Obstetricians Often Overlook Alcohol Consumption In Pregnancy, says the Australian And New Zealand Journal Of Obstetrics And Gynaecology

One in every two pregnant Australian woman still consume alcohol during pregnancy, according to a study in the Australian and New Zealand Journal of Obstetrics and Gynaecology. The responsibility of providing accurate information about the harmful effects of alcohol and its lifelong effects on the child falls on obstetricians and other health professionals.

And yet, almost half of the obstetricians interviewed said they did not routinely ask about alcohol consumption in pregnancy.

An editorial by Professor Elizabeth Elliot from the University of Sydney titled “Alcohol and Pregnancy: the Pivotal Role of the Obstetrician”, discusses the state of awareness about the adverse effects of alcohol consumption during pregnancy and the obstetricians’ participation in educating against maternal drinking.

Only 16% of the obstetricians routinely provided information about the consequences of alcohol in pregnancy, while only 5% gave advice which were consistent with the latest guidelines of The National Health and Medical Research Council of Australia (NHMRC) – which states that, for pregnant women, ‘no drinking is the safest option’.

Professor Elliot says, “Failure to provide information about the dangers of alcohol consumption in the antenatal consultation represents a lost opportunity. Accurate recording of antenatal alcohol exposure will help identify children who require pediatric assessment, since the effects of alcohol may not be obvious at birth.”

“More importantly, identifying the women who are unable to stop drinking provides an important opening for the management of problem drinking and prevention of exposure to alcohol in future pregnancies,” added Professor Elliot.

Alcohol consumption during pregnancy has been associated with increased risks of miscarriage, stillbirth, intrauterine growth restriction, pre-term birth and low birth-weight. However, the best known adverse effect of alcohol exposure on the fetus is the fetal alcohol syndrome (FAS) – which is associated with a wide range of birth defects and ongoing educational, behavioral and psychological problems.

This paper is published in the June 2008 issue of Australian and New Zealand Journal of Obstetrics and Gynaecology (Vol. 48, Issue 3, 2008).

See also;

1. Facial features of fetal alcohol syndrome
2. Alcohol and Pregnancy
3. Alcohol Free Pregnancies
4. Alcohol intervention may help.
5. Brief-TSF can assist patients cease alcohol consumption.

Dimensions of social interaction among sober female participants in Alcoholics Anonymous.

The peer-led, voluntary fellowship, Alcoholics Anonymous (AA), remains the predominant model for treatment within the field of substance abuse treatment and attainment of sobriety.

The social support network of AA has been documented as a powerful factor in the achievement of sobriety. However, for whom and in what manner does this social support network work?

This study examined the dimensions of

• perceived group,
• perceived personal, and overall
• perceived social support among 125 sober female members of AA using the Social Support Network Inventory (SSNI).

Of the SSNI’s five dimensions (available, practical, emotional, reciprocal, and sobriety-related social support), reciprocal support was the strongest contributor to group social support.

Those women who had a sponsor scored significantly higher in total social support and personal support.

Availability was the strongest contributor to both personal and overall perceived social support.

These findings indicate that availability and sponsorship are significant components of a supportive environment among women in sobriety.

Rush, M.M. Perceived social support: Dimensions of social interaction among sober female participants in Alcoholics Anonymous. Journal of the American Psychiatric Nurses Association, 8(4):114-119, 2002.

Difference in medical history classified by ICD-10 between male and female alcoholics.

The drinking history and current medical history of patients with alcohol dependence were surveyed in Japan and they were analyzed by demographics; gender, age and changes with time (2 stages).

The results showed that in the course of continued habitual drinking by patients with alcohol dependence, a wide range of physical complications occurred.

The main complications

• in men were gastrointestinal diseases and
• in women were mental and behavioral disorders, showing a gender difference in the medical history.

This result suggested that there is a high possibility that this will contribute to early discovery and early measures against alcohol related problems in women, which are difficult to bring out into the open.

Better alcohol education including mental health is important from an early age.

Nihon Arukoru Yakubutsu Igakkai Zasshi. 2008 Feb;43(1):25-34. Difference in medical history classified by ICD-10 between male and female alcoholics. Shinoda R, Mizukami Y, Nakagawa Y, Maruyama K.

See also;

• Brief-TSF is designed to address these issues.
• 12-Step Treatment More Effective than Alternative
• Subscribe to BriefTSF by e-Mail

Counseling the Culturally Diverse: Theory and Practice by Derald Wing Sue, David Sue Read more about this title…

Exhaustive Review of the Literature Reveals Even Moderate Alcohol Intake Increases Risk of Cancer

The Cancer Institute of New South Wales, Australia, has released a comprehensive analysis of current evidence for the association between alcohol consumption and risk of cancer. Limited to systematic reviews and meta-analyses of the highest methodological quality, the 194-page monograph, entitled Alcohol as a Cause of Cancer, revealed that even moderate alcohol consumption is associated with an often dramatic increase in the risk of several types of cancer.

