Medicine
Alcohol substitute that avoids drunkenness in development
26 Dec 2009
An alcohol substitute that mimics its pleasant buzz without leading to drunkenness is being developed by scientists.
The new substance could have the added bonus of being “switched off” instantaneously with a pill, to allow drinkers to drive home or return to work.
The synthetic alcohol, being developed from chemicals related to Valium, works like alcohol on nerves in the brain that provide a feeling of wellbeing and relaxation.
But unlike alcohol its does not affect other parts of the brain that control mood swings and lead to addiction. It is also much easier to flush out of the body.
Finally because it is much more focused in its effects, it can also be switched off with an antidote, leaving the drinker immediately sober.
The new alcohol is being developed by a team at Imperial College London, led by Professor David Nutt, Britain’s top drugs expert who was recently sacked as a government adviser for his comments about cannabis and ecstasy.
He envisions a world in which people could drink without getting drunk, he said.
No matter how many glasses they had, they would remain in that pleasant state of mild inebriation and at the end of an evening out, revellers could pop a sober-up pill that would let them drive home.
Prof Nutt and his team are concentrating their efforts on benzodiazepines, of which diazepam, the chief ingredient of Valium is one.
Thousands of candidate benzos are already known to science. He said it is just a matter of identifying the closest match and then, if necessary, tailoring it to fit society’s needs.
Ideally, like alcohol, it should be tasteless and colourless, leaving those characteristics to the drink it’s in.
Eventually it would be used to replace the alcohol content in beer, wine and spirits and the recovered ethanol (the chemical name for alcohol) could be sold as fuel.
Professor Nutt believes that the new drug, which would need licensing, could have a dramatic effect on society and improve the nation’s health.
The NHS report Statistics on Alcohol: England, 2009 found more than 800,000 alcohol-related admissions to hospitals in 2007-08 – and more than 6,500 deaths – at a cost to the service of £2.7bn a year.
Some charities estimate that the toll could be up to five times higher. Drink is, for example, a factor in 40 per cent of fatal fires, 15 per cent of drownings, 65 per cent of suicides and 40 per cent of domestic abuse. It also has other costs, including 17 million lost working days a year, worth about £20bn to the economy.
“I’ve been in experiments where I’ve taken benzos,” said Professor Nutt. “One minute I was sedated and nearly asleep, five minutes later I was giving a lecture.
“No one’s ever tried targeting this before, possibly because it will be so hard to get it past the regulators.
“Most of the benzos are controlled under the Medicines Act. The law gives a privileged position to alcohol, which has been around for 3,000 years. But why not use advances in pharmacology to find something safer and better?”
Getting the drug approved could be hard for the team as clinical trials are expensive, and it is not clear who would pay for them, according to Professor Nutt.
He said that the traditional drinks industry has not shown any interest, however some countries might be persuaded to sponsor the team.
Some countries have more liberal regimes than others, though, and Professor Nutt thinks Greece or Spain, within the EU, could lead the way.
The latest Home Office performance figures showed that more than one in four people believe that alcohol is blighting their community.
A survey of every police force area in England and Wales found that 26 per cent of those polled “perceived people being drunk or rowdy in public placed to be a problem in their area” – a slight increase from last year.
The fears over the affects of alcohol range from urban to rural communities, with the worst hit being Manchester, South Wales, London, Northumbria and Gwent.
Indigenous tribes more vulnerable in swine flu outbreaks
Pandemic expected to hit remote, poverty-stricken communities far harder than wealthy Westerners
Sunday, 11 October 2009
The only road to St Theresa Point in north-eastern Manitoba is made of ice and lasts just two months. The remote community’s 3,200 people, most of them Cree Indians, are squeezed into 530 homes, more than half of them without running water. Until June, a doctor flew in once a week for three days. But since an outbreak of swine flu left more than 200 people ill and sent 12 by air ambulance to Winnipeg, 600km (375 miles) away, Health Canada has been ferrying in more doctors. This autumn, in preparation for the flu season, it is also delivering something else: a supply of body bags.
In Australia, a similar scenario played out in July. An estimated 400 people out of a population of 3,400, more than 90 per cent of them Aboriginal, caught H1N1 influenza on Palm Island off the Queensland coast. In Brazil, a conference on indigenous education was cancelled in September after seven members of the Matsigenka, a tribe living along the Urubamba river in the Peruvian Amazon, tested positive for swine flu.
As health authorities gear up for the northern hemisphere’s flu season, the new strain of influenza is expected to hit indigenous peoples far harder than it will healthy, wealthy, urban Westerners. If the outbreaks in Canada and Australia are any guide, native communities could find a tenth of their populations sick, and untold numbers dead.
The World Health Organisation warned in its August briefing note on the pandemic that minorities and indigenous peoples face a far higher risk of hospitalisation and death. “In some studies, the risk in these groups is four to five times higher than in the general population,” it said.
Survival International, a London-based charity that tries to protect indigenous peoples, has called on the government of the Andaman Islands to close the Andaman Trunk Road because it runs through land populated by a nomadic tribe. The Jarawa came into contact with outsiders only in 1998; within a year, half of them had suffered respiratory problems after an outbreak of measles.
Glenn Shepard, an anthropologist who works closely with Peru’s Matsigenka, said they are not the only tribe he is concerned about. “The arrival of swine flu among the Matsigenka is especially worrying as they are known to have intermittent contact with quite isolated Indian groups living near by,” he said.
