Methylated Spirits Revisited

On Sunday my site got 155 views. On Monday  121. That is a lot more views than I usually get. Most of them were to read my post on methylated spirits which is almost seven years old. I don’t really get it since when you google “methylated spirits” my post doesn’t come up.

I was going to tweet about this, but since Twitter still won’t let me tweet my URL, I decided to write a short post about it instead. The problem with Twitter is over 2 years old. I don’t think it will ever get fixed.

I am little afraid that the sudden increase in views  was some kind of hack, but everything seems okay. If anyone knows why there would suddenly be so much interest in methylated spirits, please let me know.

Denatured alcohol

Social Drinking

Can you be a social drinker? I recently read an article in The New York Times that would suggest the answer was no. The article itself was interesting and the comments were even more interesting. The vociferousness of the comments that defended drinking indicates that drinking in America has been normalized. The recent Atlantic article that asked why there is no anti-alcohol movement explored some of the reasons for that normalization. When I was at my writing retreat this fall, one of the other attendees was a woman who has recently stopped drinking and has a blog about it.

Prior to Prohibition, the temperance movement saw drinking as being both a moral and societal issue. They sought a civil response to the problems of drinking. Although prohibitionists counseled individuals to have the moral and individual strength to stop drinking, the movement sought to remove drinking from society through political and legislative means.

Since Prohibition, the liquor industry has been very successful in framing drinking and the serious issues it can cause as an individual disease. There have been some moments where the public health analysis of alcohol and the society-wide problems it causes, have been in ascendance. Both the movement to decrease drunk driving and the 1991 tax increase on alcohol had public health components.

Today the liquor industry is completely in control and health information detailing problems with liquor go nowhere. On television you see public service announcements on tobacco and vaping. There are none about drinking.

Here is a picture of a cirrhotic liver as one example of the damage excessive drinking can do to your body and health.

Cirrohotic Liver

Chinese Drinking

I came across this really interesting article about Asian immigrants who live in Oregon and are the only distillers of the traditional Chines liquor, baijiu. When we were in China in 2005, we were frequently served baijiu. It is very viscous and has a high alcohol content.  The baijiu we had was made from sorghum. The people in Oregon seem to use rice.

I am posting something I wrote about out trip to China. I did post in the blog I had before this WordPress  site but I can’t seem to find out if I have ever posted it here. If it is a repeat, I apologize.

Chinese Drinking

My family and I recently returned from visiting Hong Kong and mainland China. My husband is the vice president of a private undergraduate liberal arts college and the purpose of our trip was to visit several Chinese educational institutions. Because of this, the very nice, friendly, and generous Chinese people we met treated us as celebrities or in their context, dignitaries. The main consequences of this treatment were many banquets held in our honor.

I have not attended that many banquets in the United States but the few I have been at have begun with a cocktail hour then proceeded to a multi course meal with dessert and wine. Chinese banquets are completely different from this. The meal always takes place in a private room around a round table. At each place setting there are three glasses; a water glass, a wine glass, and a very small shot glass, probably one-half ounce in capacity. At the beginning of the meal, the host will ask the honored guest, my husband in our case, if they want “spirits”.

At our first banquet this request elicited amused responses from the other Chinese guests as well as some good-natured warnings about the potent “firepower” of the spirits. The Chinese woman sitting next to me who spoke English stated the spirits “were not for women.” Although this surprised me, I wished to be polite and therefore refrained.

When my husband said he would try it, his water glass probably about eight ounces-was filled with a 50 percent alcohol, clear, viscous liquid. This alcoholic beverage was baijiu, which is distilled from sorghum. All the guests drinking also had their glasses filled. As the meal proceeded the host toasted my husband, pouring from his big glass into the small shot glass, raising it high, downing it while saying Gam Bei (Bottoms Up!) and then showing the empty glass to my husband. At that first banquet there must have been at least ten toasts. Many of the guests completely emptied their large glasses and then received refills. The whole event had a competitive and masculine tone with the goal being to see who can drink the most.

