By Roger Dobson, Sophie Goodchild and Marie Woolf Published: 22 October 2006 http://news.independent.co.uk/uk/health_medical/article1919105.ece Women in England and Ireland are officially the world's biggest binge drinkers, according to a unique study of global alcohol consumption. One in three 17- to 30-year-olds is now classed as a heavy drinker, bingeing on four or more drinks in one session at least once a fortnight. These disturbing figures are 11 times higher than those of Germany and Italy, prompting warnings that record numbers of women face liver damage and premature death unless they curb their alcohol consumption. The findings are based on a survey of more than 17,000 women and men from 21 countries, including Belgium, France and the United States, in the largest study ever carried out into worldwide drinking habits. The disclosure will alarm policy-makers struggling to combat Britain's growing drink problem, which has led to an escalation in anti-social behaviour, lost working hours and long-term health problems, including cancer and heart problems. A new government advertising campaign will this week highlight how drunkenness puts women at risk of sexual assault. Studies show that more than three-quarters - 81 per cent - of sex attack victims have been drinking before being attacked. A review by the Association of Chief Police Officers of drug-rape attacks has found that in many cases women had been drinking heavily rather than been targeted by men using date-rape drugs. The Government is considering tighter laws so that even when a woman has consented to sex, men can be prosecuted for rape, if she was drunk at the time. New Department of Health figures for England and Wales show that more than one in six women aged between 16 and 64 are either addicted to alcohol or suffer health problems as a result of drinking. Nine per cent of women are now classified as binge drinkers, consuming four units or more per session. The study reveals that excessive drinking has soared in England, but has declined in Germany and France. In Ireland, nearly two-thirds of young women are rated as heavy drinkers. But even though some 26 per cent of British men binge drink, England does not feature at the top of the male heavy drinkers league table. This is dominated by Belgium, Colombia, Ireland and Poland. Dr Andrew Steptoe, co-author of the report, said heavy drinking was a worldwide problem, but that England and Ireland had high figures compared with mainland Europe. "Although not all young heavy drinkers end up being heavy drinkers in later life, they are at higher risk later for health problems," said Dr Steptoe, of the department of epidemiology and public health at University College London. Doctors also blame the drinks industry for deliberately targeting women with female-friendly drinks and décor. They want ministers to exercise more control instead of allowing the industry to self-regulate. England, Scotland and Ireland are the only countries in western Europe, apart from Denmark, where alcohol consumption is rising. Additional reporting by Jonathan Owen ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The Vodka monologues: 'Women now drink like men but we don't have the livers for it' Paula Hamilton lost her modelling career to her bingeing on bottles of vodka. For 20 years she's been on and off the wagon, and only now can soberly reflect on the price she paid for her excessive drinking, as she tells Jonathan Owen Published: 22 October 2006 http://news.independent.co.uk/uk/health_medical/article1919125.ece Paula Hamilton was an Eighties icon, the impossibly glamorous woman in the Volkswagen Golf television advert who blithely discarded all her worldly possessions except her car keys. But for more than 20 years, the model has struggled to overcome her addiction to alcohol, a disease that derailed her career, destroyed her relationships and nearly took her life. Her first drink was at the age of five when her nanny gave her a hot apple cider. At the age of 13, she got drunk for the first time. By the age of 24, Hamilton was bingeing on bottles of vodka. "I knew it was a naughty thing to drink so much but I liked the way that it made me feel. I didn't feel conscious of my body and whether I looked pretty or not," says the former model who was discovered by David Bailey and partied with Jack Nicholson. "As you get older, you learn that it [alcohol] can take away painful feelings. If the alcohol hadn't been there I'd have committed suicide as a teenager. It's like being tortured and your mind says 'drink or die'." Like many damaged people, her way of coping was to run away in the hope that a new life in a foreign country would solve her problems. Hamilton fled to New Zealand but her sobriety was short-lived. Within months, she had started drinking again and was arrested for drink-driving. By 2003, she had to return to the UK for treatment. Her relapse was a "desperate time" and the "lowest point of my life". "You can't imagine how mind-numbingly disappointing it is and you are just so ashamed of yourself," she says. "I didn't have any money left - it all went on treatment and alcohol. I don't know how I got back to the UK. I was on autopilot and I don't remember going home but I do remember waking up in hospital and thinking 'what am I doing here?'