Ireland’s ‘normal’ drinking is far from the international norm
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Apropos the current alcohol debate, I recently had the pleasure of the company of a young man from Co Kildare on a flight from New Zealand, who expressed his shock on observing the different drinking trends of ex-pats working in New Zealand.
For the first time he had noticed how extreme Irish drinking norms are in comparison to his fellow workers from virtually every other country. What he had grown up to see as normal in Ireland was seen as extremely heavy drinking by international standards in New Zealand. It was not until he went to New Zealand that he first realised how ‘out of order’ our ‘normal’ drinking is in Ireland.
I had the interesting experience of speaking on one of Cork’s radio stations about 10 years ago on the topic of teenage drinking. I suggested at the time that as we were mimicking the US in other cultural matters we should also adopt their legal drinking age of 21.
To my amazement in the following weeks I was confronted by a number of well-educated, middle-class parents who were furious that I might interfere with their little darlings being allowed to drink with them in pubs and restaurants.
The problem for Ireland is that alcohol abuse is costing this state €3.7 billion per year (according to the Royal College of Physicians), and yet all the media seems to be concerned about is the €40 million that might be lost to rugby and soccer should sponsorship be curtailed.
The current price of alcohol is such that a child can currently get drunk on its pocket money, so we need urgently to stop below-cost selling of alcohol, to raise the legal drinking age, and to reduce off licence trading hours if we are to avoid a major predictable medical disaster 10-15 years hence. While the AA and the many rehabilitation centres are doing wonderful work in treating alcoholism, I have been personally very impressed by the work of Dr Olivier Ameisen (French cardiologist), who’s book ‘The End of My Addiction’ explains the therapeutic use of Baclofen in removing the alcoholics craving. I have personally used this therapeutic model in approximately 35 patients, all of whom have remained ‘dry’ over the past three Christmases.
Should any of your readers be interested in discussing this with me, I would be happy to hear from them.
Dr Seán Dunphy,
Cork Road Medical Clinic, Carrigaline, Cork.
Irish Healthcare Awards: Student alcohol deaths moved UCC team to take a stand
Having to attend the funerals of several students who died as a direct result of the misuse of alcohol impelled staff at UCC’s Student Health Department to take a radical stand against alcohol-related harm.
The College, which won the overall prize at this year’s Irish Healthcare Awards for its comprehensive Alcohol Action Plan, brought both the Best Public Health Initiative and An Duais Mhór trophies back to Cork following the gala event in Dublin last week (November 7).
The UCC scheme is aimed at reducing levels of alcohol-related harm among students, 45 per cent of whom have reported binge-drinking more than once a week.
With 20 specific actions, the plan has seen the introduction of an online brief intervention tool for all incoming first years, training for front line college staff, alcohol information sessions and awareness events on campus, peer-support leaders to encourage alcohol education, and most recently the provision of alcohol-free accommodation on campus.
“The adverse consequences of the misuse of alcohol among our students are very real, all too common, and occasionally have been very serious, up to and including devastating injury and death,” commented Head of UCC’s Student Health Department Dr Michael Byrne, who received the award.
A special Lifetime Achievement Award was also presented to retired Skibbereen GP Dr Michael Boland.
The event at the Shelbourne Hotel — hosted by IMT — was attended by 390 people representing the country’s leading public and private hospitals, medical training bodies, universities, patient organisations, the pharmaceutical industry, health insurers and community organisations.
The Mater Public and Private achieved a clean sweep in the Best Hospital category — a first in the Award’s 12-year history — with the Mater Private topping the 16-strong list with its comprehensive hand-hygiene compliance programme.
Galway and Roscommon University Hospitals Group took home two trophies, with Crumlin, the Rotunda, Saint John of God Hospital, and St Finbarr’s Hospital, Cork all among the category winners.
“These awards are now indisputably recognised as the most sought-after in Irish medicine,” commented IMT’s Publisher David Kelly. “The standard of entries has not only been maintained over the past 12 years, but has consistently improved, with the number of entries this year setting another record.”
Gaps in omega 3 prostate cancer risk study
The recent media reports implicating dietary omega 3 as a risk factor for prostate cancer in males is likely to generate public concerns about the purported health and safety benefits of dietary oily fish or fish oil supplements.
Understandably, health-conscious consumers of omega 3 supplements will be confused by these media reports and may be prompted to question, or even abandon, their long-held beliefs and practices regarding the protective nature of supplemental fish oils.
The hypothesis of risk, as speculated by the authors of the SELECT study (published July 11 in the online edition of the Journal of the National Cancer Institute), which gave rise to the media reports, is not, I believe, supported by hard evidence from within the study and the researchers concede only a correlation, but not a cause-and-effect relationship, between omega 3 consumption and prostate cancer.
