Hung-over surgeons more error-prone

Surgeons might want to steer clear of alcohol the night before operating, according to a new report that shows a hangover fuels errors during simulated surgery.

While there is no question about the immediate effects of alcohol on surgical skills, there aren't any rules for how much doctors can drink the day before going to the operating room.

"Historically, the medical profession has had a reputation for high rates of alcohol consumption," Anthony Gallagher, of the Royal College of Surgeons in Ireland, and colleagues write in the Archives of Surgery.

"It is likely that surgeons are unaware that next-day surgical performance may be compromised as a result of significant alcohol intake."

To measure the degree of that impairment, the researchers invited eight surgeons and 16 students out for a night on the town.

Half the students and all of the experts were encouraged to down as much booze as they wanted until they felt drunk. The rest of the students weren't allowed to touch any alcohol, but still went out for dinner.

The next day, the merrymakers, hung-over or not, went to the lab to perform a type of camera-guided surgery that uses a few small incisions instead of one big one -- so-called laparoscopy.

The surgery was done on a virtual reality system, not a real person. That turned out to be fortunate, because both the surgeons and those students who had been drunk did worse than when they were tested before the party.

At 9 AM, hung-over students made about 19 errors on average, while those who hadn't been drinking made only eight. This difference hadn't been seen before the night out, and faded over the day.

The surgeons also performed worse the day after their night out compared with before, with an increase in errors of about half. Yet only one of them had detectable blood alcohol levels.

For unclear reasons, the surgeons completed the surgery faster at 9 AM than they did before the party, but then became slower when tested at 1 PM.

Still, because they also made more errors and had trouble performing a type of heating used during surgery, this speediness didn't translate into a real improvement, the researchers note.

The take-home message?

"Abstinence from alcohol the night before operating may be a sensible consideration for practicing surgeons," the report urges.

SOURCE: bit.ly/9qX5ZA Archives of Surgery, April 18, 2011.

Alcohol + Energy Drinks = A Bad Combo

It’s one of the latest trends in drinking: mixing alcoholic beverages with energy drinks. Though research on the effects of combining the two is not extensive, a new study shows that choosing vodka and Red Bull over rum and Coke may lead to riskier behavior.

In the study, 56 college students between the ages of 21 and 33 were randomly assigned to one of four groups: one group drank alcohol, one group drank an energy drink, one group drank alcohol mixed with an energy drink, and the last group received a placebo drink. Researchers then observed the participants’ behavior using a task that measures how quickly a person can execute and suppress actions after drinking. The participants also reported their feelings of stimulation, sedation, impairment, and level of intoxication.

Cecile A. Marczinski, assistant professor of psychology at Northern Kentucky University and first author of the study, was quoted as saying, "Our study was designed to demonstrate that alcohol/energy drinks are pharmacologically distinct from alcohol alone and are adding to the risks of drinking."

While the study showed no difference in the level of impairment of people who drank alcohol/energy drinks compared to those who drank just alcohol, the study did demonstrate an enhanced feeling of stimulation in participants who drank mixed alcohol/energy drink beverages. This suggests drinking alcohol and energy drinks together may heighten the risks associated with drinking.

"We found that an energy drink alters the reaction of alcohol that a drinker experiences when compared to a drinker that consumed alcohol alone…," Marczinski said. "The consumer of the alcohol/energy drink felt more stimulated compared to an alcohol-alone consumer. Therefore, consumption of an energy drink combined with alcohol sets up a risky scenario for the drinker due to this enhanced feeling of stimulation and high impulsivity levels."

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http://www.ivanhoe.com/channels/p_channelstory.cfm?storyid=26786

Call to 'tag' bottles of alcohol in Scotland

Scottish Labour have called on local licensing boards to enforce the "tagging" of bottles of alcohol to help reduce under-age drinking.

Under the scheme, off licences are given a unique code to mark bottles so they can be traced to a specific store.

If under-age drinkers are found with a tagged bottle, officers can check the shop's CCTV to see who bought the alcohol.

