Archive for the ‘Alcohol’ Category

Glocality and harmful consumption of alcohol: The SDG target 3.5 and the Alto Tâmega and Barroso region

March 11, 2018

In 2015, the United Nations General Assembly approved the 17 Sustainable Development Goals (SDGs). One of the targets (3.5) of the SDG 3, underlined the importance of “Strengthen the prevention and treatment of substance abuse, including (…) harmful use of alcohol”.  However, several of the targets don’t apply to all the communities. While the epidemics of AIDS is a major concern in several communities, in others the harmful consumption of alcohol is a priority. Taking that into account, there is need to push forward the creation of local policies targeting alcohol abuse that are also related with global policies – the creation of glocal policies.


Portugal isn’t an exception. According to the Institute for Health Metrics and Evaluation (IHME), alcohol is the major component that hinders the health development in Portugal. According to SICAD (General Directorate for Intervention on Addictive Behaviors and Dependencies), this harmful habit starts at young age, with almost 50% of the men aged 18 years old registering an episode of drunkenness in the previous 12 months.


Since the majority of our behaviors are developed inside of our households and in our communities, it is important to tackle this problem locally. As an example, the Alto Tâmega and Barroso region has the third highest number of patients with the diagnose of Chronic Abuse of Alcohol in north of Portugal. According to the North Health Observatory, Chronic Liver disease and Cirrhosis are the principal specific cause of mortality that leads to potential years of life lost in this region – 396.3/1000000. Although this is a major health concern and the existence of Local and National Plans, there is the need to support the creation and funding of specific strategies developed by local health departments that target this problem.

By 2020, the Ministry of Health (MoH) should give more autonomy and funding for local diagonal health programs for the reduction of harmful consumption of alcohol. The national guidelines’ development to support these programs is essential. The MoH, the Directorate-General of Health and the SICAD should serve as advisers and monitors of the implementation of those strategies at local level, as the UN is to Portugal, at national level. The national agencies should support the implementation of international decisions by focusing on the local problems. Only by then, we will be able to achieve the SDGs and the reduction of alcohol consumption.


The Need to Curtail College Binge Drinking

August 18, 2017

Over the last 15 years in America, alcohol abuse has been on the rise, bringing with it broken lives and livelihoods.  Up to 30 million people binge drink weekly, an increase of 7 million over this time period.  Binge drinking is defined as 4 or 5 drinks (or more) on an occasion for women or men respectively.


Excess alcohol use is associated with many health problems, including injuries, violence, STDs, poor pregnancy outcomes, chronic diseases, cancer, and cognitive deficits.  Additionally, there are huge financial costs associated with binge drinking, resulting from lost productivity, health care and criminal justice costs, totaling $191 billion per year.


Binge drinking is unfortunately most common among younger adults aged 18 – 34, a vulnerable demographic with a lot to lose if this becomes a consistent habit.  Up to 38% of college students reported binge drinking within the previous month, with 1 in 4 reporting academic consequences from drinking, including missing or falling behind in class.  Approximately 1,800 college students die each year from alcohol-related unintentional injuries, while an astonishing 97,000 experience alcohol-related sexual assault.

Despite its reputation for higher education, the Northeast is the region hardest hit by binge drinking. New Hampshire scores the highest alcohol consumption per capita and is one of 23 states that does not expressly prohibit excessive drinking / happy hour practices. A policy to limit alcohol availability for NH college students could save lives.


Our recommendation to reduce college binge drinking is for the New Hampshire Liquor Commission to enact a policy preventing alcohol price promotions such as ‘happy hour’ for all establishments with a liquor license within 20 miles of a college. Research rates this high in effectiveness while lower in cost.  If this makes a significant impact, it may encourage similar policies in other states.

Post contributed by @dsomaiya2, @joshbskaggs, and @josephmreardon.


Countering the harmful effect of unrecorded alcohol in Haiti

March 10, 2017

Alcohol consumption is classified into recorded consumption monitored by governments and unrecorded consumption.  In Haiti, “kleren” or “Clairin” in french is a spirit that comes from sugar cane following a traditional (rudimentary) distillation process leading to a product like rum but less refined. It’s sold in bulk and its consumption is wide and largely unrecorded. Consumption of unrecorded alcohol can be as high as 40% in low income countries.

