Posts tagged ‘alcohol’
Women who are in the early stages of pregnancy, and who are not ready to share the happy news, know that turning down an alcoholic drink at a social occasion can be a dead giveaway. Telling friends and colleagues they are on antibiotics is the perfect excuse because they are so commonly used. Even the nosiest of acquaintances is unlikely to ask what they are being taken for.
But is it really true that you need to abstain from alcohol when on a course of antibiotics?
Some people assume that alcohol will stop antibiotics from working properly, while others believe that it will cause side-effects. When staff in a London genitourinary clinic surveyed more than 300 patients they found that 81% believed the former assumption, with 71% believing the latter.
For most antibiotics neither of these assumptions is true. The fear for doctors is that these erroneous beliefs might make patients skip their medication over a glass of wine. Anything that encourages people to miss doses of antibiotics adds to the serious problem of antibiotic resistance.
In fact, the majority of the most commonly prescribed antibiotics are not affected by alcohol. There are some exceptions. The antibiotics cephalosporin cefotetan and cephalosporin ceftriaxone slow alcohol breakdown, leading to a rise in levels of a substance called acetaldehyde. This can cause a host of unpleasant symptoms including nausea, vomiting, facial flushing, headache, breathlessness and chest pain. Similar symptoms are caused by a drug called disulfiram, sometimes used in the treatment for alcohol dependency. The idea is that the moment a patient has a drink, they experience these unpleasant symptoms, and this dissuades them from drinking more. The symptoms are unpleasant, so it is important that people abstain from alcohol while they’re taking these particular antibiotics, and for a few days afterwards.
Another type of antibiotic that comes with a specific warning not to take alongside alcohol is metronidazole. Used to treat dental infections, infected leg ulcers and pressure sores, it’s thought to cause the same list of symptoms as the previously mentioned cephalosporins. This link has been disputed since a 2003 review of studies found a lack of evidence to support it, and a very small controlled study in which Finnish men given metronidazole for five days suffered no side effects when they consumed alcohol. The authors concede that this doesn’t rule out the possibility that a few individuals are affected, and the current advice is still to avoid alcohol when taking it.
There are a few other antibiotics for which there are good reasons to avoid drinking alcohol while taking them, including tinidazole, linezolid and erythromycin, but these interactions are so well-known that doctors give patients specific warnings.
This leaves a long list of other antibiotics that can be mixed with alcohol. Of course getting drunk is not going to help your recovery when you’re ill. It can make you tired and dehydrated, but it’s not because of any interaction with your medication.
It’s possible that the isolated cases led to the myth that all antibiotics don’t mix with alcoholic drinks, but there are two more intriguing theories. One is that because antibiotics are used to treat some of the most common sexually transmitted diseases, doctors in the past were somehow punishing the patients for becoming infected by depriving them of their favourite tipple.
Or there’s the explanation given to one of the authors of the London genitourinary clinic survey. James Bingham met the late Brigadier Sir Ian Fraser, who introduced the use of penicillin for injured soldiers in North Africa during World War II. At the time penicillin was in such short supply that after a patient had taken it, the drug was retrieved from his urine and recycled. Recuperating soldiers were allowed to drink beer, but unfortunately this increased the volume of their urine, making it harder obtain the penicillin and, according to the Brigadier, led commanding officers to ban beer.
It’s a good story, irrespective of whether or not it is the true source of the popular misconception. Dispelling the myth is something of a double-edged sword. Encouraging those on the antibiotics who cannot resist a glass or two to complete their courses of treatment could help counter the spread of antibiotic resistance. However greater public understanding of the true picture may mean that women wanting to keep their early pregnancies to themselves in social situations may have to be a little more inventive in future.
Supermarket and off-licence sales in Scotland were higher than in England and Wales
Health chiefs have warned that Scots are still drinking too much, despite figures showing a fall in the amount of alcohol sold per person.
According to a report from NHS Health Scotland, the amount of pure alcohol sold per individual fell 3% between 2011 and 2012.
Its spokesman, Mark Robinson, said the recent ban on multi-buy promotions was linked to the fall in sales.
But he added: “We’re still drinking too much as a nation.”
