Alcohol | Alcoholism | Alcoholics Anomymous

Alcohol is a natural chemical, and is produced by fermenting and distilling organic material such as hops, grapes, peaches etc. Drinks vary in the percentage of alcohol present, from beer and wine, which contains anything up to 5-15 % alcohol by volume, depending on brand, to spirits such as mampoer and witblits, which can contain up to 80% alcohol. This concentration is normally published on the packaging.

Although drinking is social pastime, alcohol is a poison and it can kill brain cells. Your body sucks up vital fluids to relieve its effects from your organs to dilute the poison. It activates the adrenal glands to speed up your metabolism so as to remove this poison as fast as possible, causing euphoria.

If you continue drinking, your body runs out of the vital fluids with which to dilute the alcohol, and becomes dehydrated. Too much alcohol generally makes you throw up. Hangovers are caused by toxins and dehydration.

Alcohol acts not as a stimulant, as is often supposed, but as a depressant. It switches off nerve impulses to areas of the brain involved in memory, judgement, and coordination.

Short-term effects of alcohol use include distorted vision, hearing, and coordination, altered perceptions and emotions, impaired judgement, bad breath and hangovers. Long-term effects of heavy alcohol use include loss of appetite, vitamin deficiencies, stomach ailments, skin problems, sexual impotence, liver damage, heart and central nervous system damage and memory loss. Alcohol can cause major neurological damage as a result of causing a thiamine (Vitamin B12) deficiency - but only in very large doses over a long period of time.

Because alcohol is legal, generally it is abused with a high frequency and with little thought. Drinking can bring on aggressive behaviour. It slows down your reflexes and confuses your mind, so you should not drive when drunk. It's very dangerous not only for you, but for your passengers and other road users. Dancing is difficult when drunk, as it can make you clumsy and uncoordinated.

If your family has a history of alcoholism, be especially careful about regular drinking because you could have the tendency to develop the same problem. Alcohol shouldn't be mixed with Ecstasy since it makes the danger of dehydration more severe. The same applies to depressant drugs (e.g. Heroin). Alcohol and GHB should NOT be mixed since both of them have a sedative effect on your body. Mixing the two compounds this effect, and can lead to deep unconsciousness for a few hours.

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Harmful effects of alcohol on the foetus and infant

(See IOL: The shameful truth of foetal alcohol syndrome)

A lost, unidentified and neglected generation.

Foetal Alcohol Syndrome (FAS), is the name given to a group of physical and mental birth defects which are the direct result of maternal alcohol consumption during pregnancy. FAS is now known to be the world's leading cause of mental retardation. Symptoms can include growth deficiencies before and/or after birth, major organ damage, skeletal deformities, damage to the Central Nervous System resulting in learning disabilities, behavioural problems, lower IQ, and facial characteristics common to all children diagnosed with FAS. Foetal Alcohol Effects (FAE), is the name given when all the characteristics required for a diagnosis of FAS is not present. This does not mean FAE is a lesser problem. Children who have FAE can still display the same learning disabilities and behavioural problems as a child with FAS, and it is largely under diagnosed. Research has shown that as many as 1/3 of learning disabled children (not otherwise diagnosed) may have been affected by alcohol before birth. Figures show that between1 and 3 per 1000 live births in the UK are born with FAS, and many times that number are affected by FAE.


Alcohol has contributed to the “Ladette” culture of binge drinking, where women are drinking regularly in larger quantities well over and above the 2 units. This can lead to drunken, unprotected sex and consequently pregnancy. In the U.K. Government’s pregnancy leaflet “Drinking for two”, the advice given is that 1-2 units of alcohol once or twice a week is acceptable. This is questionable in the light of recent research that suggests there is no known safe level of alcohol consumption whilst pregnant. Whilest the UK has the highest teen pregnancies and underage drinking in Europe, the Northern Cape in South Africa has the highest incidence of FAS in the world. Research is needed to explore the relationship between these two facts especially so as if there is a linkage then these children will be at a higher risk of prenatal alcohol related harm.