In 2011, a dozen people lost their lives and 20 more were blinded and paralyzed after consuming Kleren and again in 2016 over 20 people died and many others suffered disabilities. The “Kleren” was found to be mixed with methanol instePHOTO: Haiti - Clairin vs Methanolad of the regular ethanol. Methanol is a toxic substance used as an industrial
solvent or antifreeze. It’s similar to ethanol in odor and appearance and may be inadvertently introduced into the mixture or can be used as a low-cost substitute to increase profit. Unfortunately, alcohol poisoning and its effects have not been measured in Haiti therefore the problem is likely greatly under-reported.

The production and sale of “Kleren” constitute the main source of livelihood for many small-scale farmers, distillers and tradesman and many are afraid that those deaths will scare costumer away. The consumption of “Kleren” is strongly entrenched in the culture of the country and it’s used in religious ceremonies, to treat illness or for simple celebrations. It’s more often sold and used by persons of lower socioeconomic status and the deaths and disabilities that result have further catastrophic consequences for their loved ones, perpetuating the cycle of poverty.

Policies on alcohol production and sale in Haiti should be developed and potential implementing agencies like the “Office of quality control and consumer protection” of the Ministry of Commerce need to be strengthen for effective enforcement.

Support preventive and sustainable networks for behavioral and mental health in Maryland

March 2, 2016

pic7Over 177,000 children and adults in Maryland are dependent on the public behavioral health system.   More than 1 million inhabitants of Maryland are currently experiencing some sort of mental illness. Of the 24 counties in Maryland, there are only three counties that provide fully functional, 24 hours, 7 days a week service to their constituents.

Two key bills have been introduced in both the house and senate of the Maryland General Assembly: “Behavioral Health Community Providers – Keep the Door Open Act” and “Department of Health and Mental Hygiene – Clinical Crisis Walk-In Services and Mobile Crisis Teams – Strategic Plan”.  These two bills are essential to provide a preventive and sustainable network in mental and behavioral health services for Marylanders.

“Behavioral Health Community Providers – Keep the Door Open Act” (SB497/HB595)

  • Community behavior health providers provide regular and reliable mental health and substance use treatment to Marylanders in need.
  • SB497/HB595 promotes increased access to behavioral health community providers by providing reimbursement increases for these providers.


“Department of Health and Mental Hygiene – Clinical Crisis Walk-In Services and Mobile Crisis Teams – Strategic Plan”(SB551/HB682)


  • Access to crisis response services have been shown to reduce  crisis events related to mental health and substance use.  
  • SB551/HB682 promotes greater access to crisis response systems by improving walk-in and mobile crisis services.




The upcoming hearings in the house of delegates will provide an opportunity for caretakers, parents, children, community advocates, and organizations to rally in support of preventive and sustainable networks of services for mental and behavioral health in Maryland.  Register for the rally today!

Let your legislators know you support SB497/HB595 and SB551/HB682.   Call, write and/or e-mail.

Support preventive and sustainable networks for behavioral and mental health in Maryland n the 2016 election! Are YOU ready?

Image credits: Most of the images were created by the author.  Other pictures are courtesy of NAMI Maryland, Pinterest and Maryland Health Department.

Potholes? The Proposed Pilot Program in Michigan To Drug Test Medicaid Applicants Just Hit One

August 14, 2015
Healthy Michigan Campaign

Healthy Michigan Campaign Launched Gov. Snyder 2013

Michigan’s vital economy centers around the automotive industry which has struggled since the mid 1990’s to rebound. Our struggling economy is apparent in our critical infrastructures–bridges and roads– that are crumbling in disrepair, leading to a loss of $ 1 Billion annually in our Michigan transportation assets.  Many residents have suffered layoffs, hard times, and gaps in healthcare.  Michigan initially focused on concrete ways to repair our economy and added 600,000 residents to the medically insured road with the “Healthy Michigan Campaign in 2013”. By 2015, the war on poverty had shifted to war on the  impoverished themselves with passage of SB 275 and HB 4118.

This bill permits a one yearlong pilot program in 3 Michigan counties to drug test Medicaid applicants and recipients suspected of illicit drug use. If the individual tests positive, they will be required to enter a substance abuse treatment program. If the person refuses drug testing, the benefits would be cut off for six months. If the person tests positive a second time, they will lose benefits for another six months. Michigan has previous legal notoriety for imposing drug testing of welfare recipients in 2000 which was struck down as unconstitutional by the US Court of Appeals in 2003 violating the 4th amendment. Gov. Snyder states that in 2015, new data is needed to identify suspected substance abusers who would benefit from treatment so “we can remove the barriers that are keeping people from getting good jobs, supporting their families and living independently.” No other group that receives State of Michigan support is part of this pilot program.

