Drunk & Disorderly : The true cost of the weekend warrior

I’ve wanted to write this article for a while now. I have my reasons, mostly personal, but also as a means of catharsis. I work as a registered nurse in the Medical Assessment Unit of a large hospital in the UK covering a population of around 570,000 people. The specialist services at the hospital reach a lot further; some 3.2 million. On average each year, the hospital sees around 80,000 patients through their Emergency department which averages about 220 patients a day. At the weekends, and partly because the hospital in situated in the second largest council estate in Europe, there are a lot of alcohol related admissions, which is the focus of the article.

A recent report by the Centre for Social Justice entitled ‘No Quick Fix’ reports that in 2013 alcohol abuse cost the taxpayers of Britain £21 Billion a year, with drugs (thats all drugs – but mostly addictive socially frowned upon drugs like Heroin and Crack Cocaine that require rehab) costing a further £15 Billion . To put that into perspective, roughly 14% of all Emergency hospital attendance was alcohol related. Thats 2 million A&E visits that cost the taxpayer around £21 Million. For those of you outside of the UK unaware of our healthcare system, each person of working age and in employment in the UK pays a small donation from their wages – its called National Insurance.

This means everyone in Britain can enjoy free healthcare. UK residents, the unemployed, holiday makers, illegal immigrants, everyone. And because of this we have to make the money last. It rarely does, and many people requiring expensive surgery or drugs are unable to be helped. That puts a strain on the government to implement rules to improve services which in turn puts pressure on the healthcare professionals and hospital mangers to assimilate the new rules into the business. We hear time and again that the NHS is the envy of the world, but the truth of the matter is, it barely stays afloat on a day to day basis. Chronically understaffed wards with chronically over worked and poorly paid staff have to not only provide the best care possible, for free, but also have to endure a daily expectation of being physically, verbally and even emotionally abused by patients, work colleagues and management. To be a healthcare professional takes a lot of guts and determination. Its because we care that we put up with the poor work environment, the crappy hours and the people we meet, so the next time you have to sit in an emergency room, remember the doctors and nurses treating you are probably doing so without a break, food and drink for the whole of their shifts.

Alcohol is big business and the companies want you to drink their products, a lot. …responsibly! 24.2% of UK adults are regularly drinking above the Governments safe consumption limits of no more than 3-4 units a day for men and no more than 2-3 units for women (HSCIC,2009). In Manchester, a city with a larger than most student populous its 29%. The UK has one of the highest levels of alcohol consumption in Europe and this single fact has lead to an increase in hospital stays over the last 8 years of some 40%. (HSCIC,2013). In Europe, around 70% of alcohol exporting and about half of the worlds imports are centred on the European Union. Admittedly, much of this trade is between EU countries, but it equates to €9 Billion. When you factor in jobs in the alcohol industry the total tangible cost of alcohol to European society is estimated at up to €220 Billion or about 1.3% GDP (Gross Domestic Product).

In the UK around 25% of us drink above the governments recommended safe usage limits, thats roughly 16 million people who regularly consume more than 3 to 4 units of alcohol a day. Figures from the ONS (Office for National Statistics) say that in 2012 there were over 8,300 alcohol related deaths registered and that the majority of those were in men aged 60 – 64 and women 55 -59 years old. They also say that men account for 65% of all alcohol related deaths and in England and Wales 63% of those deaths were the result of alcoholic liver disease; something that takes time to get. Fair to say then that its a societal problem and not just something ‘the kids’ do. World Health Organisation figures from 2008 on health costs vs average life expectancy show the United States spend nearly 8000 dollars ($7,720) per head for an average lifetime of 78.3 years, in the UK its 79.9 years at a cost of $3,281.The best life expectancy is in Japan with 82.8 years, the least spent on healthcare is Mexico ($892)

There’s been a few times where I’ve drunk when I shouldn’t have while DJing. In my early days as resident at Godskitchen, I remember one night in particular I was closing the 2nd room after Funkagenda. I was so drunk I was having to be sick outside the club as Funkagenda arrived. It hasn’t happened to me very often, but it’s totally unprofessional when I look back at times like that. I guess we are in a business which is surrounded by alcohol, and DJs are obviously supplied with as much drink as they want…” – Paul Thomas (Godskitchen)

A European study by Stolle et al (2009) found that most adolescents asked in a survey believed that drinking alcohol was fun, relaxing and sociable. And while I don’t necessarily disagree with those findings – lets face it, drugs are fun, or we wouldn’t do them – it fails to point out that it can also be a contributory cause of other problems and lead on to alcoholism in later life. It also doesn’t point out that much of the behaviours kids pick up are from how they are socialised as children. If their parents are drinkers, unfortunately they are destined to follow as that behaviour is expressed as ‘normal’.

