Zé Pedro, from the Portuguese rock group “Xutos e Pontapés”, spoke in the first person during the talk “Alcohol and Health”, accompanied by Professor Rui Tato Marinho (ex President of the Portuguese Association for the Study of the Liver and Hepatologist at Santa Maria Hospital) and by Dr Manuela Sousa, (from the “Olá Jovem” Welcome Centre).

This last talk in the “Faculty of Medicine of the University of Lisbon Students’ Association Cycle of Talks”, took place on the 2nd of June last and was dedicated to an issue that is sufficiently interesting to captivate students, doctors and the laymen, given that the causes associated to the excess consumption of alcohol are an increasingly prevalent and crucially important problem both on the social level and in terms of clinical practice.

Professor Rui Tato Marinho, attributing the curious title “The Benefits of Alcohol” to his presentation, brought to the debate the main cause of mortality in Portugal in the age group of the majority of people present in the hall.

Although he is currently closely connected in practice to the consequences of the consumption of alcoholic drinks on the level of hepatic illness, he did not come to only talk about the evils of consumption, but proposed to focus on only three points considered to be very important in the current National Plan for the Reduction of Alcohol-Related Problems. He thus began his talk by clearly stressing from the outset that he has no conflict of interests with alcohol, even stating that he enjoys some drinks.

Yet at the moment when he defined the size of the problem he stated that, in his own words, “Portugal is a country that lives bathed in alcohol.” That is, it is one of the countries where per capita consumption is among the highest, reaching eighth place worldwide and geographically on a continent with the impressive figures of eleven litres per year per inhabitant.

Although liver disease is not only caused by excess consumption of alcohol drinks, this risk behaviour along with hepatitis (particularly C and B) make it one of the most lethal in Europe, causing about eight times more deaths than AIDS.

The current tendency is for the so-called “feminization of alcoholism”, with there also being a tendency for binge drinking (5 to 6 spirits for men or 4 to 5 in women consumed in a short space of time, usually two hours or less).

This risk consumption corresponds to a pattern that provokes harm if it continues; and which increases the risk of several illnesses, accidents, lesions, mental disturbances or of behaviour, with it being possible to lead to early death. It has adverse consequences that are much worse than the chronic alcoholism to which we had become accustomed, as it is intimately related to an increase in violence, in death on the road, in suicide, in risk sexual behaviour, heart attacks through arrhythmias and often alcoholic coma.

One of the proposals of the National Plan for the Reduction of Alcohol-Related Problems is precisely that of reducing the alcohol in the blood rate among young people or among professionals, yet here are many points that might be controversial in this document, particularly the issue of the application of the alcohol level at 0.2 for young people, the question of 18 years old being the lower age limit for alcohol consumption and the matter of direct or indirect advertising of alcoholic drinks.

In practice one can say that in accordance with one of the graphs presented, the difference between consumption of 1 to 2 shots is that the risk of death on the road increases 7 to 8 times (from 700% to 800%) in boys and to double in girls, meaning that the results have an influence on the decision to dramatically alter the law.

The question of the minimum age limit was also based on decisions founded on scientific studies. The safest age would be 21, but not to be too extreme, other ages could be accepted.

One of the conclusions presented was the fact that those who start alcohol consumption during adolescence (from about 13 or 14 years old) has a greater chance of suffering the consequences at an adult age, highlighting the risk of the development of dependence. According to the tendency revealed, going from 16 to 18 years old as the minimum age for the legal consumption of alcohol would be a form of reducing this risk.

The limits proposed in relation to advertising have echoes in other countries, like the United Kingdom. There is a parallel curve between investment in advertising and consumption among young people, and for that reason prohibition in relation to advertising should follow the same path as that which appeals to smoking tobacco.



This talk also warned about the fact that over-consumption of alcohol has similar consequences for society in general, not being limited only to the drinker. The noxious and dangerous patterns of alcohol consumption have significant consequences on the field of public health, thus having negative effects on society and being one of the main causes of premature death and death by avoidable illnesses.