The Scottish government said tagging was an "operational matter" for police.

A tagging scheme is currently in place in parts of Dundee after being introduced by Tayside Police, working with Dundee City Council and local off licences.

Scottish Labour said it was urging licensing boards to use bottle tagging in other "hot spot" areas where under-age drinking and antisocial behaviour have been found to be a problem.

Antisocial behaviour

Labour's Community Safety spokesman James Kelly said: "Under-age drinking can all too often be a direct cause of antisocial behaviour in communities across Scotland.

"This innovative but simple approach will hopefully help bring to justice those peddling booze to young people."

Mr Kelly said those who supplied alcohol to young people needed to realise that they were often "fuelling antisocial behaviour" as well as breaking the law.

He added: "The SNP may be happy to turn a blind eye to antisocial behaviour, but Labour is not. I urge licensing boards to adopt this new approach to hammer home the message that supplying under-agers with alcohol is never acceptable and will not be tolerated."

The Scottish government said it had always encouraged police to make use of bottle tagging in the fight against under-age drinking.

A spokesman said: "As an intelligence-led tool, it can help forces crack down on the problem by proving that certain shops are selling alcohol to under-18s.

"Bottle-tagging remains an operational matter for police, often deployed during targeted exercises against under-age drinking. However, we would caution against the blanket deployment of this measure, to ensure it remains effective."

The Scottish Conservative party said it had "reservations" about the practicality of the bottle tagging scheme and that it should be made more difficult for people to buy alcohol for under-age drinkers in the first place.

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http://www.bbc.co.uk/news/uk-scotland-12083695

States Consider Banning Alcoholic Energy Drinks

Alcoholic energy drinks are facing growing public scrutiny. Several states want to ban canned, caffeinated alcoholic beverages.

In Washington state, nine college freshmen landed in the hospital recently with near-lethal blood alcohol levels after drinking a caffeinated malt beverage called Four Loko, according to law enforcement officials.

Police reports describe chaos at the October incident, where officers found female freshmen unable to talk or sit up, lying on mattresses in a basement near Central Washington University, about two hours east of Seattle.

Police shuttled loads of intoxicated freshmen back to campus and took the worst cases to the hospital. One student almost died, according to the police reports. At first, investigators thought the students had been drugged, but it turns out they were drinking Four Loko.

'A Single Mistake Can Be Deadly'

Now, Washington's Attorney General Rob McKenna wants state lawmakers to ban these types of drinks.

"The wide availability of alcoholic energy drinks means that a single mistake can be deadly. If you're a 135-pound woman [and] you drink two of these Four Lokos ... you can reach the level of toxicity for alcohol poisoning," McKenna says.

Eighteen attorneys general have pressured the Food and Drug Administration to look into the drink's ingredients and determine whether it is safe to consume.

McKenna criticizes Four Loko's brightly colored cans that look like regular energy drinks, coming in flavors such as lemonade, blue raspberry and fruit punch.

Unknown Factors

Jeff Wright, co-owner of Phusion Projects, which makes Four Loko, says his company should not be blamed for the Central Washington students being sent to the hospital. "It's kind of unfair in this example that our product is being singled out," Wright says. "I mean, according to the police report, there was hard alcohol at this function. There were multiple different types of alcohol there."

But, with no serving recommendations, calorie count or caffeine content on the can's label, it is awfully hard for consumers to figure out exactly what's in a can of Four Loko and how much is safe to drink.

Phusion Projects will give only an estimate of how much caffeine is in its drink: One can has about as much caffeine as a six-pack of Diet Coke. One can also fills an empty wine bottle and in fact, contains about as much alcohol as a bottle of wine.

Bar patrons who mix alcohol and caffeine are more likely to leave drunker and get behind the wheel.

Blackout In A Can

In the student commons of Washington State University in Richland, Wash., most students say they do not drink Four Loko.

