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Wednesday, January 4, 2012

Amy Winehouse was killed by alcohol- the UK’s favourite drug

Death by misadventure was the verdict at the inquest of Amy Winehouse, who died in July. On the afternoon of July 23, the day Amy Winehouse died at the age of 27, a friend rang me with the sad news, saying: “Shows just how deadly heroin is, doesn’t it?” I replied that heroin certainly can be dangerous but that far, far more people kill themselves with booze, with nothing added, than die of taking heroin.

Either they die of a slow disease, like cirrhosis of the liver, or the booze can kill them there and then by poisoning them, depressing their central nervous system until everything stops.

Why did it have to be so called illegal drugs that killed her?

As an example of acute alcohol poisoning, I mentioned (in a blog I wrote that day) the sudden death of Dylan Thomas: his post mortem pointed to “insult to the brain”, caused by alcohol. Supposedly, Thomas had drunk 18 straight whiskies, which is about 36 single measures of whisky in British terms.

Winehouse’s friends had spoken of her having been so drunk, earlier that week in July, that she couldn’t stand. Later her boyfriend, Reg Traviss, and members of her family made it clear she had not taken illicit drugs for some time.

Today the coroner has spoken: the poor singer’s blood contained 416mg of alcohol per decilitre*. “The unintended consequences of such potentially fatal levels,” said the coroner, “was her sudden and unexpected death.”

Professor Suhail Baithun, a Home Office pathologist, said people start losing their faculties at 200mg of alcohol per decilitre, and “when you have levels of 350mg, it is associated with fatalities”.

Why do we always assume illicit drugs are responsible in these sudden deaths? Sometimes they are, obviously. But I also think we blame drugs because they’re strange and frightening, and we don’t like to think of booze like that, we don’t like to think of it as deadly stuff.

Booze is supposed to be our friend, it’s part of our culture, it helps us to relax. Many of us couldn’t cope with life’s daily challenges without it. It is, in the words of those bossy health education campaigns of old, “our favourite drug”.

We prefer not to think about what it can be — a strong poison that kills in overdose.

*This has been expressed in most news reports as five times the drink-drive limit. In Britain the drink-driving limit is normally given in milligrams per 100 millilitres (one deciliter) of blood, or, most commonly, in micrograms per 100 millilitres of breath. The drink-driving limit is 80 milligrams of alcohol per 100 millilitres of blood. It’s certainly a lot of alcohol.

An apple or pear a day keeps strokes at bay

Eating lots of fruit and vegetables with white flesh may help to protect against strokes, says a study in the journal Stroke. But Dutch researchers say they do not know why people with a high intake of apples, pears, bananas or cauliflower reduce their risk of stroke by 52%.

The study followed more than 20,000 adults over 10 years.

Stroke experts said people should not be put off eating other colours of fruit and veg.

At the start of the study, carried out in The Netherlands, participants were asked to fill in a detailed questionnaire on diet and lifestyle for the previous year.

By using this information and tracking the health of participants over the next decade, researchers were able to examine the link between the colour of fruit and vegetables consumed and stroke risk.

The study found that a 25g per day increase in white fruits and vegetables was linked to a 9% lower risk of stroke.

Of the white fruit and veg eaten, over half was apples and pears. An average apple weighs 120g.

But no link was found between stroke incidence and green (dark leafy vegetables, cabbages and lettuces) orange/yellow (mostly citrus fruits) or red/purple fruits and vegetables.

Linda Oude Griep, lead author of the study and postdoctoral fellow in human nutrition at Wageningen University in The Netherlands, said more research was needed to find out why white flesh was important.

“It is difficult to say which nutrients are responsible in white fruits and vegetables. We know that apples and pears are high in dietary fibre, but there may be other explanations.”

She said it might be useful to consume considerable amounts of white-flesh fruit and veg to prevent strokes.

“Eating one apple a day is an easy way to increase white fruits and vegetable intake.”

Dr Sharlin Ahmed from The Stroke Association said the findings should not deter people from eating other colours of fruit and vegetables.

“All fruit and vegetables have health benefits and remain an important part of a stable diet. A lot more research is needed before the colour of our groceries alone is used to determine what health benefits they may have.”

“Everyone can reduce their risk of stroke by eating a healthy balanced diet that is low in saturated fat and salt, exercising regularly and ensuring that your blood pressure is checked and kept under control.”

Andrew Lansley condemned over HealthWatch scheme

Health secretary Andrew Lansley’s decision to launch groups designed to champion views of patients leads to complaints.
Andrew Lansley’s plans to put the patient at the heart of the NHS have been labelled as “confusing, vague and insulting”.

