July 28, 2009



Could you be an addict?

k Boster / Los Angeles Times We know Michael Jackson was dependent on sedatives and painkillers, but our reliance also needs examining.

It's not just the Michael Jacksons and Anna Nicole Smiths who pop pills. Society's reliance on painkillers and sleeping aids has us walking a fine line.

Sandy Banks
July 11, 2009

Subpoenas have gone out, the DEA has been brought in, and every doctor who has ever come within a prescription pad of Michael Jackson can probably expect a phone call soon.

But even absent the results of the inquiries and toxicological reports, it seems obvious that prescription drugs played a role in the pop star's sudden death.

In fact, what we already know about Jackson's reliance on sedatives and painkillers is enough to prompt the kind of public discussion we have sidestepped too many times before -- when Anna Nicole Smith died from "combined drug intoxication" two years ago after mixing sleeping pills and sedatives; or when Heath Ledger was found dead last year with six different legal medications for pain, anxiety and insomnia in his blood.

Instead of simply dismissing them as celebrity drug addicts or pitiable tragedies, it's time we take a look at our own lives -- and the contents of our medicine cabinets.

It's no secret that the use of pharmaceutical drugs is on the rise. Prescriptions for painkillers climbed from 40 million to 180 million in the last 15 years. More than 56 million prescriptions were written for sleeping medications in 2008, up 54% since 2004. And 7 million Americans admit to "non-medical" use of drugs prescribed for pain or mental disorders.

Even the nation's new drug czar Gil Kerlikowske has called Jackson's death "a wake-up call." More Americans die from overdoses of legal drugs each year than from gunshot wounds, he told CNN on Thursday.

It's a complicated problem. There is no bright line separating use from misuse. And a constellation of circumstances is nudging us toward chemical solutions to the struggles of everyday living.

An ever-expanding list of mental illnesses means almost anyone can be diagnosed with a treatable malady. Pharmaceutical ads -- with butterflies flitting through bedroom windows and happy, prosperous families -- promise pills that can make you happier or more social; help you stop hurting and get to sleep. And doctors have been pressed by patients, plied by drug reps and squeezed by insurance companies until a 10-minute visit gets you a refillable prescription.

Yet pharmaceutical advances have allowed schizophrenics to hold down jobs, insomniacs to get a good night's sleep, and people with depression to go about their lives.

Substance abuse recovery programs have long relied on a simple nostrum: You're an addict if "your life has become unmanageable due to drugs or alcohol."

But what if your life is only manageable because you're taking drugs? How do you recognize addiction then?

I took my questions to Vickie Mays, a nurse and professor of psychology at UCLA.

"We think about addiction as 'Your life is out of control,' " Mays said. "But it's the medication that gives you a sense of control when you've got so many balls in the air . . . with so many demands from the job, the kids."

Sounds a lot like the lives that us non-rock stars live.

"It's the demands on us that are out of control," Mays said. "You yearn for just a little bit of peacefulness, a way to try to shut things off. . . . It's the normal, average, very busy, high-achieving person" who is most vulnerable to reliance on prescription drugs.

We're not trying to get high, just trying to get some sleep, blunt the pain from that old sports injury, keep from screaming at the kids.

But pill-popping can move almost imperceptibly, she said, from habit to ritual to need.

"When there's no other way in your mind to relieve the pain, and you start taking it more frequently and in higher doses. . . . When it's become too automatic. You can't sleep and you don't wait; you just reach over for the bottle on your bedside table.

"It's a slippery slope," she said. But that's when you ought to ask, "Am I becoming an addict?"

Her answer gave me pause this week, when I tossed and turned through a sleepless night.

I rolled over and reached for the bottle of pills my doctor prescribed last year, when chest pains that sent me to UCLA's emergency room turned out to be anxiety, not a heart attack.

Is this, I wondered, how Michael Jackson's problems with drugs began?

A pain pill when your hair catches fire and you end up mainlining Demerol? A tranquilizer when you're stressed out by the paparazzi and soon you're throwing back 10 Xanax pills at a time?

OK . . . so those were middle-of-the-night thoughts. But I can't blame Jackson for wanting a break from the cacophony in his head; relief for a 50-year-old body, called on to perform for hours every day onstage.

His manner of death was a tragedy with implications for all of us.

Have I started down the slippery slope if I have refilled that year-old prescription twice? If I can tell you exactly how many of those pills I have left?

Or was I wise not to take the sedative that night, even though I stumbled through work the next day? Instead I watched the sun come up, with "Man in the Mirror" playing in my head.