All of our subsequent banquets followed this pattern. Some did not involve spirits so the drinking was much more subdued. At different banquets, various participants had a greater or lesser affinity for alcohol and the total amount of alcohol consumed varied. Women did participate although not as vociferously as the men. Some participants filled their large glasses with water and then proceeded to participate in the social aspects of the toasting ritual without running the risk of inebriation.

As a historian who has written about alcohol and the industry and has attended over twenty-five years of conferences on the general subject, the heavy drinking I observed in China came as a complete surprise. The global studies of alcohol and drugs have always focused on opium and tea as China’s chosen psychoactive substances. There is also a literature that seems to suggest that, because Chinese drinking takes place during meals, it is more moderate.

Alcohol experts define binge drinking as the consumption of five or more drinks at one time. In the United States and increasingly internationally, it is college age people who most often indulge in this behavior. Binge drinking on college campuses has led to an increase in death from alcohol poisoning and is the subject of many research projects.

At the Chinese banquets I attended many of the men present had at least eight drinks. Binge drinking in America often has a ritualistic aspect; newly “legal” drinkers in the Southwest spend their first night as a twenty-one year old seeing how much alcohol they can consume. The showing of empty glasses and the good-natured urging to continue drinking at Chinese banquets is the same kind of behavior. There is obviously a whole aspect of Chinese consumption of psychoactive substances that remains unexplored.

When I was thinking about posting the above, a front page article in the New York Times appeared. Entitled, “Got a Mint, Comrade? China Cracks Down on Liquid Lunch,” the article discussed the Chines practice of lunchtime banquets where alcohol, usually baijiu, plays a large role. The Chinese government usually foots the bill for these alcohol-laden meals and thus wants to curtail the amount of drinking.

The article also indicates that consumption of baijiu has declined as a more prosperous, younger generation has begun to drink other spirits, wine, and beer. Around the same time the Times covered this story we entertained visiting Chinese scholars in our home. They all declared that the thing they missed most from home was baijiu. The drinking habits of China, both historically and in the ever-changing global market, call out for further exploration and research.

Cirrhosis

Cirrhosis of the liver is on the rise, according to the New York Times. From 1999 to 2016, deaths increased 65%. The largest increase in deaths was in the population group aged 25 to 34. From 199 to 2008, in some groups including Native Americans and African Americans cirrhosis rates stayed steady or decreased. After 2008 both groups saw increase in  cirrhosis deaths.

The author of the study cited in the newspaper article hypothesizes that the increase can be attributed to the Great Recession and economic despair among young men.  He does acknowledge, however, that “almost every one of these deaths, particularly in the young, is completely preventable.”

Cirrhosis deaths are usually preventable because alcoholic abuse is the major cause of the illness. I have written about this in a previous post which you can read here.

This is the picture from that post.

Addiction Treatment

Yesterday I listened to Preet Bharara’s podcast, Stay Tuned with Preet. The topic was the opioid crisis. The guests were Susan Salomone, a parent advocate and Dr. Abigail Herron, a psychiatrist who works with addicts.

Part of the discussion was on treatment and what is available to help addicts. Salomone believes that currently there are not enough days for treatments. When I worked in an inpatient detox unit, the addicts were only there for 5 days and then placed in outpatient care.

Dr. Herron discussed the medical treatments that are available. There are three.

Methadone is the oldest treatment available. It is dispensed in licensed clinics and the clients usually attend every day. After a certain number of clean random drug screens, some people can get take-home privileges and reduce the number of days they have to attend the clinic.

Because methadone is an opioid and can be abused, methadone as treatment for addiction is controversial. If a person wants to stop taking methadone they will suffer withdrawal symptoms just like heroin. However, when I worked at a methadone clinic I saw many people whose lives were saved by being on methadone

Naltrexone is an opioid inhibitor. It can be used for alcohol addiction as well as opioid addiction. It reduces cravings. Unlike methadone which stays in the body for a long time, naltrexone only works if you take it. There are no withdrawal symptoms. It is available as a pill or inject-able. The injection, which is very expensive, is supposed to last for thirty days but often wears off before that period is up.

