The effect of moderate drinking on brain structure

A new study on BMJ.com, examines the effect of moderate drinking on brain structure. Heavy drinking is known to have a deleterious effect on our brains, and is linked to dementias. However, for sometime it’s been thought that moderate drinking is actually protective.

In this Podcast, Anya Topiwala, clinical lecturer in old age psychiatry at the University of Oxford, discusses the association between alcohol consumption and those structural elements.

Reference to the research: Topiwala, A et al. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ 2017; 357 (Published 06 June 2017)

Alcohol abstention advice to pregnant women is wrong, say campaigners

Health officials and experts are wrong to tell women that they should completely abstain from drinking alcohol during pregnancy, according to campaigners | OnMedica

Telling women that small quantities of alcohol in pregnancy can cause irreparable damage to a developing foetus has no basis in evidence and can cause needless anxiety, claimed academics and women’s advocates speaking at a conference in Canterbury, Kent.

The conference, Policing pregnancy: who should be a mother?, is a collaboration between the British Pregnancy Advisory Service (BPAS) charity, the Centre for Parenting Culture Studies (CPCS), maternal rights campaign group Birthrights, and engaging sociology.

Currently, pregnant women are warned that even light alcohol consumption can cause problems for them and long-term harm to their foetus, such as stunted growth, and eventual learning difficulties and behavioural problems. Warnings also include the possibility of liver damage to the baby and increased risk of the mother having a miscarriage.

Read the full overview here

Related news article by the Guardian available here

Alcohol identification and intervention in English emergency departments

Patton, R. & Green, G. Emergency Medicine Journal | Published Online: 8 May 2017

Aims: In the ED, alcohol identification and brief advice is an effective method of reducing consumption and related harms. Our objective was to conduct a national survey of English EDs to determine current practice regarding alcohol identification and provision of brief advice and to compare changes in activity to a previous National Survey conducted in 2011.

Conclusion: Alcohol screening together with referral or intervention is becoming part of routine practice in England. Compared with our previous national survey, increases in alcohol screening and intervention activity are demonstrated, with improvements in routine questioning (among adults), the number of general practitioners being informed about alcohol-related attendances, provision of training, access to specialist services and the use of formal screening tools.

Read the full article here

Reactions on Twitter to updated alcohol guidelines in the UK

Stautz K. et al. (2017) BMJ Open. 7:e015493

Objectives: In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter.

 

Conclusions: This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media.

Read the full article here

Alcohol evidence review

Public Health England has published a comprehensive review of the evidence on alcohol harm and its impact in England. It examines alcohol’s health, social and economic impact, and the effectiveness of actions in reducing its harms.

Alcohol is now more affordable and people are drinking twice as much as they did 40 years ago. The economic burden of health, social and economic alcohol-related harm is substantial, with estimates placing the annual cost to be between 1.3% and 2.7% of annual GDP. Alcohol related deaths affect predominantly young and middle aged people; as a result alcohol is a leading cause of years of working life lost in England.

The review provides national and local policy makers with the latest evidence to identify those policies which will best prevent and reduce alcohol-related harm. It details policies that impact directly on the environment in which alcohol is sold and marketed, including its price, availability and advertising along with policies directed at people most at risk.

Other findings from the review include:

• most adults in England drink alcohol – more than 10 million people are drinking at levels that increase the risk of harming their health
• 5% of the heaviest drinkers account for one third of all alcohol consumed
• alcohol is the leading cause of death among 15 to 49 year olds and heavy alcohol use has been identified as a cause of more than 200 health conditions
• alcohol caused more years of life lost to the workforce than from the 10 most common cancers combined – in 2015 there were 167,000 years of working life lost
• the evidence strongly supports a range of policies that are effective at reducing harm to public health while at the same time reducing health inequalities – reducing the affordability of alcohol is the cost effective way of reducing alcohol harm

Read the full report: The public health burden of alcohol: evidence review

135,000 alcohol-related cancer deaths predicted by 2035

Alcohol will cause around 135,000 cancer deaths over the next 20 years and will cost the NHS an estimated £2 billion in treatments, according to estimates from a new report by Sheffield University, commissioned by Cancer Research UK

Image source: CRUK

The new figures, published today (Friday), reveal that by 2035 the UK could see around 7,100 cancer deaths every year that are associated with alcohol. Of the cancer types included in the report, oesophageal cancer is set to see the largest increase, followed by bowel cancer, mouth and throat cancer, breast cancer and liver cancer.

The report also forecasts that there will be over 1.2 million hospital admissions for cancer over the 20 year period, which will cost the NHS £100 million, on average, every year.

The results were based on analyses that assume alcohol drinking trends will follow those seen over the last 40 years, and takes recent falls in alcohol consumption, including among young people, into account.

Evidence suggests that the more alcohol you drink, the higher the risk of cancer. UK government guidelines, published earlier this year, advise that both men and women drink no more than 14 units of alcohol a week.

Read the full overview here

Read the full report here

 

In-person and computer-based alcohol interventions at general hospitals: reach and retention

Freyer-Adam, J. et al. (2016) European Journal of Public Health. 26(5) pp. 844 – 849

Background: High reach of target populations is relevant for public health impact of interventions. Concerning intervention programs requiring multiple contacts, little is known about how many persons may be kept in the intervention program over multiple time points. The aim of this study was to investigate (i) the reach of general hospital inpatients with at-risk alcohol use through screening and brief intervention and (ii) whether their continued intervention participation after hospital discharge differs by in-person vs. computer-based intervention (CO) delivery.

Methods: As part of a randomized controlled trial, general hospital inpatients aged 18-64 years were screened for at-risk alcohol use on 13 wards. Participants were allocated to in-person intervention (PE), CO and assessment only. Both interventions were provided on site, and 1 and 3 months after baseline.

Results: Ninety-two percent of all eligible inpatients (n = 6251) completed the screening. Eighty-one percent (n = 961) of the screening-positives participated in the trial and received their allocated intervention. At months 1 and 3, interventions were delivered to 83 and 79% of the CO participants and to 74 and 64% of the PE participants. The delivery of CO and PE required an average of 5.2 and 7.7 contact attempts per delivered intervention, respectively.

Conclusion: General hospital inpatients with at-risk alcohol use were well reached through proactive interventions. COs may result in higher retention rates over 1 and 3 months and may require less contact attempts than PEs. Public health efforts that aim to achieve high intervention retention should consider proactive COs.

Read the abstract here