July 27, 2009

The Alcoholic Child's Story


The alcoholic child's story

The Guardian, Saturday 25 July 2009

"I got my first taste of alcohol when I was a tot – my mum used to give me whisky in warm milk to help me sleep. She was a big drinker, a binge drinker. At the age of 11 I had my first proper drink. I found a bottle of advocat in the bathroom cupboard, and I had some. I was incredibly ill, but I guess I must have liked the sensation because after that, I went on looking for more.

"I had a difficult childhood. My mum was on her own, but then when I was nine she remarried. It was an abusive relationship and I was abused, too. I desperately wanted to be normal and to cope, despite everything that was happening to me. Alcohol helped. I'd steal money from my mum's purse, and borrow from friends, to buy booze.

"At 15, I remember thinking for the first time that I really needed a drink. I was up against it and alcohol calmed me. I felt I couldn't get through the day without it. I remember searching for 10ps down the sofa so I could buy sherry. And I turned to spirits, because I got my hit faster.

"After school I got a job in a department store, but I was coming in with a hangover then drinking at work, so I got sacked. I've had jobs since, but I've often only barely managed to function.

"Eventually I got so bad that I'd be sleeping in pubs, not cleaning my teeth, plastering make-up on over make-up I'd put on yesterday … I was going downhill fast. I'd tried Alcoholics Anonymous before, and at 31 I tried it again. It was a struggle but it's now eight years since I had a drink. The legacy of my drinking years is that I've got a terrible memory and nerve damage in one hand, but it could be so much worse.

"I've gone back to university now, and it's strange being with all these young people who drink themselves silly. Sometimes I wonder if I should say something, but I never do. People have to make their own mistakes. The trouble is when you drink you're only thinking of now, never the long term."

"Sarah" is a pseudonym

What Drives a Child to Drink?


What drives a child to drink?

By the time Madeline Hanshaw's son Gary Reinbach was 13 he was drinking heavily. This week, aged just 22, he died of liver failure. Here, she defends herself – and her son's memory – against those who have been quick to pass judgment

Joanna Moorhead The Guardian, Saturday 25 July 2009

Madeleine Hanshaw, with sons Luke and Tyler, said she hopes Gary's story will be a lesson to others. Photograph: Christian Sinibaldi

Madeline Hanshaw is standing in her kitchen. The washing is whirling around the machine, there are coffee cups in the sink, and outside kids are playing noisily in the sunshine. It could be an ordinary day: but Hanshaw is wondering how life will ever be ordinary again. "My baby is dead," she says. "That's going to be in my heart every day for the rest of my life."

Hanshaw, 44, is crying now. A week ago, she is saying, she still hoped that Gary – "Gal", she calls him – would pull through. "I believed in the doctors," she says. "I thought they'd find a liver for him somehow. I thought he'd make it."

Gary Reinbach was denied a transplant because, under guidelines drawn up by the Liver Advisory Group, patients who are likely to return to a damaging pattern of alcohol consumption aren't deemed suitable candidates.

So Gal didn't make it: last Sunday, a day after Hanshaw had gone public with her plea to doctors to make a liver available to him, her 22-year-old alcoholic son died at London's University College hospital (UCH). His last hours, she says, were truly terrible. "He didn't want to die. He kept saying that. I really think that if they'd given him a second chance, he'd have changed his ways.

Gary Reinbach had shown promise as a young boy. Photograph: Christian Sinibaldi

"He was talking about going back to college, training, making a new life for himself." She pauses. "That isn't going to happen now."

Talking to Hanshaw you get the feeling that – though Gary was desperately ill in hospital for 10 weeks before he died – neither she, nor he, believed it would come to this. She still seems unable to believe that drink could have made his liver pack up while he was so young. She is adamant she didn't realise he was drinking at 13 – "don't you think I'd have done something about it if I'd known?" – and says that, when she did realise he was drinking heavily from the age of about 16, she did all she could to persuade him to stop. "But he was a young lad, and what young lad listens to his mum? I thought it was just a phase. I thought he'd come to his senses, stop drinking and move on."

What neither she nor Gary was prepared for was the suddenness, and severity, of liver failure. "One moment he was just a heavy drinker, the next he was losing weight and being sick every morning. Then one day I noticed a yellow tint in his eyes, and I told him to get to the doctor." He did – and a few days later he was in hospital, first at Queen's hospital near his home in Dagenham, Essex, then at UCH. "By then he knew it was bad, but he still thought he could get through. He was asking me to call Alcoholics Anonymous so he could start to turn his life around," says Hanshaw.