Key findings are as follows:

Alcohol intake of approximately 2 drinks per day increases the risk of

• cancer of the oral cavity and pharynx by 75 percent,
• the risk of esophageal cancer by 50 percent, and
• the risk of laryngeal cancer by 40 percent.

Moderate intake also significantly increases the risk of colorectal cancer, liver cancer, and stomach cancer.

• Intake of approximately 4 drinks per day increases the risk of any cancer by 22 percent, while
• 8 drinks per day increases the risk by 90 percent.

The risk of breast cancer is 11 to 22 percent higher in women who drink alcohol than in women who do not.

Comments: The authors were unable to identify levels of consumption associated with no risk of cancer. Although the World Health Organization lists alcohol as a Group-1 carcinogen, as noted in the introduction to this study, few people are aware that even moderate consumption can cause cancer. These findings may be limited by possible underreporting of alcohol use or misclassification of exposure (e.g., light or ex-drinkers classified as nondrinkers).

Nonetheless, information about the association between alcohol and cancer needs to be more widely available so that the public can make informed choices about their behavior.

Richard Saitz, MD, MPH. Research Reference; Lewis S, Campbell S, Proudfoot E, et al. Alcohol as a Cause of Cancer. Sydney, Cancer Institute NSW, May 2008.

See also;

• Brief-TSF can assist patients cease alcohol consumption.
• Twelve Step Facilitation
• 12-Step Treatment More Effective than Alternative
• Subscribe to BriefTSF by e-Mail

Counselling for Alcohol Problems (Counselling in Practice series) by Richard D B Velleman Read more about this title…

Beyond Codependency: And Getting Better All the Time

By Melody Beattie

Review By Neal J. Pollock (VA USA)

While I have not read Melody Beattie’s other works, I thought this a very valuable book in and of itself. It sheds much light on the topic and helped me to become sensitized to the obvious signs of codependency in people. By doing this, it enabled me to avoid situations where I could become codependent in a relationship.

I think that, as in the Diagnostic and Statistical Manual, there are levels of psychological situations and/or problems. Thus, there may be people inherently inclined towards codependency, but there may also be people who are thrust into it due to the demands of others. The latter may find this book incredibly helpful in avoiding such relationships and in helping their dependent person seek real help vs. codependency from another person. There are also a number of great quotes by the author in this book. A few are:

p. 70: “It’s hard to feel compassion for someone while that person is using or victimizing us.”

p. 71: “If everything looks black, we’ve probably got our eyes shut.”

p. 164: “Who we’re in a relationship with says as much about us as it does about them.” Earnie Tucker (quoted by Melody Beattie)

Codependency is not something to make light of, it’s as much (if not more) the codependent’s problem as the dependent’s. As Caroline Casey humorously noted in “Making the Gods Work for You” (Harmony Books NY 1998), on page 72:
“What do codependents see when they die? Someone else’s life flashes before their eyes.”

This is literally a life-changing book for codependents.

Reviewer: A reader

Once Melody Beattie’s Codependent No More has been “digested”, Beyond Codependency helps to move the recovering codependent past the hurt and on to the business of literally changing behaviors and making a better life. I absolutely recommend this book above any others to recovering codependents.

The more alcohol an individual drinks, the more the risk of suicide grows, according to a researcher at Canada’s Center for Addiction and Mental Health (CAMH).

All Headline News reported Sept. 8 that CAMH senior researcher Robert Mann found that while suicide risk rose with alcohol consumption, as well as other factors like unemployment, the risk of suicide decreased when heavy drinkers joined Alcoholics Anonymous.

“These results suggest that a 1-liter increase in alcohol consumption led to an increase of 11 percent to 39 percent in suicides,” said Mann. “This observation is consistent with individual-level studies that show that heavy drinking, alcohol abuse and alcohol dependence increase a person’s risk of suicide substantially … However, it was heartening to see that increasing AA membership was related to reduced suicide mortality rates.”

The link between drinking and suicide was stronger among women than men, Mann noted.

Night Falls Fast: Understanding Suicide by Kay Redfield Jamison Read more about this title…

Research Summary; Women and men appear to have different genetic and environmental risk factors for alcoholism, Reuters reported Jan. 24/2006.

A quartet of new family studies on alcoholism show, for example, that while both sexes are more likely to develop alcoholism if they have a history of aggressive behavior in childhood, women who experienced severe physical punishment in childhood were also at elevated risk, while men were not.

