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Book Reviews

1999 Volume 18, Issue no. 5

New Journal - Drug and Alcohol Findings

This journal is published by a consortium of Alcohol Concern, National Addiction Centre and Standing Conference on Drug Abuse. The style is obviously related to that of the crop of journals usually entitled "Evidence Based Something". The rationale of these journals is that since none of us have time to read more than a tiny fraction of the literature we need other journals to extract and condense the findings relevant to our practice.

The first issue of findings is roughly equally divided between drug and alcohol topics and was made up of short reviews and even shorter reviews referred to as nuggets. The reviews attempt to summarise source documents and relate them to current practice. I was particularly impressed by a review of Project Match that seemed to me to explain the findings and their implications for UK practice remarkably well. I also liked a short article entitled "How to show treatment works" which had some realistic guidance on the thorny question of how services could reassure commissioners that they were providing value for money.

Findings certainly condenses a lot of information into a small space and if you like that style you will like it. It is certainly worth considering for the project library or for personal subscription. The Journal cost £60 for 4 issues.

Drinking Adult Behaviour and Knowledge 1988

By Eileen Goddard and Margaret Thomas
London Office of National Statistics
ISBN 1 85774 305 9
28 pages
Price £8.00

This report comes from the Office of National Statistics (ONS formerly OPCS) which has an enviable tradition of producing high quality, statistically respectable surveys and Eileen Goddard has lead their drinking work for many years. The data for this report comes from the ONS Omnibus survey which asks questions on a range of topics. This report gives information on what people drink, the patterns of drinking, knowledge of units and benchmarks and where people buy alcohol. The questions on consumption used are similar to those used in the General Household Survey but the way the data is presented is slightly different making comparisons difficult. The most interesting chapter was that on knowledge. Which showed that 76% of men and 73% of women had heard of units though rather less were able to state how drink was in a unit. Knowledge of units was commoner in frequent than infrequent drinkers and commoner in social class I/II than IV/V. Fifty eight percent had heard of daily benchmarks for drinking but of these only about a third could correctly state what they were. A similar survey was performed a year earlier but there was no evidence that knowledge of units had increased in that time. The report provides a basis on which one can form opinions on the effectiveness of current alcohol education activity.

Proposals for a National Alcohol Strategy for England

Alcohol Concern
ISBN 1 869814 34 7
155 pages
Price £21-00 + £1-60 P&P

This substantial document is the outcome of a lengthy consultation process organised by Alcohol Concern. It is produced in response to the Government's intention declared in "Our Healthier Nation" to introduce a national strategic approach to alcohol. The aims of the strategy are

• To reduce the level of alcohol induced ill health
• To reduce the number of alcohol related injuries
• To reduce the rate of alcohol related crime
• To reduce the number of alcohol related road accidents
• To reduce the economic loss in the workplace due to alcohol misuse.

The strategy explores the places of taxation and pricing, licensing, community safety measures, measures to prevent drink driving, regulation of advertising, public education and treatment services in achieving these aims. The themes of improving treatment of problem drinkers, reducing the impact of misuse on the wider community, reducing the serious financial cost to society and protecting children and young people figure prominently in the proposals. The pros and cons of each proposal are carefully argued and there is a wealth of supporting evidence. The first chapter entitled background gives a helpful analysis of the nature of the problem and the current situation. Those interested in the role of policy in reducing alcohol related harm will find this a very useful source document.

John Kemm
Public Health Physician

1999 Volume 18, Issue no. 4

Alcohol and Young People

BMA Board of Science and Education April 99
13 pages
ISBN 07279 14294

This short paper gives a brief overview of alcohol and young people covering what they drink, how drinks are marketed to them, how this marketing is monitored, current legislation, enforcement of that legislation and education. A series of recommendations are made. Independent regulation of drinks marketing in place of the current voluntary arrangement with the drinks industry is recommended as is a review of legislation and better enforcement of laws on sales to young people backed up by test purchases. Other recommendation include a requirement that all alcoholic drinks should be labelled with their unit content and carry warnings about the dangers of excessive drinking. Increased education on alcohol starting in primary schools is also called for.

John Kemm
Public Health Physician

1999 Volume 18, Issue no. 3

Review of MCA Medical Students' Handbook: Alcohol and Health

I was rather taken a back when, on a busy underground train, a large lady I had never met before sat on my knee and proposed to me. She was drunk. Naturally I graciously declined and headed quickly towards the nearest exit. This is not a regular occurrence, but I do seem to see an awful lot of people who can not handle alcohol. Maybe it is because of the world I inhabit, full of students but particularly medical student which, according to popular mythology are renowned for their heavy drinking. But even in the real world alcohol is so ingrained in to popular culture that no matter what field I end up in I am sure to come in to contact with people who have been affected by alcohol in some way.

I was quite intrigued with the handbook which intends to 'fill the gap' between what is taught at university and what is expected of me as a doctor. I have found that alcohol and its related problems are scattered far and wide throughout textbooks and occurs sporadically in the curriculum. I think this fogs the vision of many students, myself included, in to falsely believing alcohol has less of an impact on health than is the case. I was initially astonished when I first read this comprehensive handbook. It was then that it dawned on me the true extent in which alcohol permeates in to so many areas of medicine.

The handbook consists of eleven short punchy chapters which are written clearly and interspersed with diagrams, tables and colour photographs. The first two chapters (Facts about Alcohol and Alcohol Metabolism) are rather factual (but necessary) and I must admit made my head hurt a little after reading them. However, I was enthralled from the excellent third chapter (Predisposition to Harm) onwards. The handbook incorporates everything I could possibly want to know about alcohol from clinical aspects such as how to assess a patient to psychological, social and physical aspects of alcohol. I was very impressed with the system by system account of the pathological effects of alcohol which I found most chilling laid bare on the page undiluted with the other pathological agents which alcohol is most commonly paired with in text books. I would have liked the inclusion of case studies and accounts by practising physicians about the methods they employ in dealing with certain cases. This aside, I found it hard to find fault and I think this handbook should be a permanent fixture on the book shelves of every medical student and doctor alike.

Debashis Singh
Third year medical student
University of Leicester

Alcohol and General Practice: a template for practices. Guidance for GPs

This document was produced by the General Practitioners Committee of the BMA in September 1998. It gives very helpful guidance on policies that practices might adopt to ensure the effective management of situations in the context of general practice in which individuals might have or be developing problems with the use of alcohol.

last modified: 14th December 2001