The foetus brain is developing all through the pregnancy. The brain is still developing into the early twenties. Drinking forms a large part of our social culture. Some people even plan major life events around alcohol. We therefore need to appreciate that we are talking about cultural change. Binge drinking has become a major problem, especially for women, who may consume the recommended safe weekly quota of alcohol in a single sitting. The Government should concentrate its efforts in prevention by developing an education programme, which should be integrated with smoking and drugs education programs in schools. The programme should ideally commence at age 7 bearing in mind that statistics show that children as young as 9 are experimenting with alcohol.

Alcohol education programs should be ongoing, continuing throughout school life. The United States also utilises public service announcements, brief interventions by medical personal and signage laws at points of sale. US Studies have shown that just one form of education in not as effective as several forms of education combined.

This is especially true of education that is done at an early age. The evidence shows that when these forms of education are combined with other initiatives aimed at adult consumers a significant reduction in risky drinking behaviours can result.

Attention needs to be focused particularly on women; Education and Awareness campaigns are needed to prevent the lasting damage that alcohol can cause to the Foetus.

The 1990 US Census report shows that the women most likely to drink is white with two year associates degree or a baccalaureate degree and earns an income over $20,000.

A Swedish study demonstrated that the stresses of the workplace, in combination with after hours homework escalate for women and probably contributes to the increased drinking among modern women. Very early marriage, very late marriage, no marriage (living together), marriage under duress, a significant other who drinks, financial and personal problems and a family history of alcohol abuse can all lead to risky drinking behaviours. One group we need to focus on specifically is young people, where the evidence suggests a rise in consumption, particularly by young women.

The need to belong to a social group brings peer pressure to all parts of the community, including ethnic groups (i.e. secret drinking/drug taking particularly with third generation immigrants) and starts during the primary school years.

The media influences social habits of a wide nature including appearance, entertainment, what to eat and drink as well as behaviour by giving a voice to the wrong type of role models. Women are taking greater risks because others are appearing to get away with it. However the blatant use of alcohol in our society has degraded it to a psychological oil that lubricates the way for conversation and superficial bonding. It has taken the place of honest, open relationships and prevents people and governments from openly facing the problems of education, employment and other economic quandaries. Women today face greater challenges owing to the culture of independent women. It has caused separation from men who feel insignificant and intimidated by the movement. The result is a generation of independent lonely single women who, just like men, need to use alcohol as a lubricant for beginning relationships.

The so-called Ladette culture is making the headlines more and more. This involves young women who binge drink. Often this is linked with the pub-crawl cum nightclub trawl. Some areas are more noted for it and they should be identified as causing concern. Young women often start their drinking habits on the streets at a very early age and in family homes. It is a known fact that a large number of young people are under age drinkers. They look older than their true age and are putting themselves at risk. Identity/Proof of Age card schemes could be encouraged as part of the answer here.

Pubs now offer two for the price of one and happy hours to encourage drinkers into their premises knowing full well that once a customer is in the, they are reluctant to leave. This also encourages binge drinking. Broad regional differences occur between rural and urban areas (WHO Global Status Report on Alcohol). Women tend to start drinking at a later age than men but then tend to consume more and develop serious medical problems at an earlier age. Women’s drinking can cause Foetal Alcohol Syndrome, Foetal Alcohol Effect and or other alcohol related birth defects/disorders. Men’s drinking can produce offspring who are hyperactive and unable to solve test problems and have gross motor skill problems.

Fashion and marketing within the pop/media influences a wide range of social habits including appearance, entertainment, that to eat and drink and behaviour by giving a voice to the wrong type of behaviour. The wrong role models are always in the news. Positives role models/heroes should be highlighted.

