Archive for the ‘Alcoholism’ Category

Happy Repeal Day

Monday, December 5th, 2011

Today is the seventy-eight anniversary of Repeal. I am re-posting something I wrote three years ago for the seventy-fifth anniversary. It was posted on my pre-wordpress blog so I am not sure how many people read it.

Prohibition happened because of deep ambivalence in American society over the use and abuse of alcohol. In 1920 the solution to these problems appeared to be the cessation of the production, distribution, and sale of alcohol. Thirteen years later Americans decided they had been wrong and allowed, once again, alcohol to be legally made and sold.

Repeal represented a turning point in American views of social behavior and habits. Since 1933 Prohibition has served as a negative reference point for any attempts to regulate or control problematic or unhealthy behavior. Reformers seeking legalization of other psychoactive substances such as marijuana use the nation’s experience with Prohibition to underscore the lack of wisdom in prohibiting other drugs.

Prohibition and Repeal did not eradicate our nation’s ambivalence about alcohol. As a country we are not alone in this ambivalence. Most modern states have a similarly complicated relationship with alcoholic beverages. Most governments receive some revenue benefits from taxing liquor while they must also deal with the health, safety, and public disorder problems that result from the misuse of alcohol.

From the liquor industry’s stand point the history of Prohibition and Repeal is a mixed blessing. They are always able to refer to Prohibition as the undesired end point of any attempts to increase regulation of the industry. They have been able to resume their role as financial partners in the federal government, an activity that continues to give them respectability. However they are ever vigilant in resisting any further sacrifices in the form of increased taxes. They are obviously aware, both from their own experiences as well as the experiences of the tobacco industry, that they are not invulnerable to another prohibition.

American responses to alcohol use and abuse have come in waves or cycles. From 1933 until the early 1970s American society increasingly saw alcohol consumption as a normal part of middle class social life. The low consumption rates that persisted until baby boomers became old enough to drink may have encouraged this benign view of liquor. The liquor industry as well as the medical field and academics all participated in the individualization and medicalization of alcohol problems.

In the 1970s alcohol consumption levels rose and a more public health approach to alcohol problems emerged. We are still living in this era. Public health advocates along with neo-prohibitionists had several successes including warning labels, the increase in the minimum drinking age, and a tax increase for beer. However they have not really moved forward in their attempts to restrict television advertising and drunk driving rates have not decreased for several years.

What remains to be seen is whether the pendulum will swing more severely one way or the other? Will bad economic times lead to increased or decreased drinking? Globally as the world’s population ages there seems to be a decrease in drinking. Less drinking usually leads to less negative consequences for society which in turn can lead to looser attitudes about drinking. However, at least in America, the baby boomlet could certainly impact consumption levels which might swing the pendulum towards stricter regulations and greater societal concern. The liquor industry is much better organized to withstand a regulatory or prohibitory onslaught than they were when Prohibition started.

 

Cirrhosis and Liver Cancer

Tuesday, November 9th, 2010

Several times a year I listen to CancerCare telephone workshops on different aspects of cancer research and treatment.  Today’s workshop was an “Update on the Treatment of Liver Cancer.” One of the speakers discussed the various risk factors for liver cancer. Cirrhosis underlies 50 to 60 percent of all the liver cancer cases in the United States. Hepatitis C and alcohol abuse are the most frequent causes of cirrhosis. According to the speaker, one can never ignore the degree of underlying damage to the liver when considering treatment for liver cancer. A patient would have the symptoms from the cirrhosis, such as ascites and varices, as well as the cancer symptoms. A few years ago, I wrote a post, “Your Liver on Drugs” which looked at some of the issues connected to maintaining good liver health. I am linking to it again because it still seems relevant.

Sales Tax on Alcohol

Monday, November 1st, 2010

Tomorrow people in Massachusetts will vote on three ballot questions. Two have to do with taxes. Question 3 would reduce the rate of the state sales and use tax from 6.25% to 3%.

Question 1 would remove the sales tax from alcoholic beverages. Before last year, there was no sales tax on alcohol. There is no sales tax on food, clothing, or prescriptions in the state.

I think sales taxes are very regressive and an unfortunate way to raise revenue. The basic rate for the Massachusetts income tax is 5.3%, which is less than the sales tax. Income taxes can be progressive and can even redistribute income but they are politically unpopular. Apparently, sales taxes are less unpopular.