As she shows me the death certificate – Gary died, it says, of "multi-organ failure" caused by "alcoholic hepatitis" – one of Hanshaw's two younger sons, Luke, 18, arrives. Luke, too, says he never for a second thought Gary would die. "Everyone round here is shocked," he says. "What I keep asking myself is, how come alcohol isn't illegal, when it killed my brother?

"My mates used to drink, but they're not drinking now. They've had enough – no one else wants to die like Gary died."

What Luke and his mates have discovered the hard way is what liver specialists like Dr Nick Sheron, of Southampton General hospital, have been saying for some time: that young people who abuse alcohol heavily will suffer the same consequences that older people who've been abusing it for many years do; in other words, their livers will fail.

"I became a liver specialist 15 years ago, and I remember how shocked I was when I first saw a man of 23 with liver failure. But this year already I've seen five people with it in their early 20s. Gary isn't going to be the last death. We're going to see a lot more young people in this state over the next few years.

"The mistake people are making is to think this problem can't get much worse. It can. We're already seeing heavier drinking in very young people and that can lead, as it did in the case of Gary Reinbach, to early liver failure."

But Sheron says even he is shocked by figures out this week which show that, among 11-15-year-olds who drink (ie, who have had alcohol in the past week), consumption has gone up from 5.3 units a week in 1990 to 12.7 in 2007 and 14.6 last year – an almost threefold increase in consumption in under two decades.

"We're aware of a trend towards greater consumption in youngsters who drink," he says. "It escalates – what you see is someone who starts having alcohol in their early teens, and then they start to drink more and more on more and more days of the week. It starts with the weekend binge, and then it spreads to Thursday nights and then Wednesday nights. And then they're drinking heavily on a daily basis – a recipe for liver disease."

From talking to Hanshaw, that seems very much to have been how Gary's drinking progressed. But the big question is, why? What makes a child who's doing reasonably well (Hanshaw says her boy more than held his own at primary school, though his secondary school career was inevitably blighted by his alcohol use) descend into an alcoholic daze?

Inevitably, there isn't one single reason: as Sheron points out, the reasons for alcohol misuse are always multifactorial. But availability is crucial: what a lot of people don't realise, says Sheron, is how much easier it is for kids today to not only get their hands on alcohol, but to get their hands on stronger alcohol. "Compared with 1980, beer is 170% more affordable," he says. "But wine is 280% more affordable … and spirits are 350% more affordable. It's not just that it's got cheaper: the strongest stuff has got more affordable than the weaker stuff."

So how did Gary, who reportedly got through three bottles of vodka a day at the height of his addiction, get his alcohol? "What happens is that an older kid buys them their first booze or they get it from girls who've got adult men to buy it for them," says Hanshaw. "Then they get a taste for it, and they're away – and they find ways to get it, of course they do."

But availability is only part of the jigsaw: drinking yourself into a daily stupor requires a fairly heavy dissatisfaction with life as well. Hanshaw says Gary was bored – "there's nothing for them to do round here, I think he drank to help him get through the boredom". But she feels, too, that he was deeply affected by her marriage break-up when he was 11, and that alcohol provided some solace. "I think the fact that his dad and I broke up had a lot to do with it," she says. "But then again, plenty of kids have parents that break up." She also points to the fact that Gary was a hot shot at tae kwon do, and might even have become one of the youngest black belts in the country.

"But when we split up we moved away from where the classes were held, and it was too difficult for him to get to them. I think that was a big disappointment, yes: when we had arguments, he'd always throw that one back at me."

It's pretty heartbreaking, this idea of an 11-year-old lad suddenly wrenched from the life he knew and deposited in this ground-floor flat on a rundown estate, his dream stolen from him and the world suddenly seeming to offer only disappointment.

Hanshaw says she feels both she and her dead son have been unjustly vilified in the press over the last few days. For the first time during our chat, there is an edge of anger in her voice. "I know people are blaming me and I know people are blaming him, but what I say is – you don't know me, and you didn't know my son. I did my best for him, just like any other mother. Yes, his dad and I split up, but we're still friends, he's been down here this week. It wasn't the worst break-up."

One of the things that has hurt her most has been that some people have said that it was right that her son wasn't deemed eligible for the liver transplant that might have saved his life. "I've heard people have said that reading about Gal makes them feel like ripping up their donor cards. Well, rip them up! We wouldn't want a liver from anyone like them anyway." She pauses.

