BILL: Dave, you heard about this new drug, Nalmefene? Supposed to block brain signals that makes drinking feel good? The promise is that it can curb a drunk's urge to order another after s/he's had that barrier-breaking first shot?

DR. DAVE: "Nalmefene is aimed at reducing consumption without the abstinence that Alcoholics Anonymous and other treatment programs say is necessary," says Adron Harris, director of the University of Texas at Austin's Waggoner Center for Alcohol & Addiction Research . "This less-strict approach may drive more abusers to seek treatment for the first time."

BILL: Drunks like to say booze fills the hole in your belly. I think it's a hole in your heart and soul. How does a chemical fill that?

DR. DAVE: The actual hole that Nalmafene research does fill is the craving among a small group of scientists to develop a path to controlled drinking for alcoholics.

BILL: Where I agree with Adron Harris is that the notion of complete abstinence is so scary it does keep many a drunk from seeking treatment. Why are you so dead set against that?

DR. DAVE: Experience tells me a return to controlled drinking is the holy grail of virtually every alcoholic. The unstated promise behind Nalmafene is maybe you don't have to stop drinking at all. Listen, Bill, are you having a bit of longing yourself for some pill that would allow you to have that "occasional drink or two?"

BILL: Doc, is that what you hear in my interest in Nalmefene? The siren call of relapse? To dance once more with three martinis on the other side of the moon?

DR. DAVE: What I don't like is that Nalmefene's false promise undermines work on medications that actually do support a more comfortable abstinence.

BILL: Such as Naltrexone and Acomprosate?

DR.DAVE: Both already approved by the FDA to alleviate cravings.

BILL: I remember going through bouts of depression in rehab – a feeling I had to have a drink right now or die. One of those proven suppressants would have made it a lot easier to pay attention to aftercare group counseling sessions.

DR. DAVE: And that's where the new advances in medication are at their best! In fact, even in good Minnesota Model treatment programs we see rates of recovery in depressed alcoholics hovering around 30%. Add Naltrexone and a common non-abusable anti-depressant, Zoloft, to the treatment and those research rates jump up above 50%.

BILL: Whoa Doc—aren't you back to pushing pills rather than treatment? Instead of weeks in rehab, wouldn't the temptation be to just go get a prescription from your family doc?

DR. DAVE: The statistics are that doctors who mistakenly prescribe just anti-depressant medication to improve the symptoms of alcoholism are actually choosing the least effective course of treatment.

BILL: We've certainly seen a lot of celebs who actually died trying to find a chemical way out of their alcoholism or addiction—Corey Haim, Anna Nicole Smith, Judy Garland and the pinnacles of old time rock and roll—Janis Joplin and Jimi Hendrix.

DR. DAVE: Its called Combined Drug Intoxication, or CDI, and it comes from trying to mix drugs to "get a better high" without so many negative side effects...

BILL: What you are saying is that drugs like Nalmafene could actually be called "Denial in a Bottle?"

DR. DAVE: If family physicians reading us want to see the different medications that can be legitimately used to support an abstinence-based alcoholism recovery, they can go to this medication web site.

BILL: Run by the American Academy of Family Physicians, right? Dave, I have to tell you though, that with the holidays coming to an end, the research I'd like to see would be for those infomercial favorites--Fat Burner pills, followed by two tablets of Exercise-in-a-Bottle. Now, if there had been one to evaporate the contents of a full bladder, I would never have to leave the couch!

DR. DAVE: Well Bill, we've run out of space today; but I'll be glad to reserve next week's column for medication and eating disorders—just in time for your New Years' Resolutions.


Dr. David Moore is a licensed psychologist and chemical dependency professional who is a graduate school faculty member at Argosy University's Seattle Campus. Bill Manville is a Book of the Month novelist; his most recent work of non-fiction, "Cool, Hip & Sober," is available at online bookstores. Bill also teaches "Writing To Get Published" for Temple University and at writers.com.

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Alcohol is even worse than heroin and crack on the list of "most harmful" drugs, according to a new study published in the British medical journal, The Lancet.

A variety of social, physical and psychological problems that are caused by drugs were examined by a panel of experts, who concluded that alcohol, heroin and crack were the most harmful to others while heroin, crack cocaine and methamphetamine were the most harmful to individual users, CNN reported.