To finish off, he left some indispensable advice aimed at the audience, highlighting the beginning of alcohol consumption at 18 years old; never drinking when driving; never drinking more than two or three alcoholic drinks per day; and taking the greatest care in relation to information and advertising.

Following this Dr. Manuela Sousa, a specialist in Family Medicine, currently working in the Damaia Health Centre, was invited to speak.

In 2001, after having completed a post-graduation course in Medicine in Adolescence, she was the co-founder of and, since then, coordinator of the Welcome Centre for Adolescents of the Borough of Amadora called “Olá Jovem”, about which she was invited to talk at this session.

In order to sum up the aims of the institution she coordinates in a synthetic and brief manner, she highlighted the promotion of health among adolescents between 12 and 21 years old, trying to instil healthy lifestyles in them and guaranteeing them with continued care.

This project greatly depends on improvement in access for adolescents to health care, given that at the moment there is a precarious situation in this specific area, where she stresses the need for confidentiality in primary health care and only afterwards do privacy, free consultations and other components become important.

The solution involves the “bio-psycho-social” approach through a working group acting through a specific model and with the same aims. The “Olá Jovem” Centre is therefore made up of a multidisciplinary team, including not only doctors but also nurses, a psychologist and a sociologist, functioning in an open geography. It is in this sense that it is necessary to go out to meet young people in the community.

In relation to the harmful and dangerous patterns of alcohol consumption, several items of information were given out, with the conclusion that despite the recent National Plan for the Reduction of Alcohol-Related Problems, there is no shortage of tutelage, but what is lacking is surveillance.

According to the experience of the “Olá Jovem” Centre, weekend binge drinking was focused as a risk factor, namely when related to the practice of sex without precautions by young people who for the rest of the week have exemplary behaviour in that specific aspect but when under the effects of alcohol are led to commit the most series attacks on their health through high risk behaviour patterns.

There was also the presenting of a work relative to the school project area on alcohol, by three participants in the “Olá Jovem” Centre. This work was headed by Professor Anabela Alvejado, and was subordinated to the subject “Young People and the Night”, with a critical analysis on risk behaviour linked to nighttime entertainment activity and some proposals for changing attitudes.

On the last panel, named “First Person Testimony”, the guitarist and founder of the Portuguese rock band “Xutos e Pontapés” - Zé Pedro – proposed to transmit, with the help of Professor Rui Tato Marinho, his statement on a past related to harmful and dangerous consumption of alcohol and drugs. He turned out to be an exceptional communicator, holding the audience with his respective life story, namely, that is, until he was committed to hospital, nine years ago, due to health complications including internal haemorrhaging and a hepatitis as a result of risk behaviour.

The essential aspect of the message was not so much in the sense of young people avoiding harmful and dangerous routine or cultural consumption, but for them to take maximum care, through the information that is available today and to learn from their own experiences. He also considered that the common notion that one should try everything in life is not the most correct one, rather to the contrary. He advised young people to carefully choose that which is good for them and how far they should establish the respective limits.

His main message was that of granting young people with the wisdom to say no and to know when to stop, even when they are among their own friends. That would be one of the essential trump cards in order to avoid going beyond the limits of the acceptable. As for the stimuli for the brain and for compensation for routine or frustration, he explained that they can be found through other processes, and on this matter he transmitted several hilarious examples that greatly amused the audience.

The dialogue that followed would serve to clarify the doctor/patient relationship in the treatment and recovery from alcoholism and of the consequences of risk, harmful and dangerous consumption (particularly among young people), the role of nurses and doctors in hospitalisation, the example of icons for adolescents, the limits that should not be crossed, the advantages or moderate consumption and the direct testimony on transition from excess consumption to abstinence.

He even suggested a stimulus for a possible future reflection on the “Rally das Tascas” [Pub Crawl], the “Freshman’s Week” and other traditional activities in academic life in which harmful consumption of alcohol is encouraged and is very popular, leading many students to go beyond the limits.

 

Editorial Team
news@fm.ul.pt