The alcohol industry must learn to diversify the nature of their product lines in order to ease their way out their dependence on alcohol as a primary source of income. The Government must decide whether it wishes to protect its youngest and unborn citizens above the rights of companies to make money and of adults to determine the life outcome of children before they are even born. It is not easy to change the mind of businesses that seek to make a profit but the alternative in the long term could be a general population with lower IQ’s.

How do attitudes to risk affect use of alcohol? Young people have a tendency to think, “It won’t happen to me.” This causes a great deal of complacency that in turn increases the risk factor applying to all that they do. Greater access to information and education at all ages is vital. Many people have the impression that moderate drinking is not harmful and carries no risks. The risk of alcohol related harm does not suddenly appear after a given number of units of alcohol. The use of moderate must be carefully defined as it means different things to different people, including the different genders. The US National Institute of Alcohol Abuse and Alcoholism have stated that 1 drink a day is moderate for a woman and 2 drinks a day is moderate for a man. More than this means a greater risk to organ failure, brain damage as well as a possible inclination towards alcohol dependency. For women there is an increased risk of breast cancer.

There are additional risks, and therefore problems, when alcohol is combined with other factors such as legal or illegal drugs. Foetal Alcohol Syndrome (FAS) can be caused before a woman knows she is pregnant. It therefore requires an intense pre-warning and information system long before the woman even considers getting pregnant or even wants to. The unborn child is at risk of being born with physical and neurological disabilities of varying degrees. In addition to this there is evidence that the child is likely to have a higher risk of predisposition to alcohol related problems in later life, depression and mental illness. According to recent findings by Dr Mary Connor of UCLA published in the American Journal of Drug and Alcohol Abuse psychiatric disorders, in particular mood disorders, are common in children exposed to alcohol in the womb.

Dr Mary O'Connor and colleagues from the University of California, Los Angeles (UCLA) studied 23 children between the ages of five and 13 years who were referred to UCLA's Foetal Alcohol and Related Disorders Clinic because of heavy exposure to alcohol in the womb. After assessing the children's intellectual and psychological functioning, researchers concluded that 87 per cent of the children met criteria for a psychiatric disorder. Twenty-six per cent were diagnosed with major depressive disorder or adjustment disorder with depressed mood and 35 per cent met criteria for bipolar disorder. Although the mechanisms underlying risk for mood disorders are unclear at present, the team point to recent findings showing structural damage to specific areas of the brain in children parentally exposed to alcohol. We therefore have to conclude that alcohol use by pregnant women should be a special cause for concern and must be taken into account when formulating any definition of harmful drinking. There may be some benefits to health in drinking alcohol in moderation but there is a fine line between this and drinking to excess. On balance the benefits are heavily outweighed by the risks.

Estimates of the health costs of alcohol have been made, i.e. by Alcohol Concern in their 2002 report “Your very good Health”, who came up with a figure of £3 billion per annum. Unless research is done however it will be difficult to ascertain the true cost to the South Africa of alcohol related illnesses and effects. Apart from the direct health related costs of drinking there are many others but one that is not so well known is the effect on the unborn child. In the light of the statistics given above, the ongoing costs of lifetime support for FAS children must be substantial and further research would appear to be warranted.

The most effective means is education in the primary grades of school. This must be in conjunction with the banning of advertisements on television, magazines and billboards; especially those bill boards shown during sporting events. Warning signs at points of sale, liquor stores, restaurants and pubs are also effective in conjunction with other forms of warnings and information. Professionals (medical personnel and educators) should be trained to know and recognise the symptoms of Foetal Alcohol damage so that the parents can work effectively with educators to be properly informed and can take remedial steps for the child. Studies have shown that it is essential to have organised support groups in a variety of settings for convenience and availability.