50 mg is the usual dosage for the oral medication. Low dose naltrexone, approximately 4.5 mg, is used for a variety of illness including ALS, urinary issues and Crohn’s disease.

Buprenorphine is an opioid but only partially attaches to opioid receptors. With this drug there is supposedly no euphoria. Physicians are required to take a special course before prescribing buprenorphine. Because it is an opioid, stopping the drug does cause withdrawal symptoms.

All three of these treatments have some negative aspects. It is clear that a drug alone will not prevent a relapse. I think you would have to also be under the care of a therapist and attend support groups regularly. Many people believe that addiction causes brain changes that are difficult to undo. Addiction is a disease of relapse. Just ask anyone who has tried to stop smoking.

Alcohol and Cancer

The Irish legislature, the Oireachtas, is considering adding a warning label about drinking and cancer to alcoholic beverages. Ireland would be the first country to have such a  warning label. America has had labels that warn about drinking while pregnant and driving while intoxicated since 1988. Wine labels  also inform the consumer that the bottle contains sulfites.

In Ireland the issue is pitting Alcohol Action Ireland, public health advocates against the liquor industry represented by the Alcohol Beverage Federation of Ireland (ABFI). Alcohol Action is presenting the legislation  as necessary to protect public health and safety while the industry is concerned about the effect the legislation would have on the economy, including tourism. This is the perennial tension that has existed in America since the end of Prohibition.

A warning label that mentions cancer could be the first sign that public perception about  drinking is moving in a more negative direction. Alcohol, particularly  beer, has gained a seemingly ever increasing integration into American society. Recently both craft beer and craft distilled spirits have captured the public’s attention.

In the 19th century smoking and drinking were both considered vices. In the first few decades of the 20th century tobacco gained market share while alcohol endured Prohibition. Since the 1960’s the two industries’ fortunes reversed.  Access to tobacco became severely curtailed while alcohol gained greater cultural acceptance and societal integration.

Since the 1960s the wine industry has pushed for labels that would state the heart health benefits of drinking the product. It is possible that the tide would change again if the claim that drinking is implicated in breast and other cancers becomes more widely known.

Drinking Responsibly

Someone recently wrote a letter to the editor of The Roanoke Times complaining about the ubiquity of beer related stories in the paper. Writing from a public health perspective, Mr. Klein found it bewildering that a women’s health event that a local clinic was sponsoring was being held at a brewery. He wrote, “Have we really gotten to the point as a society where alcohol is so pervasive that it has to be used to entice people to every social event even those designed to promote a healthy lifestyle.”

Klein finds the integration and normalization of alcohol throughout society troubling. This was a big point of contention for the public health activists on the Massachusetts Alcohol Tax Force sub-committee that I served on. They were all people who were working to prevent underage drinking. They also felt that the presence of alcohol at so many community events sends mixed messages. This is something Klein also pointed out.

Klein reminded readers that alcohol consumption can lead to addiction; something that is overlooked in the promotion of events. He apparently lives in Blacksburg, Virginia which is a college town. I also live in a college town where students periodically drink to excess.

There were seven comments in response to Klein’s letter. One pointed out that college students are probably not drinking craft beer which has a higher price point. Most of the other comments focused on the economic benefits of beer to the local economy This is the perennial tension between the public health movement and officials seeking economic development.

Understanding Addiction

Last Thursday I attended a seminar on “Understanding addiction.” The Institute for Natural Resources sponsored the one day seminar which was a way for nurses and other medical professionals to collect continuing education credits.

Much of the material was familiar to me and I don’t think I learned that much that was new. One interesting thing is that alcohol, tobacco, and even caffeine are now seen as drugs with psychoactive properties similar to the illegal drugs such as opioids or cocaine. In fact the legal drugs cause more societal problems than the illegal drugs. The seminar handout states that alcohol and tobacco costs the United States over $400 billion a year  due to crime, lost work productivity, and healthcare. Costs associated with Illegal drugs are about $181 billion a year.