One of the biggest societal problems (certainly in the UK) with alcohol consumption is binge drinking, which is where I draw the ‘weekend warrior’ moniker from. Its those of us that ‘save up’ all our weekly alcohol units for one blow out on a Saturday night, invariably ending up in A&E puking over the side of a gurney and feeling very sorry for ourselves. Over the last 50 years or so a casual link has been established between smoking tobacco and lung cancer. In the UK, tobacco consumption is now recognised as the single greatest cause of preventable illness and early death with smoking-related disease responsible for more than 107,000 deaths in 2007. According to Cancer Research UK, it is estimated that 86% of lung cancer deaths in the UK are caused by smoking. Other life style choices, such as drug or alcohol misuse and can also lead to poor health, however their affect on our bodies is less clearly frowned upon.

Which brings me to the almost habitual cocaine misuse associated with many of the warriors we see in the emergency rooms around the world. Research shows that mixing alcohol with cocaine causes a reaction in the body resulting in a third drug being formed called Cocaethylene. Essentially, it intensifies the action of the coke making you feel euphoric, but also amplifies the affects of the alcohol. You will start the night feeling amazing, and because the effects of the cocaine will mask the sedately action of the alcohol you will feel able to drink more, but as time goes on the strain put on your system increases the chances of aggressive behaviour and getting into stupid situations. Purely for the purpose of balance, drug related deaths according to the Health & Social Care Information Centre (HSCIC) is 1496 in 2012. A declining trend since it peaked in 2008 (1939 deaths) however admissions with drug related mental health or behaviour issues (that includes prescribed meds that patient don’t take) have increased year on year since 2002. The reason for most drug related deaths (73%) was accidental poisoning. So be careful if you indulge.

Now, I haven’t written that to scare you, although if it has – good. Smarten up. The fact is research into these fields is relatively new and the long term affects cannot be known for sure, but the point remains, you are taking an unnecessary risk by doubling up on your drug choices. This metabolite can remain in the body for a prolonged period of time, which means if you’re on a weekend bender, as many do, the affects of the first day could be exacerbated on the second – in effect you are double dosing. As I mentioned, I work in a busy 56 bed ward, I see more than my fair share of party excess gone wrong at the weekends. Some are grateful for the free bed to sleep it off, some make a fuss and walk out against medical advice only to be bought back a few hours later by police; found slumped by the side of the road asleep. Some are so sick they require medical intervention to stop them from dying. I see them all and sometimes I see them in town hammering the shots again. Destructive drinking appears to be something the British have made their own, or so I thought. Bianca, my co-author, is an American writer and social media specialist from Denver, Colorado. Her story, bravely retold in the passages that follow, is not unlike many of the people I regularly come into contact with, and keenly demonstrates the easy with which any addiction can befall us. We live our lives walking a tightrope…

Around the world, turning 18 signals adulthood. Adulthood in most countries means complete freedom to partake in everything society has to offer, which includes drinking. It might be an overt generalisation to assume most countries allow complete control of ones actions at 18, but I’m an American. At 18, though you can vote who you want as your next president, you cannot legally consume alcohol in the States. When you turn 21 here, you are finally legally allowed to drink; however, that does not mean you have not tried it illegally. I grew up in a somewhat strict household, though at the time I hated it. I’m now 25, and very thankful that my parents kept an iron fist on me for as long as they did. I didn’t get to attend parties in middle or high school, and sat home most weekends cut off from a normal social life.

Parties were not allowed, nor were sleepovers elsewhere. My parents feared the world, and so did I. Around my senior year, I began to break free a bit and get restless to leave the nest. After graduating grade school, I went to university 45 minutes away from my parents. In my mind, I was cutting the umbilical chord; however, this idea of rebellion was a downward spiral into many lonely years of addiction. As soon as I hit university, I became a statistic. I was just another number. I became part of the 87.6% of 18 year olds that had tried alcohol before 21, and before I knew it I was one of the 5.9 million underaged Americans that binge drank regularly. These are just two of many ghastly statistics from the 2012 Substance Abuse and Mental Health Services Administration (SAMHSA) Drug and Substance Abuse survey.

For me, there wasn’t just one drink, and I could never stop. The CDC defines binge drinking as consuming 5 or more alcoholic drinks in one day, which was a nightly occurrence for me. Because I wasn’t allowed to experiment with alcohol under the supervision of my parents, I wasn’t aware of my limits. I can still recall the first time I blacked out: I was 18, and it was a few weeks before I went off to college. This black out was embarrassing, and I can recall the red in my cheeks when my friends told me I was losing my mind over not being able to find an earring, and tried to open the car door in traffic. Binge drinking and the culture of getting messed up is ingrained in American society. Movies that focus on parties and peer-pressure give our youth a false ideation of how they should act when they turn 18. These movies prove that drinking is wrong under the age of 21, but it’s cool to do it anyway. It’s the cool thing to do, and that when you get to college you won’t fit in if you don’t. I grew up on this mantra, watching movies like Can’t Hardly Wait and American Pie. The typical ‘house party’ movies that made going off to college post-high school look glamorous and exciting. It isn’t just the movies that encourage partying-till-you-pass out, because we can point a finger or two at music. Artists like LMFAO have songs specifically focused on getting their listeners as fucked up as possible in the shortest amount of time, even throwing shots of Grey Goose into the crowd at shows.