“Clearly, there are some common antecedents (to alcoholism), such as conduct disorder or symptoms, but there are also predictors unique to each gender,” said researcher Aruna Gogineni of the Johns Hopkins University School of Medicine. “These are the kinds of findings that call out for many more studies on women in order to determine how the mechanisms of alcoholic parental risk may differ in men and women.”

Researchers affirmed that children of alcoholics were generally more likely to have alcohol problems themselves, but said that genetic makeup may be more important for men, while environmental factors may have more of an impact on women. For example, one study comparing children of biological and adopted parents with alcoholism found that male children of alcoholics related by blood were more likely to be alcoholics themselves.

The research appears in the February 2006 issue of the journal Alcoholism: Clinical & Experimental Research.

From; Join Together Online

See also;

• 12-Step Treatment More Effective than Alternative
• Twelve Step Facilitation
• Brief-TSF can assist patients cease alcohol consumption.
• Subscribe to BriefTSF by e-Mail

Understanding and Counseling: Persons With Alcohol, Drug, and Behavioral Addictions : Counseling for Recovery and Prevention Using Psychology and Religion by Howard Clinebell Read more about this title…

Female drinkers lose brain volume more quickly than men, according to researchers at the University of Heidelberg in Germany.

The BBC reported May 15 that researchers took CT scans of 150 women — about half of them alcoholics — and found that the heavy drinkers have smaller brains.

Female alcoholics were found to lose the same brain volume as male alcoholics, but suffered atrophy much more quickly.

“Women typically start drinking later in life, consume less … and one could reason that women are less affected by alcohol,” said lead study author Karl Mann. “But 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. This suggests that women may be more vulnerable to chronic alcohol consumption.”

The findings were reported in the journal Alcoholism: Clinical and Epidemiological Research.

Mann, K., Ackermann, K., Croissant, B., Mundle, G., Nakovics, H., & Diehl, A. (2005) Neuroimaging of Gender Differences in Alcohol Dependence: Are Women More Vulnerable? Alcoholism: Clinical and Epidemiological Research, 29(5): 896-901.

From; Jointogether

Gender, treatment and self-help in remission from alcohol use disorders.

OBJECTIVES: To examine gender differences in the influence of treatment, self-help groups and life context and coping factors on remission among initially untreated individuals with alcohol use disorders.

DESIGN: A naturalistic study in which individuals were assessed at baseline and 1, 8 and 16 years later.

SETTING: Participants initiated help-seeking with the alcoholism service system by contacting an information and referral service or detoxification program.

PARTICIPANTS: A total of 461 individuals with alcohol use disorders (50% women).

METHODS: Participants were assessed by mail surveys and telephone interviews on

• participation in professional treatment and
• Alcoholics Anonymous (AA),
• alcohol-related functioning and
• indices of life context and coping.

RESULTS: Compared to men, women were more likely to participate in treatment and AA, and to experience better alcohol-related and life context outcomes.

In general, women and men who participated in treatment and/or AA for a longer duration were more likely to achieve remission.

However, women benefited somewhat more than men from extended participation in AA.

Continuing depression and reliance on avoidance coping were more closely associated with lack of remission among men than among women.

CONCLUSION: Compared to men, women with alcohol use disorders were more likely to obtain help and achieve remission.

Women tended to benefit more from continued participation in AA and showed greater reductions in depression and avoidance coping than men did.

These findings identify specific targets for clinical interventions that appear to be especially beneficial for women and that may also enhance the likelihood of recovery among men.

Research; Moos RH, Moos BS, Timko C. Gender, treatment and self-help in remission from alcohol use disorders. Clin Med Res. 2006 Sep;4(3):163-74.

ACOA Mutual help groups, perceived status benefits, and well-being: A test with adult children of alcoholics with personal substance abuse problems.

A field experiment was conducted to examine the potential effects of mutual help group participation on perceived status benefits, depression, and substance use among 82 adult children of alcoholics (ACOA’s; aged 22-60 yrs) with personal substance abuse problems.

Participants were randomly assigned to attend either ACOA-specific mutual help group meetings or substance abuse education classes during the initial month that they were enrolled in a residential treatment program for low-income substance abusers.

Analyses were based on assessments made at baseline, a 1-month posttest, and a 6-month follow-up.

Results indicate that participation in the mutual help group promoted perceived status benefits, which in turn led to reductions in depression and substance use.

These findings have clear implications for consumers of ACOA groups and can inform research on the social psychological underpinnings of different types of mutual help groups.

Kingree, J. B; Thompson, Martie. Mutual help groups, perceived status benefits, and well-being: A test with adult children of alcoholics with personal substance abuse problems. American Journal of Community Psychology. Vol 28(3), Jun 2000, 325-342.

The Complete ACOA Sourcebook: Adult Children of Alcoholics at Home, at Work and in Love by Janet Woititz Read more about this title…