. I was dying and didn't know if I could hang on." After six months waiting for detox, Hamilton was given a place at Broadway Lodge, a clinic in Weston-super-Mare, and then spent 10 months at a treatment centre in Cornwall so she could face the world again. Her alcoholism has not only cost her in health terms but also financially: she estimates that she has spent more than £500,000 over her lifetime on treatment. Today the 44-year-old is sober and has been for the past two and a half years. And Hamilton has made an unlikely return to prominence as a judge on the television series Britain's Next Top Model, thanks to a chance encounter with an old friend from her modelling days. The experience has been mixed. On one hand, the show has restarted her career only 18 months after coming off benefits but, on the other, it has reminded her just how lonely and isolated she felt as a young woman struggling with her demons in a ruthless industry. "It was very difficult growing up in my industry as an alcoholic; it was very loathsome. In this country we love to label people. I like myself today. I don't let people in the industry bully me or make me insecure." As a survivor, Hamilton, who now lives in Berkshire, is keen to show there is real hope for sufferers, although she admits that the road to recovery is hard. She is also savagely critical of the lack of treatment available in Britain, especially for women, and likens alcohol to "legal social heroin". "It's horrific to be on the receiving end of this illness and to be a British citizen. In Buckinghamshire, for example, there's just one bed for alcoholics in detox. There are thousands of alcoholics waiting to go into that one bed and in the meantime their families are falling down because they cannot cope. "We are actually a very alcoholic country - other countries don't seem to have problems with it on the scale that we do in England. But we are being mocked by the rest of Europe for our short-sightedness and our ignorance about an epidemic of alcoholism that is taking its toll of our young. "There's a lot of binge-drinking now in this country with kids openly drinking on the streets. That just didn't happen in our time. Where are they getting the money from and where's the discipline at home? "There are people out there who have low self-worth and for whom alcohol is deadly because the rest of our society will shame them into their own death. It is horrific, and if we don't help them England is going to end up flat on its face. Alcohol leads to mental health problems. People who abuse it will end up in the mental health system." The rise in women drinking does not surprise her. "We used to play different roles in life [to men] but now we're not playing such different roles. The roles are blending and there's nothing wrong with that. But it means that women now drink like men and we don't have the livers for it. We do things we don't want to do, sleep with people we shouldn't; we wake up ashamed and don't talk about our hangovers. It's a crazy existence." Hamilton is now driven to do for drinking what Jamie Oliver has done for school dinners by educating young people about how to have a good time without drinking. "I'm an alcoholic turned good. Let me help the Government turn it around," she says. "We've got programmes on nannies. Jamie's teaching us how to cook. Don't we want a programme about how not to drink and have a really good time or how to drink normally and have a good time? "We need to have warning labels and education about this drug. We need people like me to be employed to go into schools and help to educate children of the dangers. The Government should take people like me as seriously as they do Jamie Oliver rather than judging us." Staying sober will always be a matter of life or death for the former model - "it would be absolute suicide if I picked up a drink" - but she is happier now than she has been for many years. "When you go into sobriety, as I did many times, the illness progresses. I used to be a binge-drinker but then got to the stage where if I picked up a drink I would drink every day until I passed out and then get another bottle. For me, it would be absolute suicide if I picked up a drink. "The most joyous thought last week was that I woke up and giggled at my reflection in the mirror. In the past I did everything to get away from myself but now I am content. The last year of my life has been the happiest - the only real happiness that I have ever known. "This [excessive drinking] is a social illness. There is not one family in England that can stand up and say honestly: 'We don't have an alcoholic in our family'. There's always Auntie Jane stuck in a cupboard somewhere that nobody really talks about." ONE OVER THE EIGHT: 9 REFORMED DRINKERS " I am a recovering alcoholic. To stay sober I go to a lot of AA meetings. I have to keep a permanent check on myself " Trinny Woodall, TV Stylist "All the fame and attention - I didn't handle it. I dealt with it by getting out of the system and living in a mountain" Cerys Matthews, Singer "There was my divorce, my dad dying, Matt dying and I was trying to cope with being famous. It was too much" Caroline Aherne, Comedian "At its worst, it meant ending up with my knickers around my head in a bed I didn't recognise, surrounded by vomit and having not the faintest idea where I was " Anne Robinson, Journalist and TV Quiz Show Host "I was in hospital 32 times and nearly died. I was drinking three or four bottles of vodka a day" Mary Coughlan, Singer "I had no friends left. I was more and more isolated, more and more paranoid. My health was gone " Marian Keyes, Author "I'm still a recovering alcoholic and I will avoid anything that might drag me down " Sophie Anderton, Model "Everyone who has a glass of wine when they get home from work to relax is an alcoholic, and then there's the binge alcoholic, which is what I am " Kerry Katona, Former Atomic Kitten "My friends would wake up with just a hangover but I was suffering blackouts " Denise Welch, Actress ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Dying for a drink: 1.4 