Alcohol use has become normalised over time as a socially acceptable past-time. How the alcohol industry promotes its use is consistent with the cultural and historical traditions with how alcohol is viewed in society. They don’t tend to dwell on the damage alcohol causes in terms of ill-health, crime and to society in general. It could be argued that it is strange how such an abusive and powerful drug has been given the guise of different flavours and various brand identities which nurture brand loyalty for essentially the same toxic product. If alcohol was introduced as a new drug today it would be banned outright as a Schedule I drug, if we use the United States DEA definition;
‘Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Some examples of Schedule I drugs are:
heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine(ecstasy), methaqualone, and peyote’
The two biggest killers, tobacco (nicotine) and alcohol are left off the list. Interestingly marijuana, which has been legalised for medical use in many States is categorized as Schedule I. This reflects the divergence between Federal law where marijuana is still illegal for all purposes and the aforementioned States. Historically some laws prohibiting various drugs in the US have arguably been used more as a tool to control sections of the population but that is for another discussion.
The alcohol industry is a multi-billion-dollar industry and uses its power and influence to block legislation which may inhibit its trade. A good example of this was when David Cameron (remember him?) suggested minimum pricing per unit of alcohol in the UK to reduce the harm for some of the most vulnerable in society. Following numerous visits from alcohol industry lobbyists the idea was quickly forgotten. However Scottish politicians are obviously made of sterner stuff and last year were given permission to bring in minimum pricing per unit in Scotland, but only after a five-year court battle with the Scottish Whiskey Association. The association claimed that it would ‘interfere with free trade.’ It’s amazing that any democratically elected legislative power has to spend 5 years in a court room just to pass a law that will save lives and improve the health of a significant number of people. Professor Petra Meier, Director of the Alcohol Research Group at the University of Sheffield, said a 50p minimum price would in time result in 120 fewer deaths and 2,000 fewer hospital admissions from alcohol abuse each year. To quote ‘The Guardian’ newspaper;
“Our research has consistently shown that minimum unit pricing would reduce alcohol-related health problems in Scotland by targeting the cheap, high-strength alcohol consumed by the heaviest and highest-risk drinkers,” Meier said, “Moderate drinkers would be affected to a much smaller degree.” (15/11/17)
Dr. Eric Carlin, the Director of Scottish Health Action on Alcohol Problems, a campaigning body backed by the medical profession, lambasted drinks’ companies for their “ferocious, cynical” opposition to the measure. Dr. Carlin opined that “The opponents to MUP [Minimum Unit Pricing] have shamed the reputation of their industry by prioritising profits over people’s lives. As MUP has been delayed, we have seen the tragic, premature deaths of 24 people every week in Scotland as a result of alcohol misuse, many of them in our poorest communities, and affecting families across our nation.”
The alcohol industry is transparent about why they attack any proposed legislation – their bottom line! They are much more concerned about the size of dividends to shareholders than the collective health of a nation. The alcohol industry asks its customers to, ‘drink responsibly’, when in fact they are relying on a significant portion of any population to take risks with their health in order for them to make a profit. Research in Australia shows that the people who binge drink problematically account for 75% of alcohol sales. It is difficult to ‘drink responsibly’ when the parts of the brain required to do so are being affected by the alcohol itself.
As time goes by more and more research is published about the ills of alcohol use and as this information is released new ‘benchmarks’ or limitations on ‘safe’ use is introduced. In the UK the limit used to be 21 units a week for men and 14 units a week for women. This equates to about 12 bottles of beer for men and about 8 for women. Then as people began to save their units for weekend binges, where binge drinking is a problem in itself, the limits changed to daily benchmarks of 3-4 units/day for men and 2-3 for women on days when drinking takes place (NB. People should have at least 3-4 days abstinence per week to give the liver a chance to replenish).
More recently, following a 20-year study in the UK on the effects of alcohol on health the Chief Medical Officer in the UK changed the guidelines once again. They are as follows;
‘On regular drinking
New weekly guideline (this applies for people who drink regularly or frequently i.e. most weeks).
The Chief Medical Officers’ guideline for both men and women is that:
• You are safest not to drink regularly more than 14 units per week to keep health risks from drinking alcohol to a low level.
• If you do drink as much as 14 units per week, it is best to spread this evenly over 3 days or more. If you have one or two heavy drinking sessions, you increase your risks of death from long term illnesses and from accidents and injuries.
• The risk of developing a range of illnesses (including, for example, cancers of the mouth, throat and breast) increases with any amount you drink on a regular basis.
• If you wish to cut down the amount you’re drinking, a good way to help achieve this is to have several drink-free days each week.’