Drug testing welfare recipients as a condition of Medicaid eligibility is a policy that is scientifically, fiscally, and constitutionally unsound.  Welfare recipients are no more likely to use illegal drugs than the rest of the population. Science and medical experts oppose drug testing of welfare recipients because of limited utility and creation of stigma. Drug testing is expensive. Data gathered by ThinkProgress showed 7 states spent over $1 million dollars and all but one (8.3%) had a positive drug test rate of welfare applicants below 1% with a national drug use rate at 9.4% in the general population. In addition, drug testing suspected substance abusers is ineffective to uncover drug abuse. A 1998 Oklahoma study found a questionnaire was cheaper and more effective than drug testing to detect drug use including alcohol.

In 2015, at least 18 states have introduced proposals that would require drug screening or testing for public assistance applicants or recipients. Fixing our state roads and bridges is more fiscally prudent than drug testing Medicaid recipients to remove barriers; this pilots program lacks, scientific, financial or constitutional merit. It is time to revisit the validity of the 1996 Welfare Reform Act that authorized, but did not require, states to impose mandatory drug testing as a prerequisite to receiving state welfare assistance. Michigan, for one, has hit a damaging pothole that could deter people who desperately need health care, including women and children, from a “Healthy Michigan–Saving lives. Strengthening Our State”.

Alcohol Advertising in Botswana

March 12, 2012

Alcohol in the media is said to have an impact on young people’s overall perception and behavior. Content analysis on images in alcohol advertisement links drinking with valued personal attributes and desirable outcomes. The World Health Organization has recognized advertising of alcohol as one of the major areas of intervention in the field of reducing alcohol related harm.

The Botswana Alcohol Policy strives to follow some of the WHO recommendation, however, the policy  endorses a self regulatory system by the alcohol industry that focuses on interventions proven to have little impact on reduction of use and abuse. As the industry has targeted youth culture and seeing the relationship between alcohol and advertisement, in a nation where about 38% of the population is youth, it is important to have clear stipulations in the current policy targeted towards the issue.

The policy points out that there shall be regulation of the availability of alcohol, production, trade, promotion, marketing and advertising, however it it not clear about the roles different institutions should play.

There are several bodies and institutions that can play a role in monitoring the process, to ensure that clear guidelines are followed by the industry. Ministry of Health as the custodian of health in the country, Ministry  of Youth Sports and Culture as the leading body in youth affairs could ensure positive alcohol portrayals that still promote culture and healthy youth. The Botswana National Youth Council could play a large role in ensuring the depiction of youth in a health and realistic manner.

Alcoholism in Kenya: The Power of Chang’aa among the Poor

August 15, 2010

The settlements in the outskirts of Nairobi sit in a vulnerable position. Communities plagued by poor sanitation, low employment, violence and crime are embedded and seen as a burdensome routine by locals. Another important influence of poverty ravaging these communities is alcoholism. Although conventional commercial alcohol poses a health risk, this matter is further complicated by locally made alcohol known as Chang’aa.

The cheap brew is made in homes and is unregulated with each brewer adding their own unique touches to the drink – such as battery acid from discarded car batteries.

Alcoholism in Kenya has two issues to contend with, the social norm of Chang’aa use and the danger of the unregulated production. The addictive power of alcohol is strong and intervention is needed. According to the United Nations Office on Drugs and Crime, children in these areas are also vulnerable. Legislation has been put forth through the Kenyan Parliament to help mediate these issues that are costing Kenyan lives.

A strong focus needs to be placed on education of alcoholism, as well as prevention, and hopefully through this policy a change can be observed in this behavior. The Government needs to work with people in communities to best reach those affected, both directly (consumers that need treatment and counseling ) and indirectly (families, especially children, affected by an alcoholic through education and counseling). Resources put forth by the government are very important in the maintenance of these measures and policy to help change the influence of alcohol on Kenyans.

Further information on alcohol and  support can be found at:

A dime a drink tax increase in the state of Maryland

August 14, 2010

It’s rare for government to take two unrelated problems and come up with an answer that addresses both, but the State of Maryland has that opportunity right now.

First problem: alcohol use annually causes more than 1,200 deaths in Maryland  and costs the state more than $3.5 billion. Second problem: more than a million Marylanders are without health insurance at some point every year (1.4 million were in 2007-2008).