The health secretary pushed ahead with HealthWatch, the new body to champion patients’ views, despite ministers being forced to apologise and withdraw a consultation on the new watchdog. Ministers had conceded that their original plans had been conceived in haste and without proper consultation.

But Lansley announced that 75 local HealthWatch groups were in place. HealthWatch is supposed to replace local patient involvement networks, known as LINks, in 2012 – bringing “real local democratic accountability and legitimacy” to the NHS “for the first time in 40 years”.

Malcolm Alexander, chair of the National Association of Local Involvement Networks Members, said that, instead of increasing budgets to fund the new bodies, cash was being cut even though the government was asking local groups to take on a range of new responsibilities, such as promoting the integration of care and health services and improving choice for patients, without extra money.

Alexander said: “It’s pathetic. The consultation had a figure of £20,000, which was confusing and looked like a cut. Then that was withdrawn. Our figures show that networks are having their budgets cut this year by 24% on average.”

He said there was no start-up funding for local HealthWatch “pathfinder” groups and no ringfenced money in local authority budgets to run the new bodies.

The money for HealthWatch comes out of local council budgets, which are being cut by 30% over the next four years. “Our own research asked whether these new policies were evolution or abolition. It looks like abolition to us,” he said.

Sally Brearley, senior research fellow in patient and public involvement at King’s College London, who sat on the prime minister’s Future Forum which re-examined the health reforms, said she “shared the concerns”.

“There’s a lot of extra work to develop these new HealthWatch bodies and they are supposed to be monitoring the NHS as services are being cut and finances are under strain. It’s a real issue.”

A Department of Health spokesperson said the criticism was misleading.

“The government has not cut funding, and has no plans to do so – in fact, we retained the current level of funding at £27m, rising in line with inflation, for the spending review period.”

Aspirin blocks bowel cancer risk by two thirds

Two Aspirn pills a day for two years reduced the incidence of bowel cancer by 63% in a group of 861 at-risk patients, a study reported in The Lancet said. Newcastle University’s Prof Sir John Burn, who led the study, said the evidence “seems overwhelmingly strong”.

Other experts said the findings added to a growing body of proof that aspirin could be used in the fight with cancer.

The study was conducted on 861 patients with Lynch syndrome, which affects one in every 1,000 people.

They struggle to detect and repair damaged DNA which means they are more likely to develop a range of cancers including those of the bowel, womb and stomach.

When looking at all patients in the trial, those in the group given 600 milligrams of aspirin every day developed 19 tumours compared to 34 tumours in the other “control” group, a reduction of 44%.

When the researchers looked at just those patients who took the medication for at least two years the reduction was 63%.

There was also an effect on other cancers linked to Lynch syndrome, which fell by half in the treatment group.

Prof Sir John Burn, from Newcastle University, said there were 30,000 adults in the UK with Lynch syndrome.

If all were given the treatment he said it would prevent 10,000 cancers over 30 years and he speculated that this could possibly prevent 1,000 deaths from the disease.

However, there would also be side effects.

“If we can prevent 10,000 cancers in return for 1,000 ulcers and 100 strokes, in most people’s minds that’s a good deal,” he said.

“People who’ve got a clear family history of, particularly, bowel cancer should seriously consider adding low dose aspirin to their routine and particularly those people who’ve got a genetic predisposition.”

Other studies over the past two decades have suggested the pain killer reduced cancer risk, but this was the first randomised control trial, specifically for aspirin in cancer, to prove it.

In 2010, a study suggested patients given aspirin had a 25% lower risk of death during that trial.

Prof Peter Rothwell, from Oxford University, who conducted that study said the latest research “certainly helps to build a consistent picture, all pointing in the same direction that there is a link with cancer”.

Cancer Research UK’s Prof Chris Paraskeva said: “This adds to the growing body of evidence showing the importance of aspirin, and aspirin-like drugs, in the fight against cancer.”

One of the questions asked by the research into aspirin was whether healthy people with no family risks should take the drug.

The lower the risk of heart attack or cancer, the lower the benefit of taking aspirin, yet there are still potentially deadly side effects.

Sir John said that it was a “finely balanced argument” and that he decided the risks were worth it for him.

“I think where we’re headed for is people that are in their 50s and 60s would look very seriously at adding a low dose aspirin to their daily routine because it’s giving protection against cancer, heart attack and stroke.

“But if they do that they’ve got to have their eyes wide open. They will increase their risk of ulcers and gastrointestinal bleeds and very rarely they will have a stroke caused by the aspirin.”

Avoid alcohol three days a week doctors warn

Drinkers should have three days a week off alcohol to avoid slipping into a cycle of binge drinking and risking liver disease, leading doctors have warned. The Royal College of Physicians (RCP) claims the Government’s current policy on healthy drinking limits is misleading, as it implies that it is safe for people to have alcohol every day of the week.