"At the end of the day, I'm just a mum who was trying to keep her child alive. You'd do anything … I'd do anything …"

She had heard that a transplant would have given Gary a 75% chance of recovery. She did all she could for him in what turned out to be his final weeks. "I was at the hospital every day."

Now, she says, she'd just like other mothers, and other young people like Gary, to know the reality of heavy drinking. "If they could have seen my Gary lying there, so ill and so swollen … if they could have heard how much he wanted to live. If I'd known then what I know now I'd have done something, anything, to stop him drinking but I didn't know it could turn out this bad. And I didn't know how to stop it."

How to stop young alcoholism is the $64,000 question: and according to Sheron the answer, like the problem, is multifactorial. "There isn't one single reason for it, and there isn't one single solution to it," he says.

One thing he will be pinned down on is cheap alcohol marketed directly at young people. "We've got to look at the fact that there are almost no controls on this," he says. "It's being pushed through the internet, through mobile phones, through all channels."

But for Gary Reinbach, there was to be no second chance. "I'm not saying he was the perfect son," says his mother. "But I'll tell you this: he didn't deserve to die like that, at 22. No one does. And I hope to goodness others learn from it, because I don't want any other mother to go through what I'm going through."

The Paramedic's Story


The paramedic's story

The Guardian, Saturday 25 July 2009

Steve Evans has been a paramedic for 38 years with the North West Ambulance Service.

"I remember the moment I realised what a big problem underage drinking had become. It was a Friday night in Widnes and we were called out to two 11-year-old boys and a 13-year-old girl who were unconscious due to alcohol.

"If they'd all been at the same party it wouldn't have been so bad, but what frightened me was that they were all from different callouts. One had nicked the alcohol, another had got an older brother to buy it, the third had bought it from a white-van man who'd gone to France, stacked up his car with vodka, and didn't care who he sold it to.

"That was bad enough … and then, a few weeks later, I was called out to a 12-year-old lad who was unconscious in a field all on his own. Fortunately, a woman out walking her dog saw him and called for an ambulance, or he'd probably have choked on his own vomit or died of hypothermia.

"It made me realise that the problem is out of control and that kids aren't equipped for helping one another when the worst happens. So I decided to set up a campaign called Don't Walk Away. We publish posters and we put them up in places where kids will see them, and what we're telling them is not to abandon a friend who collapses because of drinking too much. What we say is: your intervention could save your mate's life.

"Alcohol abuse in the very young is a timebomb, and it's starting to go off. Alder Hey children's hospital in Liverpool runs an alcohol referral unit, and has children of 10 among its patients!

"I've got a 13-year-old son. How will I stop him drinking? Well, I don't drink myself and that's important in terms of role-modelling.

"But beyond that, I just want to demystify alcohol. I want him to realise that it can wreck your life, and I definitely don't want it to wreck his."

Advice from Paramedic Steve Evans of the NORTHWEST AMBULANCE SERVICE (NHS) (UK)

When Things Go Wrong

Sometimes a drinking session gets out of hand. Young people can become intoxicated quite quickly, even to the point of slipping into unconsciousness. Their friends may feel frightened about the situation, but there are some basic steps you should take.

Here is some first aid advice for young people. Steve says:-

1. Don't panic, the Ambulance Service is there to help you in this situation.

2. Clear the casualty's airway of vomit by finger sweeping if necessary.

3. Make sure the casualty is breathing by looking, listening and feeling for movement of the chest or abdomen, if they are not breathing then you need to do mouth-to-mouth resuscitation.

4. If the casualty is breathing then you need to clear the area of broken glass so that you do not roll them on to it.

5. Having done this you need to roll the casualty into the recovery position, that is on to their side so that they can still breathe. If you roll them right over then they will not be able to breathe properly, as their own body weight will stop them from breathing.

6. This is the time to send or phone for the Ambulance by dialling 999, giving the exact location of the casualty. It will help the Ambulance crew if you send somebody to meet them and guide them to the casualty.

7. You should try and keep the casualty warm as a side effect of too much alcohol is hypothermia.

8. Keep checking that the casualty has a clear airway and is still breathing properly until the Ambulance arrives.

By following these simple steps you may save the life of a friend. Do not worry about getting into trouble by getting involved, because we are more interested in saving lives than telling people off.

July 26, 2009

Kirin Beer's Surprise Hit Product: Alcohol-free Beer...