Brief interventions can be offered to patients who have been identified as a risk from alcohol misuse. They may consist of a short session with a doctor or nurse to discuss a patient’s drinking and to offer help and support to cut down on alcohol intake, if the patient wishes to do this. There is evidence that brief interventions can be effective when offered to those patients at risk from alcohol misuse. However the evidence also suggests that they will not be effective for those patients who are alcohol dependent or heavy alcohol abusers. It is therefore essential that medical practitioners delivering brief interventions should have the necessary assessment skills to be able to differentiate. It is also essential that the facilities exist to refer on to appropriate services without delay. Timing is an important factor often the circumstances that lead to the patient seeking medical help at that time mean that there is a window of opportunity to intervene. This window will not necessarily remain open for long when the immediate medical crisis has past.

Posters and brochures containing information about alcohol and support groups might be placed in medical and dental offices, at the chemist, other allied medial and health facilities. Consistent reminders of the dangers of alcohol misuse and sources of help may be more effective than brief interventions.

Research has shown that alcohol dependent women do better in a single sex treatment setting. One of the major obstacles blocking women coming forward for treatment is the fear of loosing their children although there can obviously be child protection issues when parents are drinking problematically, policies need to be framed in such a way as to ensure that they do not become another obstacle to seeking help.

Residential treatment facilities which accept mothers together with their young children can have certain advantages. The mother can learn parenting skills and begin to repair the mother/child bond during the course of treatment, the child can be assessed for FAS, FAE or other problems related to the mothers use of alcohol and a structured care plan can be worked out for the child which can be fully integrated with the mothers own care plan.

Such mother and baby facilities here in S.A. have a high failure rate because of economic factors associated with the funding system. Alcoholism and alcohol related problems are normally quite complex and often require more than just physicians or psychologists working together. A program in Washington State (U.S.A.) for alcoholic mothers combines physicians with therapists, social workers, family counsellor to not only deal with addiction but to help with seeking services for the children.

Within the drugs treatment field it is accepted that patterns of poly drug use are exceedingly common. Alcohol forms part of this pattern and is often not possible to draw any clear distinction between alcohol and drug abusers. The symptoms, progression and consequences of alcohol and other drug dependencies are similar, so much so that they can best be regarded as varieties of the same condition. The tendency of alcohol services to disregard drug use and of drug services to ignore alcohol use is artificially created and is counter productive in terms of treatment. It has come about as a result of historical accident.

Addiction treatment services should be integrated, however it is important that the additional workload that this will create should be properly resourced. There is evidence that children are experimenting with alcohol, smoking, and drugs as early as 9 years old. These factors are predictive of problems with substance abuse later on in life. Children who are identified as being at greater risk should be supported with behaviour modifying classes.

In the long term, a system is called for to integrate alcohol with other drugs services.

· What evidence is there about the links between alcohol and crime and the links between alcohol and anti-social behaviour?

· Are there key studies or pieces of evidence we should be aware of?

· Where are there gaps in the evidence?

The behaviour patterns of many FAS/FAE, children/adults bring them into conflict with the law. The problems of poor judgment and gullibility that became apparent in childhood are not outgrown. The criminal justice system needs to find a more appropriate response to individuals with these disabilities. Recent research studies have revealed that our prison system is filled with adults with Foetal Alcohol Syndrome. This opportunity that presents itself to members of the judicial system is directly related to the concept of early identification and intervention. Commonly, it is the police officer on a street beat that encounters an intoxicated pregnant woman. Knowledge of community referral resources for pregnant women in crisis provides an alternative to incarceration and places the woman in a system designed to support the pregnant woman in her efforts not to drink alcohol.

The best method of dealing with FAS related crime is to prevent it. Across the world several innovative projects have been developed that take the weaknesses commonly associated with FAS teens and adults and turn them into strengths. This gives self-esteem a valuable boost that thereby facilitates further rehabilitation.

· Is alcohol a factor in habitual re-offending?

· Does it lead to particular types of crime?

· How far does it lead to one-off offences?

