News and Notes

Abstract

By Charles Parry, Neo Morojele and David Jernigan In early 2008 Action for A Safe South Africa (AFSSA) was established by a number of civil society organisations and partners in business to address the question of ‘How do we shift South African thinking, spending and action, from security, to preventative strategies for a safe South Africa?’ Eight areas were identified for attention, including addressing substance abuse. A convention was held in Johannesburg in August 2008 and a two-day, multi-sectoral strategic planning workshop was convened for each area. The focus of the ‘Sober South Africa’ workshop was on how to create an ‘alcohol safe’ South Africa. Interventions focused on drinking and driving countermeasures, brief treatment for problem drinkers, addressing the retail sale of alcohol from shebeens and taverns, reducing the density of liquor outlets, and reducing the impact of alcohol industry marketing. Two big ideas were put forward to reduce alcohol-related crime. First, it was stressed that we need to facilitate greater community ownership of the alcohol environment in our communities and second, action at various levels needs to be supported by a strong national commitment in the form of a single body, possibly an Alcohol Health Promotion Foundation funded by a 1% levy on the net turnover from the major manufacturers of alcohol, ‘1% for health’. This national organization would be used to kickstart, support and maintain the proposed community mobilization efforts and various new initiatives, such as stimulating alternative economic activities for persons who are involved in survivalist selling of alcohol, supporting counter-advertisements, providing funding for policy-oriented research, and establishing new networks for persons and agencies broadly involved in addressing alcohol abuse. Many of the specific initiatives agreed on during the workshop involve civil society (e.g. getting communities to pressure outlets to reduce hours of alcohol sales in areas where alcohol-related crime and injuries are high, and in developing a culture of social host responsibility). However government departments will also need to step up to the plate in several ways, for example: ensuring testing for alcohol at all crash scenes; passing legislation on 0.00 g/100 ml of alcohol to be allowed in novice drivers; redeveloping and standardising alcohol safety intervention programmes for persons convicted of drink driving; providing training to health care workers in trauma units to screen for alcohol problems and providing brief interventions and referrals where necessary; imposing greater restrictions on alcohol advertising; making schools alcohol free zones; requiring external regulation (pre-vetting) of alcohol advertisements, and getting police to be more proactive about addressing alcohol problems associated with shebeens, taverns and other drinking outlets. Charles Parry and Neo Morojele are with the Alcohol & Drug Abuse Research Unit, South African Medical Research Council (cparry@mrc.ac.za) and David Jernigan is with the Johns Hopkins Bloomberg School of Public Health. See also http://www.safesouthafrica.org.za Scientists at the Stanford University School of Medicine say they may have found ways to combat the cellular and tissue damage, caused by free radicals, that occurs in many diseases, from heart attack and Parkinson's to sun-induced aging of the skin. Their findings, published in the Sept 12 issue of Science, reveal how an obscure alcohol-processing enzyme helps reduce such damage 1. Before the study, scientists knew that heart muscle could be preconditioned to resist heart attack damage—for instance, moderate drinkers tend to have smaller, less severe heart attacks than teetotalers, but scientists didn't understand how pre-conditioning worked. To understand how alcohol protects heart muscle from free-radical damage, the researchers tested alcohol pretreatment in a rat heart-attack model. They compared the enzymes activated during the attacks to those switched on with no alcohol. Surprisingly, the treatment activated aldehyde dehydrogenase 2 (ALDH2), an alcohol-processing enzyme. Alcohol pretreatment increased the enzyme's activity during heart attack by 20%, leading to a 27% drop in the associated damage. The enzyme neutralizes an aldehyde molecule, a toxic byproduct of the ethanol in alcoholic beverages. But aldehydes are also formed in the body when free radicals react with fat molecules. Inside cells, the accumulating aldehydes permanently bind and damage cellular machinery and DNA. The researchers then found that a tiny molecule, Alda-1, heightened the enzyme's activity by protecting ALDH2 itself from aldehyde attack, and reduced heart attack damage by 60% in the rat model. Because Alda-1 is small, it should be easy to adapt for pharmacological use, says Professor Mochly-Rosen, senior author of the