Dr. Petros Levounis, director of the Addiction Institute of New York at St. Luke's-Roosevelt Hospital, agreed with the study findings.

"Both in terms of the medical consequences as well as societal consequences, I agree that alcohol ranks very high in overall harmfulness,"he told the News. "Alcohol has tremendous repercussions in our society in terms of drunk driving and societal consequences.”

Twenty drugs were scored on 16 criteria – nine related to the harms that a particular drug does to an individual and seven to the harms a drug does to others. All the drugs were scored out of 100 points, and overall, alcohol came in the highest, at 72 points, according to The Lancet. Heroin came in second with 55 points and crack cocaine took third place with 54 points.

While cocaine and tobacco were found to be equally harmful, LSD and ecstasy were found to be the least harmful, according to BBC.com.

Funding for the study came from the Centre for Crime and Justice Studies in London.

The report in the Lancet was co-authored by Professor David Nutt, Britain's former chief drug policy advisor, who stirred up controversy last year when he wrote an article that said riding a horse was more dangerous than taking ecstasy, CNN reported.

Almost 17.6 million adults in the United States either are alcoholics or have alcohol problems, according to the National Institutes of Health.

But because alcohol is legal and easy to access, many people don't think it is a problem for them, says addiction expert Dr. Jeffrey Parsons, chair of the psychology department at Hunter College.

"It is legal and socially sanctioned, so it does not carry the same stigma and issues that illegal drugs do,"he says. "But the negative health consequences of alcohol are even greater than with many illegal drugs.”

Drinkers tend to equate "legal" with "safe," but that's not necessarily the case, says Lebanon Valley College psychology professor Lou Manza. "In the general public's mind, because you can go and buy alcohol in the store, it is okay,"he said.

One major difference between alcohol and other drugs, such as nicotine, is that there is a "safe"level of it for many people, Livados says. It's generally recognized that two drinks a day for men and one for women can be considered safe, with exceptions such as people with depression or anxiety, those with alcohol dependence and pregnant women.

"It's not the same with nicotine," Levounis says. "We have not been able to find a low threshold under which smoking cigarettes is safe. There's no such thing."

Alcohol dependence tends to be masked more often than dependence upon other drugs, Parsons says. "With alcohol, someone can feel like a law abiding citizen despite the fact that they're abusing a drug," he told The News.

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Alcohol abuse is the third leading cause of preventable death in the U.S., and it contributes to countless diseases, car crashes, injuries, and crimes.

How can we solve these thorny problems? Making booze more expensive might be a good start, a new study suggests.

Doubling the current state taxes on alcohol -- which would tack on as much as 50 cents to the price of the average six-pack or bottle of wine -- could be expected to reduce alcohol-related deaths by 35 percent, fatal car crashes by 11 percent, and the rates of sexually transmitted disease by 6 percent, according to the study.

Higher taxes on booze would also lead to 2 percent less violence and 1.4 percent less crime, the researchers estimate.

Health.com: Do you have a drinking problem?

"What is surprising is the consistency of the effect across a broad range of health outcomes that kind of don't have anything to do with each other," says Alexander C. Wagenaar, Ph.D., the lead researcher and a professor of epidemiology and health outcomes at the University of Florida, in Gainesville.

If state alcohol taxes were doubled, the tax on a six-pack or bottle of wine would increase by anywhere from a few pennies to 50 cents, depending on the state, and the tax on a standard bottle of liquor could go up by as much as a few dollars.

Health.com: Survey: More Americans drinking alcohol

Though modest, these tax hikes would add up over time and may ultimately curb the heavy drinker who's seeing his weekly alcohol budget rise, the college student stockpiling booze for a party, and even the social drinker.

"Studies show that all these groups respond to price," Wagenaar says.

Even a slight decrease in drinking could have a large impact on public health. If millions of people living in an area consumed half a drink less per week, on average, the small differences in alcohol intake -- and intoxication -- could lead to big drops in the area's overall injury and death rates, Wagenaar says.

There is some evidence that raising taxes can reduce unhealthy behaviors, even for people who are addicts. Increased taxes on cigarettes and other tobacco products have been shown to reduce smoking rates and influence heavy smokers to cut back or quit.

Health.com: How much money are you spending on cigarettes?