Scientists and medical researchers have two hypotheses to explain the vulnerability of tribal peoples. The first is that those, like the Jarawa, who have had little contact with the global community simply have immune systems that have never been primed. Kevin Paterson, a Canadian doctor, notes that during the 1918 Spanish flu, 8.5 per cent of American Indians died, but among the more isolated Inuit in Nome, Alaska, the toll was 55 per cent. In Hebron, Labrador, 5,000km to the east, 150 out of 220 Innu were killed. Yet the global fatality rate for Spanish flu was just 2.5 per cent.
The other hypothesis applies to those indigenous populations that live on the fringes of Western society, such as the Cree of St Theresa Point and the Aborigines on Palm Island. For them, the problem is poverty, poor general health and crowded living conditions. “We have in excess of 15 people living in a three-bedroom home, which you wouldn’t find in mainstream communities,” said Alf Lacey, the mayor of Palm Island. Although Tamiflu was available, many islanders were unaware of it because they are unable to read.
“Influenza has a cure,” said Dr Paterson. “It’s called affluence.”
Billions wasted on swine flu pandemic that never came
How did the World Health Organisation get its prediction of a 7.5 million death toll so wrong?
By Paul Rodgers and Smitha Mundasad
Sunday, 16 May 2010
The spectre of plague stalked the world last year with its constant companion, fear. Schools and stadiums were closed in Mexico, tourists from Egypt to Singapore were quarantined, and the surgical mask became a universal fashion accessory across Asia. Yet predictions that the global death toll from swine flu could reach 7.5 million were well off the mark. At most, the virus killed 14,000 people, and some of those had pre-existing conditions or had been infected by other dangerous bugs as well. Against a background death toll from seasonal flu of up to 500,000, the new H1N1 strain was invisible.
Professor Ulrich Keil, a World Health Organisation (WHO) adviser on heart disease, said the decision to declare a pandemic had led to a “gigantic misallocation” of health budgets. “We know the great killers are hypertension, smoking, high cholesterol, high body mass index, physical inactivity and low fruit and vegetable intake,” he told the Council of Europe. Yet governments “instead wasted huge amounts of money by investing in pandemic scenarios whose evidence base is weak”.
The suspicion that the response to the outbreak was an unnecessary panic has been spreading since the virus slipped from the front pages. Even the WHO, the UN body that first punched the big red button, may be having doubts. An external committee has been set up to review its reaction and will deliver an interim report this week, though at the moment no bombshells are expected.
The WHO faces two main charges. The first is that between the first cases of H1N1 being reported in March and the declaration of a full, phase 6 pandemic by its director-general, Dr Margaret Chan, in June, the organisation changed its definition of a pandemic. Critics say the old definition required that a virus result in “enormous numbers of deaths and illness”. The new definition applies only if the virus is new, if it spreads easily between people, and if the population has little or no immunity to it. A bug that causes a mild case of the sniffles could qualify.
A spokesman for the organisation insists there has been no change at all – that the old definition was an error on a single web page about bird flu, the last great influenza scare. But Peter Doshi, a doctoral candidate at MIT whose thesis is on science, politics and influenza policy, argued in a paper in the British Medical Journal in September that the old definition had been widely applied by the WHO since at least 2003.
The second charge, prominently made by Dr Wolfgang Wodarg, the former head of health at the Council of Europe, is that the WHO is unduly influenced by the drugs industry, which stood to make a fortune from selling anti-virals and vaccines. The Swiss giant Novartis, for example, saw its profits jump by nearly a third in the first quarter of this year to $2.95bn, much of it from delivering swine flu vaccines ordered last year. Debate rages over allegations that some experts who recommended the pandemic be declared, have links to drugs companies, although this has been denied. But critics note that it’s hard to become an expert in the field without having some funding from big pharmaceutical companies.
Others say that the problem is due to the spread of false assumptions. Most people think, for example, that when they have flu symptoms they must have influenza. But Dr Tom Jefferson of the Cochrane Collaboration, which reviews the evidence for various medical treatments, notes that more than 200 agents can cause flu-like illnesses. Only 7.5 to 15 per cent of cases are actually influenza. Anti-viral drugs and vaccines are aimed just at this group. “To stop one new case of H1N1, you’d have to inoculate 100 people,” says Dr Jefferson “or you could get four people to wash their hands.” Masks work too, he says, and so does sending people home from work if they have symptoms.
The usual justification for the massive response to H1N1 is that no one wants a repeat of the 1918 pandemic, which killed an estimated 50 million people. But scientists are not even sure if that plague was caused by influenza at all. The virus was not discovered until 1933. And outbreaks since then have been much milder.
The last time H1N1 showed up was in 1976, at a US army base. Washington ordered the immunisation of 40 million Americans before it discovered that it had only one death from the flu but hundreds of cases of severe side-effects to the vaccine. A review headed by Dr Harvey Fineberg put much of the blame on the “influenza fraternity”, arguing that expert panels tend towards “group think” and should be backed up by independent scientific advice. Dr Fineberg is now chairman of the WHO’s external committee evaluating its response to the 2009 outbreak whose final report next May could well lead to a radical rethink of the world’s reaction to new viruses.
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