Dr Ann Streissguth of the University of Washington Foetal alcohol (FAS) and Drug unit has said that one of the most distinctive characteristics of a person with FAS is the inability to learn from their mistakes. It is self evident that this type of inability could contribute to recidivism. FAS affects men and women of all ages and they commit a wide variety of crimes. One of their characteristics is their tendency to copy what others do. Thus, a person with FAS might be incarcerated for a minor crime and then follow a fellow inmate into a more serious crime, often without recognising the inherent wrong of the other person. Dr Streissguth has indicated that she feels the most outstanding characteristic of a person with FAS is the inability to connect an action with its consequences. Because brain cell damage is permanent, it is unlikely that any modern day punishment will deter the person with FAS from committing more and more serious crimes once they are led in that direction.

To what extent can alcohol convincingly be demonstrated to be a factor in criminal and disorderly behaviour?

How much is perception and how much is reality?

What fuels the perceptions and are they accurate?

A study by Dr Julianne Conry on the University of British Columbia has concluded that nearly 60% of the men he studied in the Canadian penal system may be prenatally alcohol affected. Further studies need to be conducted. However, Dr William Healy has previously explored the connection between prenatal alcohol exposure and criminal activity as far back as 1918. Further research of older literature may reveal more studies of the connection between prenatal alcohol exposure and crime.

Alcohol is far from being the only factor in crime and disorder. Other factors are involved - for example, town centre disorder can be influenced by lack of availability of transport or design of environment. What other factors might be involved? How easy are these factors to influence? Who is responsible for them? If there is an excessive drop out rate in the schools and an increase in juvenile delinquency, the Government will be blamed. If the country has growing rates of mental health problems, violence, domestic abuse and increased use of health and mental facilities, the responsibility of improving these statistics with fall on the Government. All these things can and will happen if the Government allows problems like Foetal Alcohol Syndrome and alcohol abuse to go unchecked in the country. Starting an early education program will go a long way in preventing other problems. The important thing is to start now and not allow these problems to proliferate.

How does the impact of alcohol on urban environments differ from its impact on rural environments? What are the differences between urban and rural drinking patterns and how do they affect those communities and surroundings. The World Health Organization Global Status Report on Alcohol indicates that alcoholism might be even more of a problem in rural area. The hard work and lack of close neighbours encourages the use of alcohol. Individuals affected by FAS usually difficult to employ, they might feel that an urban area could offer better opportunities and travel there to seek a job, thus taking a rural problem to the city. There is a general tendency for young people to seek the excitement of city life. The problem with urban life is the anonymity and psychological distress that is encountered may tend to exacerbate rather than diminish personal problems and addictions issues.

To what extent can impacts on the environment (including crime, disorder, noise and waste) be designed out, for example by use of plastic drinking glasses? Are there examples of good practice it would be helpful for us to be aware of? While we do not oppose attempts to reduce the impact on the environment and we are aware of the approaches being tried such as part the various communities against drugs and crime and disorder initiatives we feel that we must point out that these initiatives only address the symptoms, rather than the causes of problems. There are also issues involved here concerning personal responsibility. To what extent are we likely to perpetuate problems in the long term if we start to take responsibility for the actions of individuals? Manipulation of the environment is a treatment after the fact and is always less effective than prevention. However, early education of children about the dangers of alcohol is the best and most complete method of dealing with the current problems of alcohol. There are some examples of good practice where a range of organizations responsible for dealing with different aspects of alcohol have successfully combined efforts and shared information to tackle alcohol related crime and disorder together. This approach should be encouraged more widely although organizations and communities are sometimes inhibited from taking such an approach.

The only thing inhibiting agencies and communities from working in the way suggested is the lack of a holistic approach across all agencies. Criminal Justice agencies still see alcohol as a legal problem, Medical Practitioners perceive it to be a medical problem and Social Workers perceive it to be a social problem. There is also a traditional lack of trust between these various sectors and also between the statutory and voluntary sectors.

