Transcript Alcoholism in Finland

Alcoholism in
Finland
By Simon Kaklugin and Johanna Lehtinen
Leading killer in Finland, above heart
disease and cancer.
(responsible for 17% of all deaths among
men of 15-65 years old)
(responsible for death of 10.5% of adult
women, along side breast cancer)
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Reasons
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The Finnish are said to be typically quiet and
shy people.
Alko, state owned and only store in finland
which retails alcohol (finland’s alcohol
monopoly), established in 1937
2004, 40% slash of alcohol tax to prevent
cheap private import from neighboring
countries.
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6 months after tax cut, there was a 10% increase in
binge drinking in 17 year olds.
14% increase in alcohol consumption since tax cut.
2006, 1 in 4 people involved in a car accident were found
to be drunk.
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2005 - # non drinkers, men = 22%, women = 47%.
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2007- # non drinkers, men = 11%, women = 14%.
1 in 3 15-16 year olds admit to being drunk within the
last month.
4% of population (150,000) are alcoholics.
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Complications
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Cost to treat alcohol related illnesses has
increased 14% since 2003.
Early retirement and longer sick leave.
Depression
Alcoholics are 5080 times more likely to commit
suicide than the general public, (due to
unemployment, economic status and social
status).
Physical Effects
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liver cirrhosis
pancreatitis
epilepsy
polyneuropathy
alcoholic dementia
heart disease
predisposition to cancer
nutritional deficiencies
sexual dysfunction
Mental Effects – 25% of alcoholics present with psychiatric
disturbances, which worsen during withdrawal (depression, anxiety,
panic disorder, bulimia, schizophrenia)
 Social Effects
-loss of employment causing financial problems and loss of home.
-drink driving
-public disorder
-marital conflict
-divorce
-domestic violence
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Preventative Measures
Increased tax on alcohol (but has lead to
increased private import by travellers)
 supermarkets cannot sell beer with greater
alcohol content than 4.7%.
 Alko cannot have a window display
 Drinks with an alcohol content of higher
than 22% cannot be advertised.
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Current evidence indicates that alcohol
dependence is:
50-60% genetically determined.
40-50% determined by environmental factors.
About 10 genes have been linked with
predisposition to alcoholism.
(e.g. 1 of these genes includes a mutation of
the dopamine receptor, which predisposes
people to addiction of opiates and endorphin
releasing drugs such as alcohol).
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Primary effect of alcohol is stimulation of GABA
receptor, causing CNS depression.
Repeated consumption causes desensitisation
of receptors and decreased number.
This causes tolerance and dependence.
If alcohol intake is stopped abruptly it results in
uncontrolled synapse firing in the CNS (anxiety,
life threatening seizures)
Therefore alcohol withdrawal must be carefully
managed.
Therapy
Many factors encourage drinking which must be addressed to
prevent relapse.
 Detoxification – drugs are given which mimic the effects of alcohol to
prevent withdrawal symptoms.
 Medication:
- Antabuse, prevents acetaldehyde release, which extends duration of
hangover acting as a deterrent for drinking.
- Naltrexone, competes with opioid receptor, preventing endorphin
function, therefore no satisfaction from alcohol and no craving.
- Topiramate, reduces level of dopamine, therefore no pleasure from
consuming alcohol.
 Group therapy and psychotherapy are used to tackle underlying
psychological issues and provide relapse prevention skills.
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Sources
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WHO
http://news.bbc.co.uk/2/hi/europe/6106570.stm
wikipeia
http://alcalc.oxfordjournals.org/cgi/content/full/34
/3/320
www.suomenafh.fi
www.utuonline.fi
www.uufisuomi.fi