The alcohol sales report said drink sales were 8% lower than in 2009, the equivalent of about 10 million fewer bottles of wine, three million bottles of spirits or 35 million pints of beer in a year.
“After a steady growth during the 90s, the amount of alcohol we consume has begun to fall.
“But that hides the fact we’re still drinking more than 10 years ago — and 19% more than in England and Wales.
“We’re consuming less beer but more wine, spirits – particularly vodka – and cider than a decade ago.
“Significantly, 60% of alcohol bought in off-licences and supermarkets cost less than 50p a unit.
“That’s the level the Scottish government wants to impose as a minimum price – a policy held up by legal challenges from the drinks industry.
“And analysis reveals most of the foreign countries objecting to minimum pricing, including Italy, Spain and Bulgaria are wine producers whose products mainly sell below the proposed level.
“The government says minimum pricing will save hundreds of lives, prevent thousands of hospital admissions and reduce crime.”
The reduction was evident across all drink categories, except cider.
The latest statistics also showed that alcohol sales in Scotland were 6% higher than in 1994 and 19% higher than in England and Wales last year.
Sales of vodka per person in Scotland were more than double the level south of the border.
NHS Scotland said the differences in other parts of the UK were mainly due to higher sales from supermarkets and off-licences in Scotland.
A total of 60% of the alcohol sold in off-sales and supermarkets cost less than 50p per unit – the Scottish government’s proposed minimum price for alcohol.
About a quarter of alcohol sold in off-sales cost less than 40p per unit (26%).
Mr Robinson said: “It is good news for Scotland’s health and well-being that alcohol consumption is starting to decline.
“We know that the ban on multi-buy promotions was associated with a fall in sales and that alcohol affordability has declined as a result of the challenging economic climate.
“However, although these positive effects are welcome, we’re still drinking too much as a nation, and a large proportion of alcohol is still being sold at relatively low prices.
- Alcohol sales per adult in Scotland declined by 3% between 2011 and 2012.
- Alcohol sales per adult in Scotland declined by 8% between 2009 and 2012.
- In 2012, 10.9L of pure alcohol was sold per adult in Scotland (equivalent to 21.0 units per adult per week).
- In 2012, 9.2L of pure alcohol was sold per adult in England & Wales (equivalent to 17.6 units per adult per week).
- In 2012, 19% more alcohol was sold per adult in Scotland compared with England and Wales.
- Sales of vodka per adult in Scotland were more than double those in England and Wales.
“There is a need to continue action on a number of fronts, including on minimum unit pricing, to ensure the welcome decline in alcohol consumption and harms does not reverse.”
Public Health Minister Michael Matheson said minimum pricing was needed because cheap drink was the “real source of Scotland’s alcohol problem”.
He added: “Minimum pricing will save hundreds of lives, prevent thousands of hospital admissions, reduce crime and save the public purse millions in dealing with the consequences of alcohol misuse.”
A separate report by NHS Health Scotland showed that of the 10 wine-producing countries that sold most products in Scotland’s off-sales, the majority of wine from four nations – Italy, Chile, South Africa and Spain – cost less than 50p per unit.
Wine from Portugal, Bulgaria and Romania, while accounting for a small proportion of wine sold in off-sales, are also more likely to be sold at cheaper prices, according to the report.
The Scottish government wants to see a minimum price for a unit of alcohol.
But the legality of the Alcohol (Minimum Pricing) (Scotland) Act, which was passed by the Scottish Parliament in May 2012, is being challenged in court by the Scotch Whisky Association (SWA) and two other trade bodies, spiritsEUROPE and the Comité Européen des Entreprises Vins, which represent European spirits and wine producers.
Following the report, the Scotch Whisky Association’s Campbell Evans said: “Reducing alcohol consumption among the 30% of the population who consume 80% of the alcohol should be the priority.
“A fall in excessive drinking leading to a drop in overall consumption is to be welcomed rather than focusing on the level of alcohol consumption per se.
“Minimum unit pricing (MUP) is not the way to tackle misuse – it does not target the heaviest drinkers, it would be illegal and it would damage the Scotch whisky industry.”
Repeated exposure to alcohol can scar the liver
By Michelle Roberts Health editor, BBC News online
A traffic-light colour-coded blood test can reveal hidden liver damage caused by drinking above recommended alcohol limits, say experts.