There are many good examples of initiatives within the drugs field where this approach is being adopted. Those areas that have chosen to have Drug and Alcohol Action Teams rather than just Drug Action Teams will have an innate advantage It is important that measures to prevent FAS and to support both individuals and families affected by FAS are part of the National Strategy and those FAS initiatives are seen as contributing to crime reduction by virtue of the links between FAS and crime.

The nature of this link and what could be seen as good practice in tackling the interrelationship between domestic violence and alcohol misuse is caused by a diminishing job market and when a job does not fulfil the needs of people involved in a relationship. Emotional inferiority often leads to picking on weaker members in family. In Japan, the child abuse rate has jumped 1600% since 1991. The late 1980s also saw an increase in the use of alcohol by pregnant women. It is entirely possible that symptoms of FAS, such as problems with school work, especially maths, problems with other children, indiscriminate touching and fondling, inability to do sequential tasks, inability to follow verbal instructions, unusual food preferences, medical problems with allergies and respiratory infections, eye and hearing disabilities or deficiencies lead to family arguments. It has been shown that an increase in medical and educational problems (which in turn lead to financial problems) causes great stress in families that can often lead to violent outbreaks that are fuelled more intensely with alcohol effected individuals are involved.

Children who are most vulnerable to the consequences of alcohol misuse are children raised in families where there is a history of substance. This appears to be at least in part a matter of genetic predisposition but wholly because of behaviour displayed by role models.

US Research has shown that it may be possible to identify those most at risk of developing problems later in life by means of enhanced EEG i.e. there is a observable physical difference in brain function. US research has also shown that prenatal exposure to alcohol, in particular FAS, is highly predictive of alcohol related problems in later life. The research also shows that these individuals also suffer from other problems: they experience neurological damage which is expressed as hyperactivity, behavioural problems, learning disabilities and a general inability to function normally in a social milieu.

Research in other countries has shown that FAS individuals who are not supported at an early age either end up in prison or on the streets. Diagnosis can be made at birth and from then on continuous support from various agencies can make a valuable contribution.

There is also evidence to suggest that groups who have lost their cultural identities and become marginalized are at a higher risk, particularly if they have no cultural history of alcohol use. Historical examples would include Native Americans, including Eskimos, and Australian Aborigines. All of these groups have developed high levels of alcohol related problems including FAS. It is important to realise that although some groups may be particularly at risk strategies cannot afford to ignore the fact that in fact anyone can be at risk. All groups from the social spectrum are at risk without adequate education and information. Those who are vulnerable to consequences of alcohol misuse often have complex problems (for example they may be homeless and may have additional mental health or drug problems) and such factors may be inter related. Key factors need to be understood in addition to alcohol use that contributes to maintaining the problems facing such groups? Interventions should be aimed at these factors in respect of individuals who are affected by FAS. Children and adults with FAS have unusual set physical reactions to the environment that affect not only the way they perceive the world but also how they physically react to it. Mentally the person with FAS may not show any emotional attachments. They may be unable to make reasonable connections between thought A and thought B. Abstract thinking is extremely difficult for them. They may be very literal in their thinking. They may be very concrete in their learning skills, unable to make adjustments or changes once a task is learned. Many times they are thought to have no consciences. They may be unable to follow verbal instructions without visual aids. They might not be able to stay on task with out external help. They may be very self-centred. They may seem gifted in some areas and severely delayed in others. They may seem terribly impractical. The most outstanding behavioural problem with a person who has FAS is the inability to connect an action with its consequences. Physically, sequential instructions and the required tasks are hard for the child or adult who has FAS. Hearing may appear to be within normal ranges but special hearing examinations often reveal deficiencies in certain sound levels that make learning difficult. Noises may be too loud or too soft. The child may hear things beyond the hearing range of normal children. Vision may be myopic or spotty and difficult to diagnose. Lights and moving objects often interfere with their ability to concentrate. Clothes may be very comfortable or very uncomfortable. Hyper and hypo sensitive may cause food allergies and/or rashes. Inability to recognise when they have to go to the toilet, or when they need personal hygiene. Nerve damage to organs might cause insufficient food processing and problems with elimination.