The truth is, alcohol and tobacco are billion dollar industries. The drunker you are, the more money you will spend on everything. Be it a show, festival, or bar or restaurant. If alcohol brands sponsor the event, their hope is to squeeze your pocket dry, and most likely make you forget the event. It’s also no surprise, is that the CDC reports that almost three-quarters of the total cost of alcohol misuse is related to binge drinking (Costing the US $223.5 billion in 2006). Underaged drinking in the United States often results in a drinking ticket, if caught by the police. Depending on where you get the ticket from, you could spend the night in detox. The police department often contacts your parents, or the school/university you are going to. From there, you are referred to a counsellor for addiction, and after pleading guilty to the misdemeanor in court (that usually gets expunged), you will have to do community service and wear an alcohol monitor for two weeks. Most of these consequences teach the person nothing, and I should know. I was one of them.

Alcohol at events is one of the main issues that Americans face. It’s easier for mainstream alcohol companies with pockets of cash to sponsor an event to keep patrons hooked. In America, it is illegal to advertise tobacco, but not alcohol. In a study conducted in 2006 on the youth and influence from ulterior motives in the media, a conclusion was made that a greater exposure to alcohol advertising contributed to an increase in drinking among underaged youth. I believe it, considering even at bars I am being advertised to with shot specials and swag from companies. Last weekend I was offered a light stick from Tuaca, and the week before a few shots from Smirhnoff. Both are alcohol I would have never drank or known about without sponsorship and advertising.

This reigns especially true in events, with most being sponsored by certain alcohols.This year, Tomorrowland was sponsored large in part by Budlight in Georgia. An article published by Julian Patterson of Do Androids Dance said upon the second day, “I desperately needed to turn up. Luckily we were rolling with the good folks from Budweiser, so beer and Lime-A-Ritas (aka thot juice) were flowin’ as fast as we could guzzle em’ down.” This quote is one of many from those who go to events purely for the substance abuse aspect. I have attended many festivals in the United States, many of which had major alcohol sponsors, some even thrown specifically for the music with their brand. The biggest abuser of sponsorship money has and always will be Budweiser, whom takes photos of patrons at their Made in America event with labels facing forward and big smiles on faces. You have to be 21 to partake in these types of events, but that doesn’t stop the novelty from not waring off as you get older.

Though I am finally at a point in my life where my alcohol dependency does not control me, I could not always say I was that way. I have missed many shows and things I wanted to be at from being out of it or having to go home early. These regrets are what encourage me to always stay in control of myself at shows, especially for those I am covering. After turning 21, and being allowed to drink, the party doesn’t stop but eventually the way you handle it begins to change. It may have taken me 4 years to get a grip on my own personal reality, but it was not 4 years too late. I am now at a point where I can be around it, and not indulge. It doesn’t bug me, but instead has opened my eyes to the sadness that is kids getting drunk out of their minds.

Since I have stepped back from the scene I have come to the realization that your state of mind directly effects your actions and abilities in everything you do regardless of being inebriated or not. Being stressed out before a show and getting hammered usually has dire consequences, looking forward to your show with a positive outlook and having some drinks can really help you to be a more expressive and exciting performer. It’s when you use alcohol as a tool and come to rely on its effects to keep you interested that its time to take a step back.” – Micah Paul Lukaswich

A recent UK government document – Reducing Harmful Drinking outlines a payment by results plan to lower dangerous drinking patterns across the country. This includes the current Change4Life public health messages and supports plans to develop hospital and community based treatment plans. One of the biggest improvements in this system is the implementation of alcohol and drug liaison nurses, however their job of formulating these plans is scuppered if the individual is not going to comply, or simply isn’t ready to quit drinking yet, reducing the amount of money Government gives to the trust. A vicious circle.