Where’s the opportunity? A modest increase in alcohol taxes—a dime a drink—can address both problems. For too long, Maryland has missed out on the dual opportunities of reducing the negative effects of alcohol use and helping people without health insurance or other support. In fact, current alcohol taxes in Maryland remain among the lowest in the nation; the tax on spirits hasn’t increased since 1955, and the wine and beer tax hasn’t been raised since 1972.

The Dime a Drink proposal from the Maryland Health Care for All Coalition could generate $214 million that could be used to expand health care coverage for the poor, help people with developmental disabilities, and support alcohol and drug prevention and treatment. At the same time, Dime a Drink will save the state $249 million annually in alcohol-related health care costs and prevent 15,000 cases of alcohol abuse.

Please contact your Maryland delegate and senator today and urge them to support the Dime a Drink proposal. Opportunities are knocking, and it’s time for Maryland to answer.

For more information, visit the following:

Prevention of Underage Drinking Among Fraternity/Sorority Students in Colleges of New Jersey

August 13, 2010

Fraternity party

Student drinking has been a long-standing problem on U.S. college campuses. It is estimated that 1,700 college students die per year from alcohol-related unintentional injuries, the majority in vehicle crashes. Underage college student drinking is a big part of this problem. Many studies show that an age-21 minimum legal drinking age results in lower alcohol use, fewer traffic crashes, and possibly fewer other alcohol-related problems such as suicide and vandalism. Underage youth, however, continue to drink alcohol and experience alcohol-related problems. This indicates that additional policies aimed at reduction of underage drinking on college campuses are necessary.

It has been demonstrated that the use of cognitive-behavioral self-management principles and challenging assumptions about alcohol effects have shown considerable promise as a method of secondary prevention of heavy alcohol use in young people. Based on these data, we are proposing a New Jersey college campus policy aimed at establishment of educational and interventional programs that target students belonging to fraternities or sororities who are alcohol-dependent or problem drinkers. This program will consist of the following parts:

  • Development of a 4-week Alcohol Management Program by clinical psychologists.
  • Identification of high-risk students among freshmen fraternity/sorority members and offering them participation in this program.
  • Follow-up monitoring regarding their drinking habits.
  • Establishment of referral system to the local Alcohol/Addiction Treatment Centers for students not demonstrating improvement during the follow-up.

The budgets of New Jersey colleges are very tight; therefore there is a need for funding and hiring of experienced psychologists for these programs. Please contact State of New Jersey Commission on Higher Education today:

Underage drinking is not acceptable on college campuses!

Emergency Departments Must Address Drinking and Driving

August 18, 2009
Scene of alcohol-related car crash

Scene of alcohol-related car crash

Illness and death related to drinking and driving is completely preventable.   In Canada, alcohol-related car crashes cause 3-4 deaths and more than 200 injuries every day.  Emergency Departments (EDs) see a large number of these inebriated injured patients.  Occasionally, some individuals are referred to alcohol rehabilitation programs.  Many patients are discharged or admitted into hospital with little follow-up. 

The problem of drinking and driving has long been recognized by the government and the community. Together, these groups, including Mothers Against Drunk Driving, the British Columbia Automobile Association, and the Insurance Corporation of British Columbia , have funded drinking and driving public service announcements, increased road side police enforcement, and increased penalties for drinking and driving.  Even the British Columbia Liquor Store has put out public service announcements denouncing drinking and driving.

However, drinking and driving still remains a problem.  The next steps must also involve the medical community.  The term “teachable moment” has often been used to characterize ED visits, where sudden adverse health effects provide a window of opportunity to motivate individuals to change; emergency personnel therefore play a key role in promoting health behavior change.  In the United States and in England,  motivational interviewing by ED personnel has consistently led to a decrease in alcohol-related injuries and traffic violations. 

Unfortunately, ED counseling in Canada is rare.  EDs are fast-paced and busy, and lack of funding and personnel resources have limited the implementation of these programs.  There is therefore an urgent need for increased funding and hiring of ED dedicated counselors to capitalize on the ED “teachable moment”.  Within this window of opportunity, motivational interviews should be performed on all consenting ED patients with alcohol dependency or abuse problems. 

In Canada, alcohol-related motor vehicle crashes continue to claim more than 3000 lives annually and cost society up to $12.8 billion per year.  We cannot afford to lose this window of opportunity.