But Jarod Franklin, 23, says he has used these drinks to the point of blacking out. He and his friends liked them because of the buzz — the feeling of energized euphoria."We would start to lose those inhibitions and then [it would be like], 'How did you get a broken knuckle?' 'Oh, I punched through a three layer of ice [because] you bet me I couldn't,'" Franklin says.Franklin says he no longer drinks Four Loko, because he did not like how he felt afterward and spending the money on it.

In Washington and across the country, schools are trying to educate students about the dangers of being wide-awake and drunk. Many schools, like Central Washington University and the University of Rhode Island, have already banned the drinks.

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http://www.npr.org/templates/story/story.php?storyId=130977580

Alcohol 'more harmful than heroin' says Prof David Nutt

Alcohol is more harmful than heroin or crack, according to a study published in medical journal the Lancet.

The report is co-authored by Professor David Nutt, the former UK chief drugs adviser who was sacked by the government in October 2009.

It ranks 20 drugs on 16 measures of harm to users and to wider society.Tobacco and cocaine are judged to be equally harmful, while ecstasy and LSD are among the least damaging Harm score

 

Prof Nutt refused to leave the drugs debate when he was sacked from his official post by the former Labour Home Secretary, Alan Johnson.He went on to form the Independent Scientific Committee on Drugs, a body which aims to investigate the drug issue without any political interference.

One of its other members is Dr Les King, another former government adviser who quit over Prof Nutt's treatment.Members of the group, joined by two other experts, scored each drug for harms including mental and physical damage, addiction, crime and costs to the economy and communities.

The modelling exercise concluded that heroin, crack and methylamphetamine, also known as crystal meth, were the most harmful drugs to individuals, but alcohol, heroin and crack cocaine were the most harmful to society.When the scores for both types of harm were added together, alcohol emerged as the most harmful drug, followed by heroin and crack.

'Valid and necessary'

The findings run contrary to the government's long-established drug classification system, but the paper's authors argue that their system - based on the consensus of experts - provides an accurate assessment of harm for policy makers.

"Our findings lend support to previous work in the UK and the Netherlands, confirming that the present drug classification systems have little relation to the evidence of harm," the paper says."They also accord with the conclusions of previous expert reports that aggressively targeting alcohol harms is a valid and necessary public health strategy."

In 2007, Prof Nutt and colleagues undertook a limited attempt to create a harm ranking system, sparking controversy over the criteria and the findings.The new more complex system ranked alcohol three times more harmful than cocaine or tobacco. Ecstasy was ranked as causing one-eighth the harm of alcohol.

It also contradicted the Home Office's decision to make so-called legal high mephedrone a Class B drug, saying that alcohol was five times more harmful. The rankings have been published to coincide with a conference on drugs policy, organised by Prof Nutt's committee.

'Extraordinary lengths'

Prof Nutt told the BBC: "Overall, alcohol is the most harmful drug because it's so widely used.

"Crack cocaine is more addictive than alcohol but because alcohol is so widely used there are hundreds of thousands of people who crave alcohol every day, and those people will go to extraordinary lengths to get it."

He said it was important to separate harm to individuals and harm to society.

Government advisor Professor David Nutt likens the effects of alcohol to a range of other drugs including heroin.The Lancet paper written by Prof Nutt, Dr King and Dr Lawrence Phillips, does not examine the harm caused to users by taking more than one drug at a time.

Gavin Partington, spokesman for the Wine and Spirit Trade Association, said millions of people enjoyed alcohol "as part of a regular and enjoyable social drink"."Clearly alcohol misuse is a problem in the country and our real fear is that, by talking in such extreme terms, Professor Nutt and his colleagues risk switching people off from considering the real issues and the real action that is needed to tackle alcohol misuse," he said.

"We are talking about a minority. We need to focus policy around that minority, which is to do with education, treatment and enforcement."

A Home Office spokesman said: "Our priorities are clear - we want to reduce drug use, crack down on drug-related crime and disorder and help addicts come off drugs for good."