Should you be driving?

Aussie drink-driving laws have similar penalties, but our BAC level is still at .05. This will be moved to .02 in the coming years.
Be safe for you, your family and the person you may injure because, you thought you were ‘ok to drive!’



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Public Health Significance—Dual use of alcohol and cannabis appears to be associated with adverse behavioral and psychological consequences and is a rapidly growing public health concern. This study suggests dual users have greater demand for alcohol, steeply discount delayed alcoholic drinks, and are at higher risk for alcohol use disorder than individuals who consume alcohol but do not consume cannabis.

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The reinforcer pathologies model proposes 2 behavioral economic constructs interact in addiction: operant demand and delay discounting. These constructs manifest as behavioral markers of addiction in the form of excessive reinforcer value and strong preference for immediate access and consumption of this reinforcer despite suboptimal long-term outcomes. The first aim of this investigation was to identify the degree to which delay discounting (of money and alcohol) and demand for alcohol differ between college student drinkers (N = 185) who do and do not co-use cannabis. As a second aim, we sought to replicate the 2-factor solution for alcohol and cannabis demand within a college sample. Results suggest dual users have significantly stronger Persistence and Amplitude for alcohol, demonstrate steeper delay discounting of alcoholic drinks, and are at greater risk for alcohol use disorder than individuals who drink yet do not use cannabis. These results provide further support for the reinforcer pathologies model and contribute to the literature on dual-substance use in the college populationNude, G. P., Reed, D. D., Thornton, T. J., & Amlung, M. (2021). Dual use of alcohol and cannabis among college students: A reinforcer pathologies approach. Experimental and Clinical Psychopharmacology, 29(4), 407–417. (PsycInfo Database Record (c) 2021 APA, all rights reserved)



Background: Reducing the alcohol-attributable cancer burden in the WHO European Region is a public health priority. This study aims to estimate the number of potentially avoidable cancers in countries of the WHO European Region in 2019 for three scenarios in which current excise duties on alcoholic beverages were increased by 20%, 50%, or 100%.

Methods: Mean prices and excise duties for beer, wine, and spirits in the Member States of the WHO European Region in 2020 were used as the baseline scenario. We assumed that increases in excise duties (20%, 50%, and 100%) were fully incorporated into the consumer price. Beverage-specific price elasticities of demand, with lower elasticities for heavy drinkers, were obtained from a meta-analysis. Model estimates were applied to alcohol exposure data for 2009 and cancer incidence and mortality rates for 2019, assuming a 10-year lag time between alcohol intake and cancer development and mortality.

Findings: Of 180,887 (95% Confidence interval [CI]: 160,595-201,705) new alcohol-attributable cancer cases and 85,130 (95% CI: 74,920-95,523) deaths in the WHO European Region in 2019, 5•9% (95% CI: 5•6-6•4) and 5•7% (95% CI: 5•4-6•1), respectively, could have been avoided by increasing excise duties by 100%. According to our model, alcohol-attributable female breast cancer and colorectal cancer contributed most to the avoidable cases and deaths.

Interpretation: Doubling current alcohol excise duties could avoid just under 6% (or 180,900 cases and 85,100 deaths) of new alcohol-attributable cancers within the WHO European Region, particularly in Member States of the European Union where excise duties are in many cases very low.

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Atrial fibrillation (AF) is a condition which creates irregular heartbeat/rhythm. Previous research has found that chronic alcohol use could predict the condition. 

A new study has found that acute alcohol use is also linked to triggering of AF episodes.  Which means by reducing/stopping alcohol use patients could improve heart health by decreasing the number of AF episodes.

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…The existing research clearly indicates several implications for alcohol policies, including guidelines: First, as most dose–response curves are monotonous, the lower the level of alcohol consumption overall, the betterit seems clear that less consumption is better (i.e., between 10 and 20 g/day [34,75]), and the risk is sex-specific.

This means that most current low-risk drinking guidelines have thresholds which are too high [75]. Second, as many of the dose–response curves are exponential, risk reduction is greater for heavier drinkers compared to moderate drinkers, if both reduce their drinking by the same number of drinks per day [18]. Empirical evidence suggests that this is best achieved by moving the overall population mean downwards [56,76].

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Mortality from liver disease has increased over the last decade in the US. Alcohol is a known cause, but its use also contributes to the development or progression of other types of liver disease, complicating efforts to quantify the overall impact of alcohol use on liver disease. Researchers developed causal and statistical models based on a narrative review of the literature to assess the relationships between alcohol use and the development or progression of various liver diseases in the US in 2017, including through alcohol’s interactions with other relevant behavior-related risk factors.

  • Alcohol use caused 54,500 incident cases of liver cirrhosis, of which approximately 35% were from diseases other than alcohol-associated cirrhosis.
  • Through interaction with behavioral risk factors, alcohol use accounted for the progression to cirrhosis of 10,400 cases of obesity-related liver disease and 7700 cases of hepatitis C virus.
  • Alcohol use caused 47,300 total deaths from liver disease, including 6600 from liver cancer.

Comments: Accounting for alcohol’s role in liver diseases that are exacerbated by alcohol consumption or caused by alcohol-associated risk factors yields substantially higher estimates of morbidity and mortality than those based on diseases for which alcohol is the original or principal cause. This has important implications for public health surveillance, and serves as a reminder to clinicians about the role of alcohol in a wide range of liver diseases.

Timothy S. Naimi, MD, MPH

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