In the new study, which was published in the American Journal of Public Health, Wagenaar and his colleagues re-analyzed data from 50 studies that investigated the link between increases in alcohol taxes and the rates of drinking-related problems including death, diseases, car crashes, STDs, violence, crime, and suicide. Most of the studies, which were conducted between 1955 and 2004, looked at alcohol tax increases in American states.

One of the studies -- led by Wagenaar himself -- focused on Alaska, one of the few states to have implemented substantial alcohol tax increases. The researchers found that the state's alcohol-related deaths dipped in 1983 and 2002, immediately following tax increases. The 1983 increase, which upped the tax on a bottle of beer from four to six cents, was associated with 23 fewer deaths -- a 29 percent drop.

Alcohol abuse has been linked to an increased risk of liver disease, heart disease, stroke, depression, and some cancers, in addition to causing the impaired judgment that leads to risky sexual behavior and drunk driving.

Sara Markowitz, Ph.D., an associate professor of economics at Emory University, says that even small increases in the price of alcohol are likely to result in measurable gains in public health and safety.

Some health problems are likely to respond more than others to a tax increase, depending on how closely linked they are to alcohol abuse.

"The proportion of crime and suicide that are alcohol-related would be far smaller than diseases such as liver cirrhosis," says Markowitz, who has researched alcohol taxes but was not involved in the new study.

Indeed, the only health measure in Wagenaar's analysis that did not show a significant drop following higher alcohol taxes was suicide.

Health.com: Booze, drugs, and bipolar disorder

Higher taxes on alcohol could provide a much-needed source of revenue for state and local governments reeling from budget shortfalls and cost-cutting. But the willingness of elected officials to increase the tax on alcohol is questionable, says David Jernigan, Ph.D., an associate professor and alcohol policy expert at the Johns Hopkins School of Public Health.

Alcohol tax increases have lagged behind the inflation rate since the 1950s, which Jernigan attributes to the nation's anti-tax climate. There have been very few federal and state alcohol tax hikes in the past several decades, he says, and states like California and Maryland that have proposed increases have faced opposition from the restaurant and beverage industries.

What's more, a proposed tax increase during a sluggish economy would almost certainly be unpopular among drinkers, including those who limit their intake to the occasional glass of white wine and those who'd never dream of getting behind the wheel after drinking.

Health.com: Is drinking actually good for you?

But boosting the tax on alcohol would be a "win-win for government" by increasing revenue and decreasing costs, Jernigan says.

In Maryland, Jernigan has estimated, a 10-cent-per-drink tax increase would save the state $214 million in healthcare costs and generate $249 million in revenues, in addition to reducing alcohol consumption by 5 percent.

"In terms of the analysis we did, there's nothing that makes Maryland stand out from other states," Jernigan says.

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Here's mud in your eye, or at least vodka.

The latest ridiculous (and health-endangering) drinking stunt to gain popularity among college students is called "vodka eyeballing," where buzz-seeking partiers tip back their heads and have a shot of vodka poured directly on the eye.

The trend is believed to have originated at Las Vegas nightclubs, as waitresses, hungry for tips, performed this cheap trick. Since building momentum in the U.S., vodka eyeballing has gained a foothold in the U.K. and Scotland, reports the Daily Mail’s Barbara Davies.

YouTube features more than 800 clips of vodka eyeballing. There’s even a Facebook page devoted to the craze — and it has over 100 fans.

Vodka eyeballers claim to experience an instant high and deeper inebriation. Their medical rationale: The alcohol passes easily through the mucous membrane and enters the bloodstream through veins at the back of the eye for a quicker buzz than drinking.

While doctors have dismissed this reasoning, they are deeply concerned about long-term damage, like permanent scarring and deteriorating vision.

"In the past, vodka has been used as a disinfectant," Prof. Robin Touquet, a consultant in emergency medicine at St. Mary’s Hospital in Paddington, U.K., told the Daily Mail. "At 40% proof, imagine what it can do to an area as sensitive as the eye? It is highly toxic."

But, immune to sensible thinking and urged by peers to compete, students act recklessly and with disregard to the consequences.

Melissa Fontaine, a former university student and prolific vodka eyeballer, is troubled by a constantly watering eye and worries about future side effects.

“I'm in constant pain because of what I did,” Fontaine told the Daily Mail. “I'm terrified that it will get worse. I wish I could turn the clock back and change things. But I can't.”

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