The best time for intervention is before FAS children encounter the frustration of the school environment. This means diagnosis soon after birth and before school starts. There are again plenty of examples of good practice from the drugs field. There is a severe lack of political will to tackle alcohol related problems that is not evident when it comes to drugs brewers and distillers are seen as valued members of the business community and are to be consulted while other drug dealers are not. Unfortunately until the time comes when alcohol is seen as the killer drug that it is there will probably not be much progress. Again this is a matter of cultural change.

Education is the most effective means to bring about change. This should involve not just public education but also the professional education of medical and allied health professionals, teachers, social workers and criminal justice professionals. Mainstream services in S.A. are under funded. Funding itself is not the answer until the mainstream services receive substantially more training in alcohol related issues, especially in recognition and assessment skills, further resources will only be squandered on ineffective schemes. There must be more cooperation between professionals, educators and public agencies. There needs to be an effective case management and care co-ordination system in place before this co-operation can prove really effective.

The role of self-help groups such as Alcoholics Anonymous has been consistently ignored and minimized. They help many thousands of people with alcohol dependency problems annually, there are groups right across the country and they provide a free resource that does not cost a penny!

With regard to FAS the objectives should be:

· To undertake research on Foetal Alcohol Syndrome, in particular it’s prevalence, with a view to establishing baseline statistics.

· To review the international evidence base regarding effective prevention and intervention strategies for FAS. (This will minimize the cost).

· To initiate projects designed to raise the profile of Foetal Alcohol Syndrome in the general community, the caring professions and within the alcohol and other drugs fields.

· To develop systems to identify and support children who are affected by Foetal Alcohol Syndrome or its effects.

· To inform and educate the professionals who pass on facts about alcohol.

· To review in the light of current worldwide research and to change where appropriate the advice given to women regarding the consumption of alcohol while pregnant and breastfeeding.

· To ensure that alcohol awareness campaigns raise the level of awareness that alcohol is a drug and that its long-term effects are cumulative.

· To ensure that all children and young people receive education about the dangers of drinking alcohol including the effects on the unborn child and binge drinking.

The objectives mentioned above will create baseline figures against which effectiveness can be measured. In the meantime there needs to be a country wide survey that can produce statistics relating to alcohol and its effects on the wider community. Statistics need to be compiled, stating with children homes, and schools where there are known adopted/fostered children to investigate whether these children are already on special measures for behaviour and learning difficulties or indeed they are receiving special needs support. Alongside this, children who have biological parents but are showing the same signs of behaviour and learning needs require diagnosis. The difficulty here is that natural parents are in denial when it comes to assessing their children’s special needs.

Schools have an ongoing Special Needs process but the teachers are limited in their knowledge of how a child’s behaviour is affected by alcohol either through direct drinking or by his/her mother when pregnant. It is important that children affected by FAS they are identified very early on and supported. This will help in reducing the cost to the Government in the long-term. It is very clear that message of sensible drinking is not getting across to the public. A perfunctory examination of the amount of highly sophisticated alcohol advertising in our media as compared to the amount of health education material about alcohol should be enough to explain why.

Increasingly alcohol advertising is aimed at women and young people. Until we can run campaigns that present not drinking as being as fashionable, or more so, than drinking we are not likely to be effective.

Sensible drinking promotions based on fear are not as effective as those that promote not drinking as something desirable. In other words sell what you do want rather than try to prevent what you don’t! To make a good positive start introduce alcohol health warnings on alcohol containers, similar to those on cigarettes and tobacco, include an honest warning of the lasting damage that alcohol creates to the developing foetus. We see little evidence to support the idea that scientific research is feeding into alcohol education. If there were evidence to the effect that all the available international research was feeding in then there would be no concern on our part to complete this challenge. Foetal Alcohol Syndrome is 100% preventable with education and awareness, yet totally incurable. There is a vital role for schools, colleges, universities and other educational institutions in providing facts about alcohol and its effects on people and future generations. Information regarding the dangers of alcohol consumption and the effects on the unborn child should be treated with the same importance as drugs and smoking and incorporated into the national curriculum.