million of us - and that's just the bingers You don't have to be an alcoholic to be a binger. But the effect on health and the damage to those around us are as alarming. And women are most at risk. By Paul Rodgers Published: 22 October 2006 http://news.independent.co.uk/uk/health_medical/article1919113.ece Take a sip of vodka. You may notice a burning sensation on your tongue. That's the alcohol hitting pain receptors wrapped around your taste buds, the same nerves that warn you of high temperatures. From the moment it passes your lips, alcohol is setting off alarms and, mostly, causing damage. English and Irish women drink more heavily than any others in the world, as our front page today shows. Whatever their reasons, the science suggests they are taking more risks than men. The latest research shows that women become drink-dependent more quickly than men. If a man and a woman drink the same amount of alcohol, her body will suffer more harm. Women also have to worry about breast cancer, unwanted pregnancies, and causing brain damage and skeletal deformities in their unborn babies. All these are linked to drinking. Alcohol is so popular because it lets us have more fun at pubs, clubs and parties by working on the central nervous system to suppress inhibitions. But it also injures organs in both sexes, from the brain to the pancreas. Officially, 8,000 deaths a year in Britain are directly linked to alcohol, more than double the figure 15 years ago. And some charities estimate that the real number may be five times higher. Drink is, for example, involved in 40 per cent of fatal fires, 15 per cent of drownings and 65 per cent of suicides. The costs are not just to individual bodies. The NHS spends £1.7bn a year dealing with the effects of alcohol abuse. Drink causes 17 million lost working days a year, costing the economy £20bn. Beyond the physical and financial, the effects of alcohol can be felt throughout society. More than one million adults are alcoholics. An estimated 1.4 million are binge drinkers. And 1.3 million children are affected by alcohol abuse. Drink is also involved in 40 per cent of domestic abuse cases. You only have to walk through a town centre on a Saturday night to find evidence of alcohol-related violence and vandalism. The first difference between male and female drinkers, albeit a small one, comes when that nip of vodka splashes into the belly. There, a tiny amount of the alcohol is broken down by an enzyme called alcohol dehydrogenase. A man has slightly more of this than a woman, meaning that his body is already dealing with the vodka more efficiently. But for both sexes it is not the stomach that does most of the work, says Professor Ian Gilmore, president of the Royal College of Physicians and chairman of its alcohol committee. Most alcohol enters the blood through the walls of the small intestine. That's why eating while drinking is so important; it slows the movement of liquor into the bowels and hence into the blood. Alcohol is a simple molecule, small enough to cross into any cell. It is also a solvent, able to dissolve lipids, the fatty molecules that make up cell membranes. Women have more fatty tissues than men - for example, the breasts - which may be one reason they are more susceptible to drink. From the intestines, alcohol is taken by the portal vein to the liver, the body's chemical factory and the main filter for toxins. Here, again, alcohol dehydrogenase gets to work. The enzyme comes in several different, genetically-determined forms, called polymorphisms. These variations explain why some people - usually men - can tolerate more drink than others. But even in the most efficient males, the enzymes can break down only about one unit of alcohol - eight grams - an hour. There is a downside to the process. It produces a poison, namely acetaldehyde, a chemical relative of the formaldehyde used by Damien Hirst to pickle his cows. This is what makes you feel sick after a heavy drinking session. It is in turn broken down by a second set of enzymes, becoming water and carbon dioxide, but the process takes time. Before the liver finishes its work, the poisons from even a single unit of alcohol may have been round the body more than 100 times. The liver clears alcohol out of the blood, but is not immune itself to alcohol damage. About a third of heavy drinkers, such as the late George Best, end up with liver disease. Who gets it and who doesn't probably comes down to a genetic lottery. Some people are just more vulnerable than others. As the liver cells are destroyed, they are replaced by scar tissue, a process called cirrhosis. This has two effects. First it reduces the amount of chemical processing and decontaminating that can be done by the liver. Second, it reduces the blood flow through the organ. In time, the circulatory system finds ways to bypass the damaged liver, taking unpurified blood directly to the heart. This can kill you. Only half of heavy drinkers are physically dependent on alcohol. The others could easily cut back or quit altogether. "They're waiting for an early warning," says Professor Gilmore. But they're not likely to get one. The first outward sign of cirrhosis of the liver is a distended belly and yellowish pallor. By then, the disease has reached its end stage. In many cases, only a transplant can save the patient. But potential recipients far outnumber donors. Eleven thousand women a year are admitted to hospital with cirrhosis of the liver, but fewer than 1,000 organs are available for transplant. As the vodka moves through the blood from the liver to the heart, there is a shot of good news, though. Small amounts of alcohol are known to reduce levels of so-called bad cholesterol