Dry January: Dr Pauline Grant – Dry February?

Guest blogger Dr Pauline Grant describes her continuing progress during Dry January…

We are very nearly at the end of dry January. I will be allowed to have a glass of wine on Saturday. I could stay up until midnight on Friday and have a glass of wine. The thought has crossed my mind. But will I? I am surprised to find that I am not counting down the days and am instead feeling a bit apprehensive about starting to drink again. I have enjoyed being clear headed. And although we are having some tough times at the moment with my husband losing his job, I have the feeling that drinking is not going to help that. I remember how it used to make me feel low and irritable after the initial euphoria, and am not sure I want to go back to that.

Yesterday I went to a reception at the Houses of Parliament to celebrate dry January. Unfortunately I was late as I had to attend an RCGP alcohol training day. It was exciting as I had never been to the Houses of Parliament and found myself feeling all patriotic and sentimental about the seat of power in this country and the long history represented by the building. Patriotism is not something I am usually prone to! I just crept in to hear Alistair Campbell speaking in support of the campaign and in support of measures to reduce alcohol consumption in Britain. He had visited a doctor working with patients with alcoholic liver disease in Liverpool (just noticed the name there, could it be that Liverpool has a history of excessive drinking going back a very long way?) and was moved by the situation. It is reassuring to know that some people in high places are championing health.

I also met a lady who is working for Alcohol concern, a charity which is working to publicise the problems of alcohol in our society and lobbying for change. Given the recent outcry about the unbalanced access allowed to politicians over the minimum pricing legislation it was interesting to find that alcohol concern had not been allowed access despite trying.

Like those who have stopped smoking or ex alcoholics (again I reiterate I was not an alcoholic!) I have become a bit of an anti alcohol campaigner. It may not last. You’ll probably find me supping with the rest in 2 weeks time! But if not here’s to dry February!

Pauline Grant

See Pauline’s original Tumblr post here
@paulinegrant1

Dry January: Dr Pauline Grant – Testing Times

Guest blogger Dr Pauline Grant describes her progress during Dry January…

My husband has just been told he has lost his job. He announced this on arriving home last night. After the initial 10 minutes shock the next reaction was to consider a drink. Interesting to speculate why this should be. Is it a cultural habit, along the commiseration lines, or is it a way we manipulate our mood, hoping it will cheer us up after our mood has taken a dive? Suffice to say I felt it would be cruel to deny him, so handed him a beer.

I am still abstaining, however.

It is getting easier and easier on a day to day basis. I am really enjoying my grape juice in a wine glass and would like to continue into February. I just read on twitter of someone who enjoyed dry January so much that he has now not had an alcoholic drink for 42 weeks. I am certainly not counting down the days, which has come as a surprise to me.

I am also amazed by how many other people are participating in dry January this year, or have done it in the past. I will seriously consider doing it every year as a way to break that insidious relationship with sneaky alcohol.

Pauline Grant

See Pauline’s original Tumblr post here
@paulinegrant1

Blue Lights and Symbolic Violence

A post by Dr Euan Lawson, who compiles SMMGP’s Clinical Updates, discussing a recent study published in the Harm Reduction Journal

“A qualitative study of the perceived effects of blue lights in washrooms on people who use injection drugs”
Crabtree et al. Harm Reduction Journal 2013, 10:22
http://www.harmreductionjournal.com/content/10/1/22

The aim of fitting fluorescent blue lights into toilets is to make injecting difficult and deter people from using these areas as a location to inject drugs. This qualitative study published in the Harm Reduction Journal asked people who inject drugs about their perception of blue lights in public washroooms (defined as any facility not in a private home). They interviewed 18 people in two Canadian cities in British Columbia. These interviews were around 30 minutes long and were semi-structured. The interviews were recorded, transcribed verbatim and analysed.

The results were presented by the major themes. Preferred geographic locations for using injection drugs. Privacy was a high priority when it came to using injection drugs. However, most of the participants also stated that immediacy was a major issue – sometimes when withdrawing and under pressure then public spaces, including bus stops, alleys, car parks and toilets, were more likely to be used. Perceived effectiveness of blue lights as a deterrent. All the participants understood about the practice of installing blue lights but yet 16 of them described situations in which they had still attempted to inject in a toilet with them fitted. All agreed it was harder to inject under blue lights. The majority said they would try to avoid them, but three of the participants were entirely undeterred. Perceived negative consequences of blue lights. The participants highlighted the increased risk of harm to the person injecting. Participant recommendations in favour of blue lights despite the negative effects. Almost half still made positive statements about the use of blue lights despite knowing the harms. They prioritised other non-drug using people’s health above that of the person injecting drugs.

If you are working in a practice or a healthcare setting where they are using blue fluoro lights to deter people from injecting drugs then you need to take a long hard look. It puts up barriers: violently stating ‘we don’t trust you and you are not welcome here’. The authors talk about the concept of symbolic violence that has been used to describe the impact of blue lights. Symbolic violence often seems natural to both the victim and the perpetrator – and it is obvious in this study in the paradox that the participants accepted blue lights despite the harm likely to be caused to them personally. And, this study, like others before it, also reinforces the evidence that it doesn’t necessarily stop people from injecting in public toilets in any case. It’s a lose-lose counter-productive policy that epitomises a Daily Mail-esque nimby attitude to drug users. They are an act of symbolic violence against a section of society who need support not stigmatisation.

 – Dr Euan Lawson

Note: Euan Lawson is Editor-in-Chief of the Harm Reduction Journal where this paper was published.

Dry January: Dr Pauline Grant – Day 3

Guest blogger Dr Pauline Grant describes her progress during Dry January…

So ‘how’s it going?’ I hear you ask. Or maybe you don’t care how it’s going; I’m going to tell you anyway. I have never done this before so it is interesting to me to analyse my thoughts and feelings about it. The first thing to say is that once you have made a definite decision and told everyone about it, there seems to be no going back. I have not actually at any point in the last 3 days worried that I will weaken and actually drink; that would be impossible. In my mind it is a done deal and I am convinced I will make it all the way through to February. Of course, it is only Day 3 so this could all change. I have seen the same happen to patients, starting with rock solid resolve which then steadily crumbles.

I have been drinking red grape juice at room temperature, in a wine glass as a red wine substitute, and will use chilled white grape juice when appropriate (fish, chicken). One doctor friend commented that I should stop kidding myself and just drink water, but I have always found kidding myself works better. Eg when trying to lose weight, eat dried berries instead of sweets, similar but different. Maybe I’m a wimp who can only take baby steps.

Fortunately it appears that hubby who initially said he wasn’t going to do it with me, has followed my lead, although his resolution is ‘I will not open a bottle of wine in January’ which allowed him to finish up the left overs on New Years Day. I also notice this doesn’t mention beer at all and, specifically, going to the pub with his mates. I suspect it means he won’t drink in front of me, which is at least a kindness.

So already I have realised that the reason I used to fall asleep in front of the telly every evening was not, as I thought, because I had had a really busy day, but because I was sedated with wine. So now I can do other things in the evenings like admin or learning, or housework! Joy.

Yesterday was Friday evening, and I realised that it was probably the first Friday evening in about 20 years that I had not had any wine! Felt very strange and at 7 pm was definitely missing it, could have done with a mocktail at that point, as a treat to celebrate the Fridayness. Will have to plan to make one next Friday.

Pauline Grant

See Pauline’s original Tumblr post here
@paulinegrant1