I have not decided how I am going to vote on Question 1 because the liquor industry already pays excise taxes so the sales tax is, in some way, double taxation. Governments have usually seen alcoholic beverages as appropriate for taxation because they supposedly have inelastic demand.

Prior to Prohibition, the states did not generally tax distilled spirits, beer, or wine. Since Repeal, many states generate significant revenue through taxiing alcohol.  Only five states do not have a sales tax on liquor.

Both before and after prohibition, some legislators have felt that taxing alcohol provides benefits to society since it could potentially reduce drinking. This attitude would imply an elastic demand. Since the 1980s, public health advocates have called for increased taxation of alcohol to help pay for the societal costs associated with alcoholism, drunk driving, and other manifestations of alcohol abuse.

Usually the government’s need for revenue is what wins out. It is interesting that Massachusetts is looking at losing revenue from alcohol while California is seeking to gain revenue from legalizing marijuana. Legalizing the recreational use of pot would enable California municipalities to generate tax revenue, which would help shore up sagging budgets.

I urge everyone to vote tomorrow because voting is a privilege. If you don’t vote you shouldn’t complain.

Academic Couples

Tuesday, August 17th, 2010

This post is an expansion of a comment I made to Tenured Radical’s post, “Never Mix, Never Worry: A Brief (and incomplete) History of the Academic Couple”. She wrote the post in response to Caroline Bick’s  essay in the Sunday New York Times, “Is the Husband Going to Be a Problem.”

That question arose in the mind of a professor interviewing Bick for her first academic position. Bick’s essay mentions this sexist thinking about her husband potentially being a hiring issue. However, this is not really the main point of the article, which is not about sexism in academia but is about the intersection of careers and relationships.

Her advisor reassured her potential employer, not Bick as Tenured Radical indicates. Bick wishes she could have responded. She would have told them that it would be no problem because she planned to chain him under the bed. Bick does acknowledge that the “adult” behavior expected of her in the moment would up influencing her choices for many years.

Tenured Radical and many of the commenters felt that Bick’s story had a happy ending because she, her husband, and their children live together in the same city. It is a successful conclusion from the point of Bick’s relationship with her husband. The husband’s first career ended and he had to reinvent himself. As I know from personal experience this can be very difficult. If the woman had to give up her chosen academic career but got to live in the same city with her husband and children would it still be a successful conclusion?

Tenured Radical feels that the issue of “academic commuting” is a recent problem. “Once women decided to stop baking cookies for their husband’s seminars and type manuscripts for love and pin money, it occurred to them get their own advanced degrees (it was around the mid 1960s, when women’s liberation really took off,…)” Was feminism really as straight forward and simple as women making a conscious choice to stop baking cookies and get PhDs? I guess there were not any social forces that kept them baking and no changes that enabled woman to have more options, in both career and personal life.

The post contains several pictures of Elizabeth Taylor from Who’s Afraid of Virginia Woolf and the reader might assume she represents the prototypical faculty wife. Honey, the younger woman in Edward Albee’s play, actually better fits the stereotype of the faculty wife.

Sandy Dennis, Who's Afraid of Virginia Woolf?

Sandy Dennis, Who's Afraid of Virginia Woolf?

Martha, the character Elizabeth Taylor plays, is an alcoholic, frustrated and vengeful woman. Her frustration does not seem to be related to her not having obtained an academic job. She does not really fit into the point Tenured Radical makes about  secret drinking by faculty wives.

Who's Afraid of Virginia Woolf?

Who's Afraid of Virginia Woolf?

College campuses across America have scholarship funds for women returning to school, loans for students, funds for campus beautification, and wings in medical centers because of faculty wives. Apparently, these women found time to do other things besides baking cookies and becoming alcoholics.

Spousal hires are much more likely if one or both of the people are stars or if they are looking for jobs at large public universities. In general, small private liberal arts colleges cannot easily add a second line when trying to hire someone. In addition, spousal hires can often conflict with affirmative action goals.

Two people in the same field are unlikely to wind up with two jobs at the same institution.   Someone will have to give up and do something else; that is what happened to Bick and her husband.

Beyond Amethyst: The Conference

Tuesday, April 28th, 2009

This past Friday I attended a conference at Hampshire College about the drinking age and whether it should be changed. Alex Torpey, a graduating student , organized the conference as part of his Division III, or senior project.