Aside from uncomfortable psychological triggers, another reason why most former drinkers generally don't like to discuss "alcohol-free" beer is that it's not really free of alcohol. Surprised? In the US, "non-alcoholic" is defined as anything with less than 0.5% ABV and in the UK, "no alcohol/alcohol free" is defined as not more than 0.05% ABV. That's definitely NOT "non-alcoholic" in most people's books.

We now have a case with 0.00% alcohol-free beer having less alcohol than a glass of orange juice...which often has small negligible amounts of naturally-occurring alcohol.

Many inside Japanese brewing company, Kirin, were actually very skeptical that such a product would have any future in a country like Japan, where drinking alcoholic beverages seems very ingrained into the culture. So, they were taken aback when sales soared and they actually sold out of product.

This is probably not a good product recommendation for any recovering alcoholic who is not yet 100% comfortable in their sobriety especially if the taste of beer might provide a psychological trigger for relapse.

Those who think they might have a drinking problem and want to take a stab at controlled drinking and/or moderation, might find this useful however.


Alcohol-free brew surprise hit in beer-loving Japan
Thu Apr 23, 2009 2:01pm EDT
By Taiga Uranaka

TOKYO (Reuters Life!)
- Japanese thirsting for a beer, but not the buzz, are quaffing an alcohol-free brew that is a first in a country with a strong drinking tradition.

There are many beers on the market from all over the world that are labeled as non-alcoholic, but brewer Kirin Holdings, which makes "Kirin Free," claims its brew is the only one with 0.00 percent alcohol.

In Japan, alcoholic drinks are defined as those that are 1 percent or more proof.
"Those drinks, albeit in very small amounts, contain alcohol," said Kirin spokesman Kuniaki Tamai, referring to the drink's competitors. "Restaurants and shops had not been able to loudly tout them as non-alcoholic drinks either."

Non-alcoholic beer is a niche product in Japan, home to several brewers such as Asahi and Sapporo whose drinks are as popular at home as abroad.
Japanese businessmen and executives regularly go out for drinks after work, and beer has long been one of the country's most popular alcoholic drinks.
But Kirin, one of Japan's biggest brewers, said demand for its drink, which it advertises as a soda with a beer-like taste, has been overwhelming.

Earlier this week, it ran adverts in newspaper apologizing for the shortage of "Kirin Free" due to stouter-than-expected demand.

Kirin said demand was especially strong among drivers and pregnant women who did not want to take in alcohol. A few years ago, the government introduced stiffer penalties for drunk driving.

"We are hearing from pregnant customers who say they like it because it has no alcohol content," said Kirin's Tamai.

A 350ml can of Kirin Free costs around 150 yen ($1.5), while regular beer is priced at about 220 yen ($2.2).

The popularity of the new product is a rare bright spot for Japan's beer industry, which faces sober reality at its main market. The country's beer market shrank by 15 percent in volume in the past decade amid aging demography and diversifying taste. ($1=98.30 Yen)

(Editing by Miral Fahmy)

Craig Ferguson Speaks from the Heart

The Late Late Show host, Craig Ferguson speaks on his past problems as an alcoholic...
(the total video is 12 minutes... give him about 4 minutes until the serious part of his monologue kicks in - it'll be worth it. Guaranteed.)

To get a free (legal) online copy of the AA "Big Book", go to this post.

Alcoholics Anonymous BIG BOOK (The Anonymous Press PDF Edition)

Before reading the post below, first, take a look at the excellent Youtube monologue by The Late Late Show host, Craig Ferguson:


"A recovering alcoholic, Ferguson has been sober since February 18, 1992. He said he had considered committing suicide on Christmas Day 1991, but when offered a drink by a friend, Tommy the Irishman, for celebrating the holiday, he forgot to jump off Tower Bridge in London as he had planned."

I promise that it won't be a waste of your time....
(The video is about 12 minutes ... give it about 4 minutes until he starts getting into the serious part of the monologue)

Alcoholics Anonymous BIG BOOK
(The Anonymous Press PDF Edition)

For many people, one of the first organizations they turn to advice when they are deciding whether to quit drinking is Alcoholic Anonymous (AA). The "Big Book" as it is known contains the stories of recovery gathered from all types of alcoholics.

f you think you have a drinking problem and would like to learn more about AA, this is the next best solution to attending a meeting: read the book...

Alcoholics Anonymous BIG BOOK (The Anonymous Press PDF Edition): The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism -