Bruce Ritson

Comparison of two benzodiazepines in the treatment of alcohol withdrawal effects on symptoms and cognitive recovery

Forty newly admitted alcohol-dependent patients were randomly allocated to equivalent 6-day regimes of either lorazepam or diazepam, to compare involvement in physical, emotional and cognitive state during the first 8 days in hospital. Diazepam provided a more comfortable withdrawal period and was associated with slightly better cognitive functioning on the eighth day.

MEDICAL ADMISSIONS IN MEN: THE RISK AMONG DRINKERS

Information on alcohol consumption was elicited by the same method from men in a general population survey and from male medical inpatients in a hospital serving that population. A measure of risk controlling for age, the logarithm of the odds ratio, showed that for liver disorders, upper gastrointestinal disorders, myocardial infarction, other cardiovascular disorders, and respiratory disorders, rising consumption of alcohol was related to increased risk of hospital admission relative to abstention. The risk of admission for the remaining heterogeneous category of disorders was lower than that for abstention, perhaps reflecting the effect of chronic illness on drinking habits, and also suggesting that the link between alcohol consumption and medical diagnoses is not simply due to greater frankness about drinking in hospital inpatients.

Gender Differences for the Risk of Alcohol-Related Problems in Multiple National Contexts

The primary research question asked is: After holding alcohol consumption constant, will men and women be at equal risk for a variety of alcohol-related problems? Since women are actually at a higher blood alcohol content at the same consumption levels, a physiological argument would suggest that women are at equal or greater risk for alcohol problems than men. However, variation in societal norms surrounding gender roles and/or societal-level stress may mediate the experience of men and women, regardless of the differences in physiology. Ten cross-sectional general population studies are used. Analyses control for individual-level variables (age, quantity, and frequency of drinking) and societal-level variables (proportion of women in the work force and female suicide rate) that might confound these relationships; cross-study homogeneity is examined.

Merits of Simple Intervention

This chapter concerns the growth of an idea about the merits of simple intervention. At the outset, I should own up to the bias of my own vantage point, that of a psychiatrist working within the United Kingdom National Health Service. It is important to acknowledge this particular perspective because it has determined the clinical influences that I feel have been important. Shedding firmly held beliefs about treatment is a disconcerting and unnerving process, particularly when new beliefs come to be held with equal tenacity. Are the new beliefs about simple intervention based on convincing evidence or are they simply the latest fashion waiting to be discarded for the next season’s model? In 1977, The Lancet commented on current approaches to services for alcoholics thus: This treatment approach owes its existence more to historical process than to science. It is possible to discern the deposits, akin to geological layers, of a sequence of therapeutic fashions—the residue of almost forgotten enthusiasms for in-patient psychotherapy units, for group processes and the therapeutic community, for family therapy and later for community psychiatry. To say that treatment for alcoholism is only an accretion of fads and fashions would be too harsh, for it is also built on much clinical experience; but it must be admitted that we have not done enough to assess scientifically the effectiveness of treatment methods. (Lancet, 1977, p. 489)

Alcohol-related problems and primary health care.

INTRODUCTION Throughout most of the world alcoholic beverages are being produced in continuously increasing quantites and becoming more readily available. This increased production has been particularly striking in developing countries; thus between 1960 and 1980 the registered output of commercially produced beer increased by more than half in 46 countries, of which 43 were in the developing world (World Health Organization 1982). The reasons for this change are varied and often uncertain. In many countries availability of alcohol has increased in recent years. In some situations European styles of drinking have been added to those which were already present. This trend towards homogeneity in world use of alcohol has been promoted by commercial interests and their improved marketing and distribution techniques. A further change is the trend towards consumption of commercially brewed beer in rural areas. This has partially replaced village brewing, so that drinking patterns are no longer dictated by harvest time and the availability of crops such as maize, millet or banana for the brewing process. Commercial beers are also usually stronger in alcohol content and although more consistent in quality are in some cases believed to be less nutritious than those brewed in the traditional way. This paper is concerned solely with ethyl alcohol; there are additional health hazards with methyl alcohol and other toxic substances sometimes associated with domestic brewing. One inevitable consequence of increased availability and per capita consumption in a community is a rise in the level of alcohol-related problems. Beaubrun (1977) has shown that a fall in the price of rum in relation to disposable income in Trinidad was closely correlated with a great increase in consumption and a simultaneous rise in the level of road-traffic accidents in the island. It has been demonstrated in many other countries that rising consumption is unfailingly followed by a rising level PSYCHIATRY I 15

Dr Evelyn Gillan.