The UK doctors who devised the test say anyone who regularly drinks more than three or four bottles of wine a week, for example, is at significant risk.
Ultimately, GPs could offer the test to patients, especially since many people do not recognise unsafe drinking.
Often damage is only noticed at a late stage as the liver starts to fail.
Although the liver can heal itself to some extent, repeated onslaught will cause irreparable damage.
Amber means we can’t be absolutely sure but there is at least a 50:50 chance that you have scarred liver, and there is a significant possibility that you could die of it within 5 years”
Dr Nick Sheron Liver expert at the University of Southampton
By the time the patient reaches hospital, the liver can be very scarred. And even when they stop drinking entirely, in many cases it is too late and they will die of liver complications over the next 12 months.
The traffic-light test can give an early colour-coded warning – green means damage is unlikely, amber means there is a 50:50 chance it is there, and red means the liver is most probably damaged and potentially irreversibly.
It combines a routine liver test doctors already use with two others that measure the level of scarring, also known as fibrosis.
Tried and tested
To try it out, the University of Southampton researchers tested more than 1,000 patients at their liver clinic.
- Although it can take as long as 10 to 20 years, drinking just a bit more than you should over time can seriously harm your liver
- Not feeling any side effects from drinking does not mean that you are not risking chronic ill-health or lasting liver damage from alcohol-related liver disease
- Are you drinking too much? Take the test
This revealed that the traffic-light test was also good at predicting the prognosis of liver disease. Half of the liver patients had a red traffic light and (of a subset of these who were followed up) about a quarter died over the next five years, whereas none of the patients with a green test died or developed complications.
The findings are published in the British Journal of General Practice.
Dr Sheron’s team have also been investigating how the test can be used in primary care.
Preliminary results in about 400 hazardous drinkers from 10 GP surgeries suggest many patients are willing to be tested and that learning the result can change behaviour.
A third of those given a green result cut down on their alcohol intake, while more than two-thirds of those given a red or amber result subsequently drank less.
Dr Nick Sheron, who devised the test, said: “It is a powerful tool and message for people. We can say, ‘Amber means we can’t be absolutely sure but there is at least a 50:50 chance that you have a scarred liver, and there is a significant possibility that you could die of it within 5 years’.
“We find that for most patients this is a pretty good stimulus to stop drinking or at least to cut down to safe levels.”
He said, generally, people were receptive to being tested.
“People are immensely curious about if their alcohol intake is doing any harm. They want to take the test.”
As well as people who drink more than the recommended amount, people who drink and are overweight or have type-two diabetes should consider getting tested, says Dr Sheron. This is because they are at increased risk of liver damage.
The Department of Health says men should not regularly drink more than three to four units of alcohol a day and women should not regularly drink more than two to three units a day.
“Regularly” means drinking every day or most days of the week. And if you do drink more heavily than this on any day, allow 48 alcohol-free hours afterwards to let your body recover.
The Royal College of Physicians (RCP) advises no more than 21 units per week for men and 14 units per week for women. But also, have two to three alcohol-free days a week to allow the liver time to recover after drinking anything but the smallest amount of alcohol.
There are one and a half units of alcohol in a small glass (125 ml) of ordinary strength wine (12% alcohol by volume) or a standard pub measure (35 ml) of spirits (40% alcohol by volume).
Estimates suggest 10 million or one in five adults in England drink above recommended levels.
Prof Sir Ian Gilmore, chair of the Alcohol Health Alliance, said: “One of the challenges of liver disease, which is rising dramatically in this country, is the silent nature of the condition until it is often too late to reverse the damage.
“However minor changes in standard liver blood tests are so common that it is difficult for GPs to know when to refer for specialist advice.
“This large study from Sheron and colleagues in Southampton may prove really useful for guiding the right patients towards specialist care in a timely way.”
Andrew Langford of the British Liver Trust said: “If we are to make an in-road in reducing liver deaths – the only big killer increasing year on year – we have to make it easier for primary care to better understand the management of liver conditions as well as spotting the signs early.”
Cutting daily alcohol intake to half a unit can prevent chronic diseases.
About 4,600 lives in England could be saved by reducing alcohol intake to just half a unit a day, say experts.