There is an opioid crisis but the speaker did not spend that much time on it. He made the point that at different times different drugs are in fashion. Unfortunately heroin seems to be in vogue right now. It is clear that the War on Drugs has failed and we need to invest much more money on treatment. We also need to find a balance between maintaining pain medicines for people with chronic pain while reducing the more casual prescribing of opioids.

 

 

Russian Beer Taxes

This post is in honor of the issue that has been dominating the news cycle for at least a week: Russia  and its role in the presidential election. I don’t know if you can correlate  a decrease in drinking beer with an increase in nefarious behavior but it is a fact that beer production in Russia has declined significantly since 2010.

In 2010 the Russian government decided to raise beer excise taxes by 200 percent. Before this, beer was not legally considered alcohol. It was an attempt to curtail drinking and a response to alcoholism in the country. In 2010 Russian brewers produced 1 billion deciliters, about 630,000 barrels (31 gallons to a barrel). In 2015, they produced 659.5 million deciliters. Production has steadily gone down.

Since 2010, the Russian government has increased the excises taxes on beer every year.This year the Russian government once again raised taxes. Although overall production has decreased, the largest brewers have been losing market share to craft beer.

It is not clear that the high excise taxes have produced any decrease in alcoholism rates.  The taxes, however, contribute money to the national budget. Beer excise taxes are 1.3 percent of the budget and 45 percent of the overall alcohol excise taxes.

Although most people  would assume that Russians are heavy vodka drinkers, the drink of choice is beer. Russia ranks 26th in world-wide beer consumption. The United States is 17th.

States can often have two motives for taxing alcoholic beverage – financial and sumptuary. Governments need to find a balance since deeply curtailing consumption can hurt the bottom line. Russia’s tax policy for beer seems to be more weighted towards public health and decreased consumption.

For more information about Russian beer, see this USDA report.

On the Road to Health: VB6

I have decided to write about something that is a little more personal than what I have usually posted on this blog. It is not about beer (except indirectly), women (except that it is about me and I am a woman), nursing, (except that health maintenance is a big part of nursing)or history (except that patterns of food consumption is a very complicated historical subject). Anyway …

Today my husband and I are starting to follow Mark Bittman’s VB6. The short version of this is that he became a part time vegan several years ago and lost thirty pounds and got healthier. He wrote a book about it and then a cookbook.

We decided to do this because I would like to eat healthier. Last year, because of various medical issues, I went from March to June not eating soy or cow diary. That was quite an eye opener as I discovered that soy is in everything we eat and use.

Of course, like most people, I would like to lose weight but I don’t think his weight loss was typical. I totaled up the calories for one day of his 28 day diet plan and it was 1800 calories. If I ate 1800 calories a day I would gain weight. I think his weight loss came from giving up alcohol which I bet he drank a lot of. I am not saying he was or is an alcoholic but I am pretty sure that people in the food business drink a lot.

Bittman’s plan is for you to eat vegan for breakfast and lunches and then healthy dinners that can have animal products. He also wants you to try as much as possible to eat “real” food; if commercially prepared it should have five ingredients or less. His final stipulation is no alcohol or a lot less. He says; “More than anything else in the VB6 diet, alcohol is a judgment call: definitely off limits during the day, and up to you at night. But if you’re seriously trying to lose weight, very limited drinking – or none at all – is something to consider.”

Bittman’s admittedly arbitrary division of vegan before 6 p.m. really doesn’t work for us. The lunches seem like they take a long time to cook and if you are not at home for lunch how do you do that? We decided to try to be vegan for dinner because that is the meal it seems we can handle. Breakfast is pretty much vegan without trying unless you have bacon and eggs which I usually don’t. For now we are leaving lunch as the meal that can be non-vegan but we will see how that goes.

I am writing this before we have had our first dinner. I will let you know how it turns out.