Evelyn died on Tuesday 14 July 2015. Her death at the young age of 55 represents a great loss to family, friends and all those who worked with her. She was Director of Scottish Health Action on Alcohol Problems (SHAAP) from 2007 until 2010, when she moved to become chief executive of Alcohol Focus Scotland where she continued to work closely with SHAAP. She was a tireless and eloquent advocate for improving the quality of life, health and welfare in Scotland, and indeed throughout the world. She was an energetic campaigner for the prevention of alcohol-related problems and had showed skill in articulating the medical and scientific evidence about the damage to health attributable to alcohol and the measures which could be taken to reduce this harm. She was a brilliant communicator with the media and the international conferences to which she contributed. She was fearless in expressing her opinions, which were always well founded. No-one could doubt the sincerity of her motives. …

Working with Drug and Alcohol Users—A Guide to Providing Understanding, Assessment and Support

Working with Drug and Alcohol Users—A Guide to Providing Understanding, Assessment and Support . By Tony White, Jessica Kingsley, 2012. £19.99. 224 pp. ISBN: 978-1-84905-115-6. The author is a registered psychologist in private practice in Western Australia. He is also a teacher and a supervisor of transactional analysis psychotherapists. The book comes from his experience of 30 years of work with clients suffering from various forms of drug misuse-including alcohol. The book is clearly written and would be of interest to those setting out on a career as a counsellor or cognitive behaviour therapist. The clinical illustrations in the book bring alive some of the constructs of transactional analysis. The first chapter contains a cursory …

Addiction: A Kind of Loving

Addiction: A Kind of Loving by Dr David Marjot. Published by Southern Universities Press. London. 2013. Pages 238. No index. Distributed by Gardners books: www.gardners.com. ISBN: 978-0-9570504-2-6, no price given. ![Graphic][1] David Marjot is a senior psychiatrist with long experience in the treatment of alcohol- and drug-related problems. In 2009, he wrote The Diseases of Alcohol , which distilled this experience and his views about alcohol-related problems and their clinical aspects. Some of this is repeated in the present work, but here he advances a theory of addiction which he feels has been almost totally neglected. His hypothesis is that addiction is akin to an enduring love affair, a ‘mistaken attachment’. It is … [1]: /embed/inline-graphic-1.gif

Obituary: J.S. Madden

Dr John Spencer Madden (1928–2012) Spencer who died on 24th February 2012 aged 83 was a founder member of the Medical Council on Alcohol or ‘Alcoholism’ as it was then known. He devoted much of his professional career to treating individuals with alcohol and drug related-problems and advocating improved services. He also saw the importance of better training for doctors and medical students in recognizing the damage alcohol inflicted on health and family life. For many years, he was Vice Chairman of MCA and Chairman of our Journal Committee and Deputy Editor of ‘Alcohol and Alcoholism’. He was also Section Editor of the journal ‘Current Opinion in Psychiatry’ (1988–1993) and wrote an influential book; ‘Guide to Alcohol & Drug Dependence (1979)’. In 2006, he was awarded the first Max Glatt …

Alcohol Nation: How to Protect Our Children from Today's Drinking Culture

Alcohol Nation: How to Protect Our Children from Todays Drinking Culture . Aric Sigman. 276 pp., Piatkus, London, 2011 The UK has good reason to be concerned about its drinking habits, particularly so as we are passing on these habits to our children. Teenagers in the UK are more likely to get drunk than their counterparts anywhere else in the industrial world, with levels more than double that of many other countries. Among girls, the gap between the UK and other countries is even wider. Aric Sigman writes in an attractive and compelling way about the extent of this problem and the need for an action by parents, educators, public health workers and Government. He believes that adults need to adopt a more challenging approach towards young people, abandoning the permissive non-directive attitude that has characterized so much recent thinking about education and child rearing. He has pursued this …