The Oxford University report warned that alcohol consumption is a risk factor for many chronic diseases.
The government recommends that men drink no more than three to four units per day and women no more than two to three.
But the current guidelines are “not compatible with optimum protection of public health”, the researchers said.
Ill health linked to alcohol is estimated to cost the NHS in England £3.3bn every year.
“Half a unit of alcohol is as little as a quarter of a glass of wine, or a quarter of a pint” ”
Dr Melanie Nichols Lead Author
The Oxford University team used data from the 2006 General Household Survey looking at weekly drinking patterns of 15,000 adults in England.
The researchers used a mathematical model to study death rates from 11 illnesses known to be linked to long-term alcohol use, the British Medical Journal reported.
These included coronary heart disease, stroke, high blood pressure, diabetes, cirrhosis of the liver, epilepsy and five cancers.
Dr Melanie Nichols, lead author of the paper, said: “Over 4,000 deaths from cancer, heart disease, stroke and liver disease in England could be prevented if drinkers reduced their average level of alcohol consumption to half a unit per person per day – a level much lower than current UK government recommendations.
“Half a unit of alcohol is as little as a quarter of a glass of wine, or a quarter of a pint.”
But the researchers said they were not trying to lecture people, just give them the information so they could make an informed decision.
They added there was a widespread belief that alcohol protects against heart disease.
Alcohol Concern chief executive Eric Appleby said that government guidelines must offer the public a realistic way of reducing the risks associated with drinking.
“As alcoholic drinks have started to vary in strength we use ‘units’ to measure alcohol intake but it can be very difficult for people to understand what this means in practical terms.”
But Henry Ashworth, chief executive of the Portman Group, which also represents UK drinks producers, said; “78% of people in the UK drink within recommended low risk guidelines – as set by the chief medical officers.
“Drastically cutting everyone’s consumption to half a unit a day (ie one large glass of wine a week) is not the way to reduce harms in the smaller groups who are misusing alcohol and need specific and targeted help”.
Could LSD be used to treat alcoholism?
One dose of the hallucinogenic drug LSD could help alcoholics give up drinking, according to an analysis of studies performed in the 1960s.
A study, presented in the Journal of Psychopharmacology, looked at data from six trials and more than 500 patients.
It said there was a “significant beneficial effect” on alcohol abuse, which lasted several months after the drug was taken.
An expert said this was “as good as anything we’ve got”.
LSD is a class A drug in the UK and is one of the most powerful hallucinogens ever identified. It appears to work by blocking a chemical in the brain, serotonin, which controls functions including perception, behaviour, hunger and mood.
Researchers at the Norwegian University of Science and Technology analysed earlier studies on the drug between 1966 and 1970.
Patients were all taking part in alcohol treatment programmes, but some were given a single dose of LSD of between 210 and 800 micrograms.
Dangers of LSD
- During a trip the person may put themselves in danger without realising it such as thinking they can fly and trying to jump off a high building.
- In some people, especially if LSD is taken in high doses, the drug can cause intense anxiety and panic attacks.
- Some people experience flashbacks, reliving a bad trip weeks or even months after it happened.
- In those already vulnerable, LSD may be the trigger for psychotic illness. Paranoia and other symptoms typical of schizophrenia may occur.
- BBC Health: LSD
For the group of patients taking LSD, 59% showed reduced levels of alcohol misuse compared with 38% in the other group.
This effect was maintained six months after taking the hallucinogen, but it disappeared after a year. Those taking LSD also reported higher levels of abstinence.
The report’s authors, Teri Krebs and Pal-Orjan Johansen, said: “A single dose of LSD has a significant beneficial effect on alcohol misuse.”
They suggested that more regular doses might lead to a sustained benefit.
“Given the evidence for a beneficial effect of LSD on alcoholism, it is puzzling why this treatment approach has been largely overlooked,” they added.
Prof David Nutt, who was sacked as the UK government’s drugs adviser, has previously called for the laws around illegal drugs to be relaxed to enable more research.
He said: “Curing alcohol dependency requires huge changes in the way you see yourself. That’s what LSD does.
“Overall there is a big effect, show me another treatment with results as good; we’ve missed a trick here.
“This is probably as good as anything we’ve got [for treating alcoholism].
Read More : BBC