There is a considerable body of US research on the problems of alcohol use on campus that is worth examining. Several US educational establishments (at all levels) have formed the Association of Recovery Schools with a view to providing specialised educational programs for students in recovery from alcohol dependency. This is a new way of combining support services with education and is worth further research. Education regarding the abuse of alcohol should start in the home, but there is little or no evidence to suggest that parents possess the knowledge or motivation at this time. This is because they themselves can be ignorant of the facts. At the present time education in school has to be paramount for the welfare of the child.

Children listen to teachers and other children if a package is presented in an interesting and informative way. Older pupils will listen to their peers, role models and anything that the pop/media gives however the message must be positive. Alcohol is often a gateway drug and should therefore be included in educational initiatives in the field of illegal drugs.

It is essential to remember that people affected by FAS are not contributors to society but must often avail themselves of its services. US estimates for the cost of a FAS child add up to $1.5 million over that person’s lifetime, not including the time and the lost income of those who must contribute to the care of this person with FAS. It is possible to do a lot of education and prevention work for that kind of money! There should be guidelines set to measure the amount of alcohol advertising aimed at the young women. Alcohol advertising on magazines, television and billboards should be banned. Alcohol beverage companies should not be allowed to sponsor any public events.

It would be very beneficial to all if there were honest information on all labels. It would also be interesting to see if the Alcohol companies would use some of the huge income that comes from alcohol sales used to help eradicate Foetal Alcohol Syndrome. Civil law suits for damages bought against alcohol retailers where it can be proved that they have knowingly sold alcohol to minors resulting in serious consequences such as death or injury must become the norm. Alcohol companies need to look at down the line as have the U.S. tobacco companies. It would be most advantageous for these companies to diversify their product lines and look into acquiring businesses in other sectors.

Alcohol companies aim a substantial part of their advertising at young people, especially women. Designer drinks make alcohol and drinking a fashion accessory. This is a market ploy to diversify the types of drinks available. It is simply a way of reaching a wider age range and minimizing the dangers of alcohol. The only interest that the alcohol industry has to reach consumers is to sell more alcohol. If the government is interested in seriously reducing alcohol related harm it will not co-operate with the industry instead it will hold the industry accountable for both it’s actions and it’s products. What would be the government’s attitude to any other kind of manufacturer whose products contributed to the deaths of tens of thousands of people a year?

Unfortunately because of the large amounts of revenue generated by the alcohol industry for the government we do not foresee this happening. The Government and the alcohol industry need to approach this objectively and not back down as happened in the U.K. and Europe with the sponsoring of Formula 1 and the tobacco industry. Look at future implications of alcohol related problems so that children and young people are protected so they develop into valued member of the community. They should show realism when reading all the consultation documents as here are the keys for solving a great number of problems.

When calculating the economic costs of alcohol please consider that the US and Canadian research shows:

Plenty of research has been done on FAS worldwide but for some reason it does not seem to have registered with the Government. It has not been phased or used to protect those most vulnerable. Dr Moira Plant who hosted the first conference for Women Alcohol & Pregnancy has conducted considerable research.

When Foetal Alcohol Syndrome occurs the government pays. When the child with FAS cannot achieve in school the education authorities don’t accept the cost of trying to educate a child whose brain cannot process information in a typical manner. When that child skips school or drops out, society pays the costs incurred for an individual with few skills, even less education and the inability to hold down a useful occupation.

When that child grows up and cannot earn a living and commits a crime, it is the Government who pays for the prosecution and the detention of this individual until he/she can be transferred to prison. No one person can be held responsible for the cost of Foetal Alcohol Syndrome because, in the end society will pay for all of the damage in one-way or another.

Clinics, Drug Rehabs etc.

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