Tuesday, January 18, 2011

Binge Drinking...let's talk about it

From The Canadian Press, in Toronto Star, January 18, 2011
A national strategy is needed to control overall alcohol use in Canada, particularly heavy drinking or binge drinking, says an editorial Monday in the Canadian Medical Association Journal.

Although no one wants to live in a nanny state, it says that taxpayers are feeling the burden of heavy alcohol use and simple evidence-informed regulations and policies are worth considering.
"Public health agencies, the hospitality industry, liquor manufacturers and control boards, municipalities and major granting agencies should collectively turn their attention to evaluate strategies to curb binge drinking," states the editorial, signed by doctors Ken Flegel, Noni MacDonald and Paul Hebert.
They point to the tradition of "happy hour," the sale of cheap alcohol for a short period of time in a bar or restaurant, and question whether it does anything more than promote risky behaviour among price-sensitive people such as college students and the socially disadvantaged.
Statistics indicate 8.8 per cent of Canadians reported binge drinking over the past five years, and most were men aged 15 to 24. Five drinks or more in one sitting, and four drinks for women, is considered binge drinking.
The editorial calls for studies to learn which interventions work best, suggesting scrutiny of approaches such as minimum unit pricing, restricting availability or advertising.
In addition, it says health-care professionals should routinely ask patients — especially young patients — about alcohol consumption and related risk behaviours.
"Children and youth should be reminded that binge drinking can result in serious loss of self-control and therefore heighten the risks of involvement in dangerous sex, rape, violence or injuries," the editorial said.
"Dialogue can also reinforce how easy it is to die while intoxicated or to cause death on the road.
Nanny state or not, this problem is in need of attention by all public officials, governments, schools, universities, colleges and distribution outlets for alcohol, such as sports bars and "happy hours" in any venue.
From this desk, there seems to be a silent complicity with the issue of binge drinking, except for the occasional television public service announcement from MADD (Mothers Against Drunk Driving) or some NHL coach urging views to select a different option than driving while under the influence of alcohol.
We are preparaed to talk about the dangers of driving a motor vehicle while under the influence of alcohol but we are not prepared to talk about the dangers inherent in excesive drinking in itself.
Are we so polite or are we so detached that we "don't want to interfere with another's private life"....almost as if we think, "If they want to drink, that's their business, and I have no business expressing a different view"?
I recall a conversation in the U.S. after I had conducted a funeral for an individual who had died of alcohol poisoning. His spouse attended the funeral, herself also an active alcoholic, and in danger of losing her life from the same poisoning. A couple of months following the funeral, I met a social worker who had paid her a visit, presumably because of her excessive drinking. And in that conversation, I heard him say, "It's not illegal to be an alcoholic; it's only illegal if you hit someone with your car while you are under the influence of alcohol." The social worker was, himself, an active, untreated alcoholic. I threw up my arms in frustration and walked away.
The relationship with substances that can and do control lives in North America, like alcohol and non-prescription drugs, is so virulent and so difficult to manage, if not control, as to be a scourge on the social and political culture. Our rates of 'dependency' on alcohol and on non-prescription drugs far outstrip those in Europe and the problem is one that is, or seems to be, literally both unsolveable and under the radar.
We treat the bodies that are broken from the disease in the Emergency Rooms; we treat the effects of the disease through social work interventions with family members of the offending/diseased person; we patrol the streets and highways with the intermittent R.I.D.E. program (Reduce Impaired Driving Everywhere) and there is evidence that at least on the roads, there are fewer drivers who are under the influence of alcohol.
So, some parts of our interventions are having some positive impact. And, I'm sure the police forces do not have the resources to conduct as many R.I.D.E. sessions as they would like.
The Canadian Medical Journal is a reputable publication, and these authors are not innocent to the impact of binge drinking, and while this piece will be considered by some as "pompous and arrogant and even presumptuous" by those who do not want to hear these thoughts or read these words, nevertheless, the issue is one that can and does result in unnecessary deaths, for example, of university students across North America every year.
How our society confronts "pressure" or "anxiety" or "stress" or "depression" or "loss" or "trauma"....these are dynamics that require support systems, real friends who will intervene with both courage and compassion because they had talked about the situation before it becomes a "problem"....
We have become so isolated from one another, and so alone in a world of ubber-communication devices that "keep us connected" in the most superficial ways, that a woman apparently suffering from dementia can leave her home, in Toronto, and wander in her neighbourhood with very little on, and die from hypothermia on the coldest night of the year, even though her screams were heard by at least two people who identified themselves after her death was made public.

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