve seen a woman in Tescos on horseback neknominating next to the chill counter, and numerous young men neknominating with their heads in a loo bowl (original, huh?)
As with all drinking games, people can die, and there have been deaths. These appear to have happened because of the acutely toxic effects of alcohol – drink a bottle of vodka over three days and you might feel pretty ill, but you won’t die. Drink a pint of neat vodka down in one in less than a minute, and the risks are high – your body can’t handle it, and nor can your brain.
There’s been a lot of outrage in the press about why people would play a game like neknominate, but for me it’s really not that difficult to understand. Firstly, it’s about the thrill of taking risks (young men are particularly prone to this, for neurological reasons). Secondly, peer pressure is involved – you’re nominated by someone you know, and it’s on social media so the world can see whether you do it or not. Thirdly, it’s narcissistic (again, a particular problem for young men and women, whose brains have not developed enough for them to know they are not the centre of the universe – do they really believe the rest of the world cares whether they drink a pint of alcohol down in one? Yes, they really do.) Fourthly ,drinking alcohol has already proved a positive experience – a learned behaviour if you like. Alcohol alters mood, in a good way most of the time and if you get the levels right. Those neknominating have learnt that from previous episodes of drinking, so why should they believe that the effects of neknominating will be any different? Fifthly, it’s competitive – you have to go one better than those before you. Humans are nothing if not competitive. Sixthly, no-one thinks they’ll die – it’s a bit like smoking in that you don’t think it will get you. How many of the outraged commentators are ex or current smokers? How many of them have driven a car too fast to see what it feels like? Thrown themselves down a black run knowing that their skiing wasn’t actually up to it? Stayed for another drink or six when they know they have to get up for work in the morning? I smell a little hypocrisy here.
The vast majority of people who participate in neknominate will be fine, ill but fine. We’ll find some other “youth” behaviour to tut and obsess over next week – legal highs again perhaps, teenage sex, increasingly strong cannabis. I’m not arguing that we should ignore this stuff. I just think that doing something effective about it needs to start from a position of understanding why something happens, not from throwing our hands up in horror.
By the way, neknominate stories in the UK appear to be on the wane now, but the US media has got hold of it. Let’s see what comes out…. Here’s CNN on the subject http://edition.cnn.com/2014/02/18/world/europe/neknominate-drinking-game/
And now time for something completely different. I found out today that Jane Austen used to brew beer, and that according to the BBC News Magazine, women are increasingly turning to brewing as a career. Read the article here BBC: women and beer
There’s more evidence out this week for those who are interested in favour of alcohol minimum unit pricing, and it’s published in PLOS One, one of the most respected scientific journals in the world. You can find the research here PLOS one article on minimum unit pricing Where the findings of this research differ from a lot of what we already know, is that having specifically looked at what types of drinkers minimum unit pricing would affect – light drinkers, moderate drinkers, and heavy drinkers – it finds that minimum unit pricing affects heavy drinkers, not light or moderate ones. This provides more evidence against the alcohol industry’s argument that minimum unit pricing penalises “responsible” (their word, not mine) drinkers. It doesn’t. It cuts down drinking in those who drink the most, ie those who are more likely to become dependent on alcohol, those who are more likely to suffer physical health complications because of their drinking, and those who are more likely to contribute to social harms in their families and communities.
I’ve written previously about how minimum unit pricing goes against the philosophical grain for me, but that I am convinced it’s the right thing to do. Read my reasoning here: Why I’m an unlikely supporter of minimum unit pricing
As the trolls who sent abusive messages to Caroline Criado-Perez and Stella Creasy MP are jailed today, a fact comes to light in Judge Howard Riddell’s judgement against Isabella Sorley I was not aware of. She has 25 previous offences recorded against her for drunk and disorderly behaviour, and says she was drunk at least for some of the time when she was sending abusive tweets.
Here’s some of what the judge said:
Ms Sorley, you were recently assessed as unsuitable for an Alcohol Treatment Requirement as you lack the necessary motivation… you are an intelligent and well educated woman. You have a 2(1) degree in Creative Advertising. To your credit you have mostly remained in work, even though you were unable to find employment in your chosen field. In addition you have real support from your family, for whom this has been a very harrowing time. Mr Caulfield has emphasised to me the disconnect between the pleasant and articulate person he has seen, and the person your record demonstrates. He points out these offences occurred in a 30 minute window well after midnight when you must have been heavily under the influence of alcohol. I accept that. However you have offended so many times when drunk that it must have been obvious to you that you needed to deal with this problem if you were not to continue to cause harm to others. His full sentencing report is here Judgement: Nimmo and Sorley
This suggests that alcohol has contributed to the harm not only suffered by Caroline Criado-Perez and Stella Creasy, but also by Isabella Sorley, who tonight will spend her first night of many in jail. She’s not the only woman with a drink problem to do so. I’m not arguing that Isabella Sorley was not responsible for her actions – certainly in the eyes of the law she was. I am however pointing out that the harmful effects of alcohol are everywhere. You only have to look a little deeper.
I am proud to be a Trustee of a charity called Blenheim CDP which provides drug and alcohol services across London. Yesterday Blenheim celebrated 50 years with the launch of a book called “London Calling: Voices from 50 years of social action”, but in typical Blenheim fashion, this launch was combined with an innovative new treatment tool, The DARTT (Drug and Alcohol Recovery and Treatment Tool). You can find details of both on Blenheim’s website
Although a relatively small charity, Blenheim punches above its weight not only in terms of its approach to treatment services, but also in terms of making its voice heard among policy makers. London Calling and DARTT were fittingly launched in the Houses of Parliament, in an event hosted by Baroness Hayter, who is Blenheim’s Patron. The event was also attended by Norman Baker MP, Minister for Crime Prevention, who gave a speech. His responsibilities include drugs and alcohol, and from the perspective of crime prevention he is the Minister of State for these. I was encouraged to hear him talk tough on the alcohol industry. I even detected a glimmer of hope that minimum unit pricing might be back on the agenda…. although it’s entirely possible I was hearing what I wanted to hear. It wouldn’t be the first time.
This post is something of a diversion from my usual subject matter, but I thought it worth a mention. Tonight on BBC4 at 8pm is the screening of the first of three Royal Institution Christmas Lectures, given by Dr Alison Woollard, a geneticist from Oxford http://www.rigb.org/christmas-lectures/2013-life-fantastic/alison-woollard. The lectures have been running since 1825, when they were first started by Michael Faraday, with the aim of bringing science to young people in the form of lectures at Christmas. Alison is in illustrious company: previous lecturers include David Attenborough, Richard Dawkins, Susan Greenfield and Carl Sagan. I had tickets for the recordings of lectures one and three this year, with my family, and I am delighted to report that Alison fully lived up to her predecessors. Tonight’s lecture starts by looking at single cells, and Alison explains how these tiny pieces of life divide and multiply to make up a human being. It’s great to watch a scientist who is not only totally committed to her work, but who can communicate her enthusiasm, and tailor her message to a non-academic audience in a way that is not patronising, but also not too technical.
The three Christmas lectures were recorded earlier this month at the Royal Institution, and will all be broadcast by BBC4, starting tonight, for the next three nights. If you’re at all interested in science, or in what makes you human, take a look. The lectures may be aimed primarily at young people, but Alison’s skill is that she makes them interesting for adults too. You can find details of all three programmes here http://www.bbc.co.uk/programmes/b03mv59j
I’ll blog about the third lecture later – it was on genes and cell therapies, and gave me much to think about when it comes to addiction.