They also omit valuable information about the use of prescription drugs (like statins) by the participants, which inevitably impact on risks to health.
The outcomes from several reputable studies contradict the speculative reports by the SELECT authors, showing “fish oil consumption may be protective against progression of prostate cancer in elderly males” (PLoS ONE 8(4):Oct 11, 2012.), and these findings are supported by population-based studies involving Japanese, Swedish and Eskimo males, who have a low incidence of prostate cancer and who consume liberal portions of oily fish regularly.
The absence of hard data from the SELECT study about the duration of fish oil consumption, and the source for the fish, or supplemental products, is one of several weaknesses that in my opinion characterises this study, rendering it perhaps a less than an authoritative guide to healthy dietary practice.
The source of dietary oily fish, or fish oil supplements, may impact significantly on the level of health hazard attributed to trial participants, given the high levels of environmental toxins (PCBs, mercury) that may be present in certain areas of farmed salmon, or inadequately purified omega-3 supplemental products. I have prescribed for my patients, and personally used, a purified form of omega 3 (EPA/DHA) for the past 20 years without any emergent evidence of risk for prostate cancer, and will continue to do so in the foreseeable future.
Dr Neville Wilson,
Leinster Medical Centre, Maynooth.
Patients with arthritis have been treated with procaine solution since the 1950’s. A Dublin doctor, Dr. Patrick A. Collins, who found that it could alleviate the symptoms of many forms of arthritis, developed the treatment. Today, an increasing number of GP’s around Ireland and abroad use the same treatment. The Lucan practice, run by Dr. Maurice Collins, continues as a specialist centre for this treatment and associated research.
What is it?
A very dilute solution of procaine in saline. Procaine was used in the past as a local anaesthetic, though its effect on arthritis symptoms has nothing to do with its anaesthetic properties.
What is the treatment called?
In order to distinguish the procaine treatment developed by Dr. Patrick A. Collins from other forms of procaine treatment, this treatment is now called ‘PACAINE’ (the initials P A C are taken from his name).
Who can be treated?
Patients with different types of arthritis, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile chronic arthritis and arthritis associated with SLE. Other conditions such as fibromyalgia may also be treated successfully.
How is the treatment given?
The method of treatment is unusual. Using a glass rod, a measured amount of the solution is applied to the skin of the upper arm (no needles are required). The solution is just allowed to dry for a few minutes.
How often is the treatment needed?
The treatment is repeated every 4 weeks initially. Later, when the arthritis symptoms have responded, the time interval between treatments may be longer than 4 weeks (eg. 8 weeks, 3 months, etc.).
What kind of response is expected from the treatment?
Following a treatment it is not unusual for the patient’s symptoms to get worse temporarily (this is what we call a flare). Normally this will only last a few days and improvement follows. However, if the starting dose is too big the flare may last longer. Benefit may also occur in some patients without any initial worsening, but if the starting dose is too small the benefit will be short-lived.
Patients may also notice an increase in energy levels and general wellbeing after treatment with Pacaine.
Eventually, a general level of improvement in pain and stiffness is maintained and flares, if they do occur, are mild.
How long does it take to get a response to Pacaine?
The speed of response to treatment will vary from patient to patient and while some may improve quite quickly, for most patients it tends to be a slow gradual improvement with some ups and downs on the way.
Approximately 70% of patients will respond to treatment. If no reaction shows after 3 treatments, treatment is stopped. To stop after 1 treatment is a waste of time. The initial reaction may be quite slight and the patient may be expecting much more and hence not notice the slight change.
How Long do patients stay on treatment?
Every patient is different. Pacaine treatment is continued where troublesome symptoms occur. While in the early stages this is every 4 weeks, usually this interval extends to 8 weeks, 3 months or even 6 months in time. It is not possible to predict the speed this will happen.
How does Pacaine work?
It is thought that the treatment in some way stimulates a reaction in the immune system which can then influence the joints affected by arthritis and thereby alleviate symptoms.
Does the treatment have side-effects?
There are no known side-effects to this treatment.
Does the treatment interact or interfere with other medication?
It is important that other medications are not changed at all when treatment with Pacaine has started , otherwise it may not be possible to tell whether a change in symptoms is due to Pacaine or the alteration of other standard medication.
In time, it may be possible to reduce the need for painkillers and anti-inflammatory drugs.
Where is Pacaine treatment available?
Dr. John Dunphy,
Cork Road Medical Clinic, Carrigaline, Co. Cork.
Tel: 021 4371177
Dr. Maurice Collins,
Crescent View, Spa Hotel Grounds, Lucan, Dublin
Tel: 01 6280240