So what do we do about it? Clearly its not a problem only the alcohol consuming public of the UK endure. The epidemic is global, and to my mind stems from how we are socialised into adult life – yes, I do blame the parents! My mum was raised in a strict Catholic household in the 1950s and 60s, she like me and well, every generation, found that growing up and becoming an adult meant a period of rebellion. Be it ‘the system’, parents, teachers whomever, forging your own identity; your own moral code is an important step in childhood development and a lot of recent psychological research outlines how important this is to balance alongside strong socially constructed life rules. Having sais that, my mum was pretty liberal with us. We were allowed wine for Sunday lunch for as long as I can remember: one glass which was watered down and we had to sip, but it was a grown up thing and we learned to respect it (alcohol I mean). As I was a sporty kid (believe it or not) and regularly played rugby with older boys at the local club, I would be allowed a pint of beer as a post match treat. Again this was a socialisation into the world of Manhood (I was maybe 12 or 13). ‘Men’ drank beer and held their liqueur. ‘Boys’ got pissed and had a fight… crude ideology, but affective on teenage lads nonetheless; I’ve never been arrested for drunken behaviour. And trust me, I can drink!

During my research for this article I was fortunate to get an interview with my hospitals Senior Alcohol Liaison Nurse – Hazel Peet. During our interview I asked her what would be the one thing that would make her job easier,

…I guess it would be for people to by more open about their alcohol use. So people who are having issues don’t feel stigmatised.” 

We later got on to how alcohol is viewed socially…

”I guess it will go in the same way as smoking has – that its seen as ‘uncool’ ” Helen says, “And that its ok to drink in moderation, but like anything it can be dangerous. People don’t realise that you can get alcohol related brain damage, they don’t realise that these young people are dying of liver disease, it needs to be more publicised. Its a worrying thing that people dancing on a bar for instance, find it acceptable to come to hospital after they are injured and laugh about it.

There is a psychological theory that we learned in nurse school I’d like to share with you. Its called the Heath Belief Model, and essentially it says that you only really do something positive about your health and well being when you experience, or are close to an event which threatens your life as you know it. For example, the woman who smokes 40 a day has a heart attack and quits smoking, or the guy who eats McDonalds all day and has a stroke. Many of us go around with our heads in the clouds, especially 18 -25 year olds who go binge drinking every weekend. We believe we are invincible until we end up in the back of an ambulance with vomit all down our front and our mates crying because they think you’re going to die. We come round the next day and swear off drinking forever…until the following weekend when we’re back in town slurping vodka jellies of the chest of a good looking girl or as I saw on Facebook recently performing sexual favours in a bar on holiday for free drinks. Alcohol is evil, master it or it will master you. Forever.

So what can we do to protect ourselves when drinking alcohol? Well the advice of the alcohol team is pretty simple and essentially can be used for a weekend bender or even a festival day out:-

• Know your limits and stick to them.
Its a social activity and you’re the life of the party, but one too many and you become an embarrassment.

• Remember to eat food while your drinking.
Particularly protein rich foods like peanuts or cheese. As the alcohol binds to the food, it slows the absorption of the alcohol allowing you to continue to party unaffected.

• Space your alcoholic drinks out.
Having a non alcoholic drink now and again has a similar action to food and increases your bodies ability to process the alcohol efficiently. Lets be honest here, no-one will know or care if you rock up with a glass of cola or a vodka tonic if they’re your friends.

• Try to stick to one type of alcohol.
We all know what happens at parties. We start to feel drunk and then career headlong into a catalogue of poor choices, which usual start with spirits – I should know, I have the tattoos to prove it!

• Have drink free days.
This isn’t as silly as it sounds. Much of the new evidence in alcohol research points to the fact many alcohol related illness can be avoided, or at least suppressed by taking a day off alcohol. For one, it means we don’t become more tolerant to the affects of excess drinking, being able to cut out alcohol means we don’t become dependent upon its use – thats the slippery and insidious route to addiction, remember you can become psychologically dependent way before physical defense appears. Regular (and by that I mean daily) drinking has also been linked to indigestion and headaches as well as poor sleep patterns which all take their toll on the body and can lead to more serious things like liver disease and other conditions. As with everything in life moderation is key, and as you get older you’ll find other elements take your time and reduce the opportunity to get blasted out of your mind.

It’s okay to have a couple of drinks before / during a show, but if you’re wasted and not performing the way you should you’ll be throwing in your own windows as they’d say here in Holland! It’s all fun and games when you’re young, but when you’re getting a bit older it isn’t that easy anymore to recuperate for a night of heavy drinking, bad food and lack of sleep (or no sleep at all)” – Paul Hazendonk (Manual Music)

Admittedly following the excesses of ADE which you’ve all become sick to death of (if you weren’t here) this article might appear to come across as a shade hypocritical, the fact is, alcohol and recreational drugs have been around for 1000s of years and will for 1000s more I expect. The real value and underlying purpose of articles like this is draw awareness for the need to educate ourselves and our loved ones to behave responsibly, and take ownership of our health and well being before disaster strikes and we are forced to re-evaluate our priorities. Only by a country wide social awakening: a revolution of the mind, can we move forward and allow the dedicated healthcare workers of the NHS and other organisations to provide the care they were trained to give to the most vulnerable and poorly members of our society.

Written by Simon Huxtable and co-authored by Bianca Cadloni