that clog and harden arteries, leading to high blood pressure and heart attacks. Unfairly, the benefits are more marked in men. "But as a nation we're drinking well above these cardio-protective levels," says Professor Gilmore. For heavy drinkers, the benefits are quickly outweighed by the risk of cardiomyopathy, a weakening of the heart muscles. Binge drinking can interfere with the sympathetic nervous system so that the heart beats irregularly, a condition that doctors call "holiday heart" because it is so common among people who spend their time off from work knocking back pints. In some cases, it can lead to sudden death. From the heart, alcohol in the blood is pumped to every other organ, including the brain, within a couple of minutes of it entering the blood stream. And unlike many other toxins, it can slip into the brain. The immediate effect on the brain is to shut it down. Our inhibitions are the first to be depressed, hence the pleasure. But soon afterwards, we lose the ability to make the decisions and judgements necessary for safe driving, and eventually even basic functions such as walking or standing up become impossible. By the time blood alcohol levels reach 360mg/ml - four and a half times the legal driving limit - most people are unconscious; by 400mg/ml, all but the most hardened drinkers are dead, usually because the alcohol has depressed the part of the brain that controls respiration. The victims simply forget to breathe. Women, because they are, on average, smaller than men, reach this level with fewer drinks. And even if they don't die suddenly, heavy drinkers can suffer from brain damage. Research using CT brain scans at the University of Heidelberg showed not only that brain mass was lower among alcoholics, but also that women suffered the same percentage decrease even though they had drunk far less. "There is evidence for a faster progress of the events leading to dependence among female alcoholics and an earlier onset of adverse consequences of alcoholism," said Professor Karl Mann of the University of Heidelberg. "This suggests that women may be more vulnerable to chronic alcohol consumption." Other less-well known drink-related illnesses include chronic pancreatitis, a painful condition that reduces the ability to digest food and leads to diarrhoea and diabetes. Bone marrow - where blood cells are grown - can be damaged, leading to poor clotting in wounds and reduced immunity to infection. Osteoporosis, a weakening of the bones already common in older women, can be made worse. And skeletal muscles, like those of the heart, can be weakened. The movement of the tiny hairs in the lungs that sweep contaminants out can also be impaired, making chronic drinkers more prone to diseases such as pneumonia. The danger of having an accident while inebriated is obvious, but other risks are more subtle. For instance, 80 per cent of women report that alcohol was involved in their first sexual experience. That lowering of inhibitions can also lead to unprotected sex, unwanted pregnancies and sexually transmitted diseases, including HIV/Aids. Research shows that 81 per cent of rape victims have been drinking before the attack; undoubtedly many attackers have been drinking too. For many women, one of the greatest fears is foetal alcohol syndrome. During the first three months of a pregnancy, foetal stem cells are changing into forms specific to particular organs. Drugs such as alcohol that cross the placental barrier during this period can have dire effects, including severe brain damage and other birth defects. For women who drink, the problem is twofold. Early in a pregnancy, they may not ever realise that they are carrying a child and should be abstaining. There is no known minimum safe level. One drink at the wrong time can damage the baby. And then there is cancer. Areas that come into contact with concentrated alcohol, such as the mouth and throat, are more likely to develop tumours, as are organs with a high proportion of fatty tissues, such as the breasts. People have been boozing since the dawn of civilisation - the earliest evidence is from 9,000-year-old fragments of neolithic clay pots found in northern China. Some archaeologists have speculated that agriculture itself may have been invented to provide crops for making beer. Attempts at prohibition in America early in the last century were such dismal failures that no one seriously thinks they can stop people from drinking. Fortunately for those who enjoy an occasional tipple, the doctors aren't demanding that every woman climb on the wagon. Professor Gilmore would like to see alcohol become more expensive and harder to find, but says that, unless you are pregnant, moderate drinking is not a problem. Moderate means 14 units a week. You do the maths. Your health: How alcohol affects the body STOMACH: eating while drinking slows the rate at which alcohol enters the blood from intestines LIVER: vital in removing poison, the organ is itself scarred by alcohol. Cirrhosis hits without warning HEART: can benefit from low levels of alcohol, but heavy drinkers risk 'holiday heart' attacks LUNGS: become more vulnerable to pneumonia. Too much alcohol and the brain will forget to breathe PANCREAS: most cases of the painful disease pancreatitis are linked to alcohol abuse BRAIN: women suffer the same percentage of cell death as men, but after drinking less alcohol BONES: both sexes suffer marrow damage, but women are more prone to osteoporosis BREASTS: women have more fatty tissues, where alcohol accumulates, raising cancer risks WOMB: babies can suffer birth defects including brain damage if the mother drinks during pregnancy |
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