study. She expects the new molecule to have many possible drug applications. In addition to its lofty medical applications, Alda-1 could also have a much lowlier use: fighting hangovers. Many nasty hangover symptoms are due to aldehyde buildup. Alda-1 may also improve alcohol tolerance and reduce susceptibility to free-radical diseases in people with a common ALDH2 mutation. The mutation affects 40% of people of Asian descent and causes intolerance of alcohol. The Herald-Sun reports that Independent Distillers, producer of leading alcopop brands, has developed new sweet beverages using alcohol derived from lower-taxed beer in a bid to find a way around a new tax on premixed drinks in Australia. The new tax was introduced by the new Labour government to redress a tax loophole which allowed spirit-based mixed drinks to be sold at a tax rate equivalent to beer. Nationwide alcohol consumption figures show the tax rise on ready-to-drink beverages in April had a massive impact on sales and the broader consumption of alcohol. It was reported that the 40% tax hike resulted in a reduction of 3 million standard drinks consumed each week. While the figures show some compensation in beer and spirit consumption, overall consumption is still 3 million standard drinks less than the same time last year. The spirits industry is reportedly very worried about disappearing profits and has responded with the beer-based alternative in three sweet flavours—raspberry, passion fruit and blueberry—designed to appeal to younger drinkers. The BMJ reports that the UK body responsible for advising academic institutions and NHS trusts on how to deal with research misconduct has launched a protocol to try to standardise the procedure for investigating allegations and ensure that cases are fairly handled. The protocol is a step-by-step guide to investigating and acting on allegations of research misconduct brought by other colleagues or external bodies, from the types of documentary evidence required, to who should be involved and over what time frame. The protocol was devised by the UK Panel for Research Integrity in Health and Biomedical Sciences, part of the UK Research Integrity Office, which was set up in 2006 after almost a decade of pressure from biomedical scientific editors, ethicists, and publishers, spearheaded by the Committee on Publication Ethics. The office also operates a helpline for universities and NHS trusts unsure as to how to proceed, when faced with suspected breaches of publication ethics. The Procedure for the Investigation of Misconduct in Research can be found at http://www.ukrio.org. Source: BMJ 2008;337:a1612 Niger's government has issued a decree enforcing a ban on smoking in public places and on communal transport. The law provides for fines ranging from 5000 CFA (£6) to 1 million CFA (£1240). Shops and services that breach the ban can also have their licenses removed. The ban covers public transport and taxis, but not private vehicles. The government is planning a media campaign to inform people about the new measure. Niger's parliament passed the smoking ban in 2006, but the cabinet had not issued the decree to make it effective. Source: BBC News, 12 September 2008 CBC News reports that the Norwegian injection room will be closed from 1st January 2009. The Oslo City government decided to terminate the trial injection room in Oslo and although the final decision rests with the city parliament, the City government forms a majority in that body. The decision was expected following a negative evaluation report and the loss of support of several key bodies including the Norwegian Medical Association. The injection room was evaluated by the Norwegian Institute for Alcohol and Drug Research (http://www.sirus.no/internett/narkotika/publication/397.html). The main findings were that the room was not often used and that it did not reach many of the objectives. According to the researchers the situation has improved somewhat since they finalized their assessment, but the relative number of actual injections in the room was and still is very low. The greatest victory is the fact that it was possible to conduct a pragmatic and balanced discussion. The debate was largely conducted without this being a battle about drug liberalization etc. but about priorities, effectiveness and not least cost effectiveness. However, the open injection drug scene in Oslo remains unresolved and there are still about 200 deaths caused by overdose each year. The room cost about 1.5 million euros a year. More than half of this will now be used for other low threshold services (shelters etc) and for inpatient treatment of dual diagnosis. The World Health Organization (WHO) has reported that electronic cigarettes do not help smokers to quit as marketers claim and may be toxic. The devices resemble a real cigarette, but consist of a stainless steel tube with a chamber that holds liquid nicotine. The E-cigarettes have been marketed as a healthier alternative to tobacco, and since they do not need to be lit, some people are using them to evade smoking bans in public places, the UN health agency said. The device is powered by a rechargeable battery and produces a heated mist of nicotine that is absorbed in the lungs. Douglas Bettcher, acting director of the WHO's Tobacco Free Initiative said, ‘The World Health Organization knows of absolutely no scientific evidence whatsoever that would confirm that the electronic cigarette is a safe and effective smoking cessation device.’ Some manufacturers have implied that WHO considers electronic cigarettes to be a legitimate form of nicotine replacement therapy, like nicotine gum, patches and lozenges. Dr. Ala Alwan, assistant director general of WHO's noncommunicable diseases and mental health branch, called on electronic cigarette marketers to immediately remove from their websites and promotional materials any suggestion that WHO considers it a smoking cessation aid. Source: CBC News, 19 September 2008 American Academy of Addiction Psychiatry 19th Annual Meeting & Symposium, 4–7 December 2008, Boca Raton Resort & Club, Florida, USA. Website: http://www.aaap.org Drugs and Cultures, 11–13 December 2008, Paris. Organised by the Observatoire Français des Drogues et des Toxicomanies (OFDT). Contact: email com@ofdt.fr. Website: http://www.drugsandcultures2008.com/ Annual Drug & Alcohol Professionals Conference, 13th January 2009, Royal Institute of British Architects, London UK. Organised by the Federation of Drug and Alcohol Professionals. Website: http://www.fdap.org.uk/fdapevents/fdapevents.html Alcohol our Favourite Drug: from Chemistry to Culture, 26–27 February 2009. Organised by The Royal Society of Edinburgh, Scotland's National Academy. Contact: Duncan Welsh, Royal Society of Edinburgh, tel. +44 (0) 131 240 5027, fax +44 (0)131 240 5024; email dwelsh@royalsoced.org.uk. Website: http://www.royalsoced.org.uk/events/conf2009/alcohol_r_favourite_drug.pdf Third Annual Conference of the International Society for the Study of Drug Policy, 2–3 March 2009, Vienna, Austria. Website: http://www.issdp.org/vienna2009/index.htm 14th World Conference on Tobacco or Health, 8–12 March 2009, Mumbai, India. Website: http://www.14wctoh.org National Drug Treatment Conference 2009, 19–20 March 2009, Novotel London West Hotel and Convention Centre. Website: http://www.exchangesupplies.org/conferences/NDTC/NDTC_intro.html Harm Reduction 2009: IHRA's 20th International Conference, 19–23 April 2009, Queen Sirikit National Convention Centre, Bangkok, Thailand. Website: http://www.ihra.net/Thailand/Home Society of Behavioural Medicine 30th Annual Meeting & Scientific Sessions, 22–25 April 2009, Palais des congrès de Montréal, Montreal, Quebec, Canada. Website: http://www.sbm.org/meeting/2009/ Collegium Internationale Neuro-Psychopharmacologicum (CINP) Thematic Meeting on Major Psychoses and Substance Abuse, 25–27 April 2009, Edinburgh International Conference Centre. Contact: email cinp2009@glasconf.demon.co.uk. Website: http://northernnetworking.co.uk/CINP_thematic_meeting.htm The American Association for the Treatment of Opioid Dependence National Conference, 25–29 April 2009. Hilton New York, New York City, USA. Website: http://www.aatod.org/aatodnational.html Society for Research on Nictotine and Tobacco (SRNT) 15th Annual Meeting—Joint Conference of SRNT and SRNT-Europe, 27–30 April 2009, Citywest Hotel Conference Leisure and Golf Resort, Saggart, Co. Dublin, Ireland. Website: http://www.srnt.org/meeting/2009/index.html American Society of Addiction Medicine (ASAM) 40th Annual Medical-Scientific Conference, 30 April—3 May 2009, New Orleans, LA. Website: http://www.asam.org/AnnualMeeting.html National Association of Addiction Treatment Providers Annual Conference, 17–20 May 2009, PGA Resort, West Palm Beach, Florida, USA. Website: http://www.naatp.org/conferences/annualconference.php 12th European Federation of Therapeutic Communities Conference, 2–5 June 2009, World Forum Convention Centre, The Hague, The Netherlands. Website: http://www.eftc-bepartofthesolution.eu National Conference on Tobacco or Health, 10–12 June 2009, Phoenix Convention Centre, Phoenix, Arizona. Website: http://www.tobaccocontrolconference.org/2009/ The College on Problems of Drug Dependence (CPDD) 71st Annual Meeting, 20–25 June 2009, John Ascuaga's Nugget Casino Resort, Reno/Sparks, Nevada. Website: http://www.cpdd.vcu.edu/index.html 2009 UK National Smoking Cessation Conference, 22–23 June 2009, Novotel London West Hotel and Convention Centre. Website: http://www.uknscc.org News and Notes welcomes contributions from its readers. Send your material to Peter Miller, News and Notes Editor, Addiction, National Addiction Centre PO48, 4 Windsor Walk, London SE5 8AF. 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