In January of this year new evidence found the direct link between alcohol and cancer which found that ‘alcohol causes cancer by scrambling DNA in cells, eventually leading to mutations. Just one pint of lager or a large glass of wine a day significantly increases the risk of mouth, throat, oesophageal, breast and bowel cancers.’ (The Guardian)
We know that alcohol isn’t good for us yet we continue to guzzle. Perhaps a sort of cognitive dissonance is in play where we drink and try to sweep the risks under the carpet by rationalising and making mythical adaptations to our mindset. Maybe we grasp at fig leaves put out by the alcohol industry about possible health benefits of a proven carcinogen. Yes, red wine contains polyphenols which is found to lower blood pressure and act as an antioxidant to protect against ‘free radicals’ which ironically is something which is also produced by the consumption of alcohol. But polyphenols are just as prevalent in every day foods and drinks such as nuts, berries, apples and even a cup of tea or coffee. So we can get our fair share of polyphenols without having to resort to drinking red wine and put ourselves at risk with the toxins in the alcohol. Years and years of study in this area have identified that a narrow subgroup of women over 55 years, drinking up to five small glasses of red wine a week, may have some protection from heart disease, but if they drink over this they lose the protective impact of the alcohol. Even this sounds like a desperate attempt to find some positive effect of alcohol and even that comes with caveats.
It’s not just cancer, alcohol has been linked with numerous other types of disease, liver cirrhosis and Type 2 Diabetes to mention just two. Alcoholic Cirrhosis of the liver used to be just the domain of the middle-aged man, now we are starting to see it in men in their 20’s and 30’s as people start to drink more hazardously at a younger age.
Country to country patterns of alcohol use vary but generally more people are starting to abstain from the drug. Perhaps 15-25% of populations compared to perhaps 10% in the past. While this might be a promising trend for the general health of any nation it would also appear that while alcohol dependency levels appear to have stayed the same, levels of ‘binge’ drinking (5 or more drinks at one time for men and 4 or more for women) have risen. The recent STEPS survey results in Anguilla also seems to echo this trend with relatively high lifetime and long-term abstention rates countered by a propensity for binge drinking. The survey showed that one in four male respondents reported more than 6 drinks on any occasion in the past 30 days. There was no data on physically dependent drinking but generally this is usually around 5-10% of any given population.
So, what do we do with this information? As an individual, do we avert our eyes and carry on as normal or do we change tack and reduce or abstain. What do Governments do? Alcohol is a legal drug, but governments should be aware of the risks to its population, so what is their role in minimising the risk? We may ask, ‘Are our Governments trying to poison us?’ by keeping alcohol legal but we cannot blame governments as history has shown us we are complicit in its legality – generally, people want to drink which was demonstrated during ‘Prohibition’ in the US and the force of that will to drink was one of the main reasons for its repeal. The libertarian view would find that as adults we are aware of the risks and should be able to do as we wish ‘if we aren’t doing any harm to others’ but as alcohol is a strong psychotropic drug that changes behaviour, not always for the better, that is a big ‘IF’. Could it not be seen as reckless to drink problematically and then expect the state to step in to cover costs related to health, social or alcohol related violent crime, costs which run to hundreds of billions of dollars in the US alone.
As we have seen with the aforementioned ‘minimum pricing’ it is difficult for any legislature to act on sales but employing a minimum price per unit could be an option. The higher the price the less problematic drinkers will drink. This policy would certainly have a positive impact to minimise the harm of ‘binge’ drinking as the evidence suggests. Another way of upping prices would be to increase taxes on alcohol although this would not exactly be a vote winner any taxes from this option could be ‘ringfenced’ to be ploughed back into prevention and services for the care of problematic drinkers, costs of detox, that sort of thing. Another policy government could look at is restricting the availability of alcohol. Less licensed sellers of alcohol has been shown to reduce problematic use.
Evidence suggests that the younger a person starts drinking the more problems they are likely to have in the longer term in terms of binge drinking or physical dependency. One way of delaying initiation is to increase the age restriction on alcohol and enforcing it. We have age restrictions on alcohol to protect our youth but what are we protecting them from? Since the 18-year age limit was made we have learnt a lot more about how alcohol can impact the developing brain which continues to develop until the mid to late 20’s. So, if we were serious about having an age restriction for this reason, it would be more in line with the age restriction in the US of 21 as the old age limit of 18 is a very arbitrary and outdated law.
As individuals there are various strategies we can use to minimise harm if we want to;
• Avoid liquor or spirit drinking.
• Drink water in between drinks to keep hydrated and to slow down and reduce the intake of alcohol. Your liver needs an hour to break down one unit of alcohol.
• Try to have at least 3-4 days of non-drinking days during the week. Your liver will thank you for it.
• Don’t binge drink.
Iain Bibby
Department of Education.
(Published without editing by The Anguillian newspaper.)