Official guidance on sensible drinking suggests that men should have no more than 21 units of alcohol a week, while women are restricted to 14 units.

But experts at the RCP said the policy does not take account of the fact that drinkers should have two to three days a week without any alcohol to let their bodies recover.

Drinking alcohol every day causes a “significant health risk”, doctors warned, increasing the chances of developing liver disease and other life-threatening illnesses.

“People should have two to three alcohol-free days every week to reduce the risks of long term damage from binge drinking, including liver disease,” a spokesman for the RCP said.

“After a day of drinking there is a need for a time to recover and that is why we need rest days in between our alcohol consumption.”

Younger drinkers are particularly at risk, the physicians warned, with daily drinking also common among middle-class women who often have a glass of wine after work.

As well as urging people to restrict their drinking to four days a week, the doctors recommend introducing lower limits for elderly people, as their bodies are more likely to suffer lasting effects from alcohol.

Speaking to the House of Commons Science and Technology Committee, Professor Sir Ian Gilmore, special adviser on alcohol at the RCP, said Britain’s binge drinking culture was creating a “tide of harm” in hospitals across the country.

“Given the burden of harm that we’ve got, it’s vital that levels are not increased at this point,” he added.

“We recommend a safe limit of 0 to 21 units a week for men and 0 to 14 units a week for women, provided the total amount is not drunk in one or two bouts and that there are two or three alcohol-free days a week.  At these levels, most individuals are unlikely to come to harm.”

The RCP’s warning comes after Professor Nick Heather, a lecturer at Northumbria University, urged MPs to increase daily drinking guidelines to include a “binge drinking limit” for maximum consumption in one day.

He argued that the Government should issue separate guidance on upper limits for daily and weekly drinking, without increasing recommended overall alcohol levels.

Guidlines from the Chief Medical Officer say men should not drink more than three to four units of alcohol a day, while women should limit themselves to two or three.

One unit is 8g of alcohol, roughly equivalent to half a standard glass of wine, half a pint of beer or a pub measure of spirits.

Bed blocking rise of 11pc in last year

Elderly patients are increasingly being kept in hospital beds because there is no one to support them at home, or there are no places available in residential homes, figures indicate. The number of hospital bed days lost to so-called ‘bed blockers’ across NHS hospitals in England has risen by 11 per cent in the past year, official figures show.

The rise comes after years of success in tackling the problem, and illustrates growing pressures on the NHS and social services.

According to Department of Health statistics, the number of hospital bed days lost to bed blockers rose from 115,648 during September and October 2010, to 128,517 in the same two month period this year.

That comes after a sustained period of falls between 2003 and 2009, as a result of concerted ministerial action to tackle the problem.

With the average cost of providing a hospital bed for a day estimated at £255, that means the daily NHS bill for bed blockers has risen from £483,000 to £537,000.

Aside from this economic cost, it also means hospitals cannot admit new patients as quickly, which can delay waiting times for pre-planned operations.

The statistics confirm what many have been fearing for months: that reductions in local authority social care budgets would quickly lead to clogged up hospital wards.

In February Bupa warned that “chronic under-funding” of care home places would lead to an “intolerable” bed-blocking crisis in the long term, costing the NHS millions of pounds a day.

Oliver Thomas, director of UK care homes for Bupa, said last night: “If you slow down the number of people placed in residential care, because you are trying to manage your budgets better, then inevitably people will stay longer in the acute sector.”

Others described the latest figures as a “warning” of worse to come and a “pinch point”.

Jo Webber, of the NHS Confederation, which represents health service authorities, said: “This is a worrying sign of the pressure which is building in the system. Like waiting times, it is a pinch point.”

Last month The Daily Telegraph reported that government funding for nursing homes and home help for pensioners had been cut by almost a fifth, with some councils cutting spending by up to 30 per cent.

At the same time many hospitals are cutting hospital bed numbers, by up to 10 per cent, in part to meet tough efficiency saving targets.

Dr Ian Donald, of the British Geriatrics Society, said: “The trouble is hospitals operate on such tight margins. Even small delays can cause problems.”

The term ‘bed blocker’ tends to imply the patient is the cause of the problem, but Dr Donald emphasised that was not the case.

“Delayed discharges are not just statistics, but individual patients who are frail and vulnerable. “To them and their families it can feel like they are stuck and lost in the system,” he said.

The new figures follow the introduction in August 2010 of a new monthly reporting system for counting ‘delayed discharges’ – incidents when an otherwise healthy patient is kept in due to lack of community care facilities – brought in due to concerns over quality of data.

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