Ralph Hexter introduced the keynote speaker and indicated that he feels the issues around the drinking age and drunk driving hinge on responsibility. President Hexter is a signer of the Amethyst Initiative which called for lowering the drinking age to eighteen. (more…)

60 Minutes

Sunday, February 22nd, 2009

I just finished watching a segment of 60 Minutes on the drinking age. I have written about this subject before but I guess there is always more to say. The spokesperson for the college presidents who want to lower the drinking age to eighteen was John McCardell, former president of Middleburry College while the head of MADD spoke in opposition. 60 Minutes told a horrific story about an eighteen year old who died of alcohol poisoning following a fraternity initiation rite. His friends left him alone to die. Both his parents and McCardell seem to feel that the situation would have been different if the drinking age was lower. I am not sure if the legal status of the alcohol and the drinkers could change the basic immaturity of the people involved. To my mind, their lack of judgment in every area caused the death of that young man.

McCardell wants to accompany the lowering of the drinking age with mandatory alcohol education and a subsequent license to drink. He proposed this after saying he wasn’t suggesting temperance or prohibition. However, his ideas for alcohol education sound a lot like Scientific Temperance Instruction which was a program of the Woman’s Christian Temperance Movement and featured a shriveled up liver in a jar. Although McCardell wants to paint his opposition as prohibitionist, his ideas support a temperate or moderate approach to drinking. McCardell acknowledged, to Leslie Stahl, that many people are opposed to lowering the drinking age but he feels history is on his side. After all, according to him, everyone knows that Prohibition failed. If the issue is strictly levels of alcohol consumption, Prohibition did not fail. Levels decreased significantly and did not climb back up to pre-Prohibition levels until the 1970s.

Periodic Abstinence

Wednesday, January 28th, 2009

Recently the British paper, The Independent,  had an article entitled, “Booze: Why You Need A Day Off”. (Thanks to David Fahey and the ADHS website for the citation). British doctors apparently advocate stopping drinking for two weeks in January in response to the excesses of the holiday season. The idea is to delay building up tolerance, test if you can stay away for a sustained period of time, and rest your liver.

The idea of a two week vacation from drinking is part of a larger awareness among the British medical community that long-term daily drinking has far more serious consequences for liver health than binge drinking, even on a weekly basis. However British public health advocates have continued to push for daily limits on drinking rather than weekly. At least one doctor feels this approach encourages daily drinking which will only lead to increased tolerance.

This whole discussion is very intriguing when placed in an American context. Binge drinking is currently a big focus for public health advocates and ne0prohibtionists.  A group of college presidents have even called for a decrease in the minimum drinking age in part to curtail binge drinking connected to turning twenty-one.

In America Alcoholics Anonymous has set the definition for abstinence and it is total. The idea that a healthy approach tod drinking could include occasional heavy drinking would certainly be an anathema to AA.

Your Liver on Drugs

Wednesday, December 31st, 2008

normal liver

Cirrohotic Liver

Cirrhotic Liver

Tylenol has apparently started an advertising campaign to warn people about abuse of acetaminophen and liver damage. The television commercial, which I saw while I was running on the treadmill at the gym, explains how your liver processes almost everything you ingest. If you take too much acetaminophen you can harm your liver. You might take the right amount, but other drugs you take could also contain it. An example is taking a prescribed pain med such as vicodin and then an hour later taking two extra strength tylenol. The other problem is that many people think that if two pills are good three must be better.

This public service campaign and its focus on maintaining a healthy liver reminds me of a paper I wrote when I was taking a graduate course in public health nursing. In “American Indian and Alaska  Native: A Healthy People 2000 Proposal”, my partner and I envisioned a healthy liver curriculum that would teach young peoples about the dangers of abusing drugs and alcohol and the harm it can cause the liver. Of course Scientific Temperance Instruction, a major aspect of the Women’s Christian Temperance Union program,  involved showing a classroom of young students a shriveled up liver in a jar Recently A Good Beer Blog was questioning the validity of research showing that as little of a pint of beer can  damage your liver.

Alcohol related disease often goes unreported as a cause of death. From the public health perspective alcohol abuse is most often the problem with an ensuing focus on the psychosocial dynamic misuse of alcohol engenders.  Although society often characterizes alcoholism as a disease, both scholars and practitioners often slight the physical aspects of the disease. Further complicating matters research shows that some alcohol consumption is healthy, particularly for the cardiovascular system.  Heart disease is the number one killer of Indians and non-Indians alike.