April 2017 | Vol 39 | No. 2 | ISSN 1351-054
In this issue 1
Editorial
2
Alcohol misuse in people with mild to moderate learning disabilities living in the community by Christos Kouimtsidis, Katrina Scior, Gianluca Baio, Rachael Hunter, Vittoria Pezzoni and Angela Hassiotis
4
Enough of the blame; lets talk about shame by Dr Francesca Sawer, Dr Kate Gleeson and Dr Paul Davis
5
MCA 2017 Nurse Symposium
6
MCA 2017 Symposium
7
Symposium programme
8
NAAD Competition details Latest Open Access Journal article Call for Regional Advisers
From the Editor In this issue... Welcome to the April 2017 issue of Alcoholis. Part of the MCA mission is to increase knowledge and understanding of the effects of alcohol Dr Dominique Florin on health, an area of Editor medicine often not given its due weight. In this issue, we have included two articles which focus on neglected areas within this already neglected topic. In an article from the University of Surrey, colleagues raise the issue of shame. Whilst shame has been used as a message in some public health campaigns to demonstrate the negative effects of excess alcohol consumption, these authors suggest that feelings of shame may actually pre-date alcohol problems and may in fact be causative. They propose that the effectiveness of recovery approaches such as AA could be due to the way in which they address issues such as blame and shame. So perhaps the emphasis on shame in some public health campaigns is misplaced. In a second article, colleagues from Surrey and borders NHS Foundation Trust looked at a group which often falls below the radar – those with learning difficulties. Their study was designed to research the feasibility of an RCT of brief interventions for alcohol in those with LD. A number of preliminary findings emerged. Firstly the rate of alcohol misuse seemed to be lower than in the general population, but this may have been due to incomplete ascertainment. Secondly, perhaps because of this, recruitment to the study was difficult. Thirdly however, brief intervention did seem to be both acceptable and effective in this group.
translation and ensuring policy making is informed by the experiences of the wider community. The key note speech was given by Professor Dame Til Wykes, who has been instrumental in developing the inclusion of user perspectives in research and recounted how to achieve meaningful user involvement despite a range of practical difficulties. Simon Denegri , National Director for Patients and the Public in Research at the NIHR, left no doubt as to the importance policy makers now give to this area. Most striking was the enormous value placed on user involvement by the various and varied individual and groups of users and researchers who were present on the day. Also at the conference, the formal announcement was made of the merging of ARUK with Alcohol Concern. We wish the new organisation well. Historically, an element of the MCA’s work has been around the support for doctors in difficulties from alcohol use. Whilst the MCA has never offered support directly, it has had a signposting and educational role and our various Committees have benefited from the input from a number of doctors in recovery. As such the MCA has been a supporter of the Practitioner Health Programme, which since 2008 has offered support for doctors with mental or physical health problems and addiction. Their funding has been principally for those in the London area, however earlier this year the PHP was awarded a contract to offer services for GPs with mental health or addiction problems throughout England. This is an exciting development, particularly as GPs often fall outside the usual occupational health channels. This new service was introduced to the delegates at the PHP Physician Health Conference
News from recent conferences
Contact details The Medical Council on Alcohol 5 St Andrews Place, London NW1 4LB T: 020 7487 4445 | E:
[email protected] W: www.m-c-a.org.uk
[email protected] @mca_med Registered Charity Number 265242
Alcohol Research UK held its annual conference in London last month, entitled ‘Working Together: people, practice and policy in alcohol research’ . The focus was on including service user voices in research. Key issues addressed included the way in which those seeking to address alcohol harm can better understand each other’s perspectives, bringing the experience of those affected by alcohol harm into research development, supporting service providers in research | APRIL 2017 | 1
held in London last month and there was much lively discussion about the issues concerning both clinical and regulatory aspects. MCA 2017 events This year marks the 50th anniversary of the MCA. In this issue we outline the special anniversary symposium on the 15th November
at BMA House. We are also planning a Witness Event the preceding day at which some of the very earliest and most long standing MCA members will be able to share their experiences over the last 50 years. This will be followed by a special anniversary dinner. Finally for the first time on the MCA’s history, we have organised a conference particularly aimed at nurses on the theme of alcohol and health. We very much hope to see members and new faces at some of these events which are outlined in this issue and on the MCA website.
Alcohol misuse in people with mild to moderate learning disabilities living in the community; lessons from the Extended Brief Intervention in learning disabilities (EBI-LD) feasibility study By Christos Kouimtsidis, Katrina Scior, Gianluca Baio, Rachael Hunter, Vittoria Pezzoni, Angela Hassiotis - Surrey and Borders Partnership NHS Foundation Trust
T
he extent of the problem. Alcohol misuse affects over 24% of the adult population in England (NICE, 2011), with over 1 million hospital admissions related to alcohol misuse in 2013/14—a 5% increase to the previous year’s estimates (NHS, 2015).
Given the magnitude of the problem it is expected that different subgroups of the population might be more or less affected, depending on the presence or absence of risk and protective factors. One of those population groups might be people with learning disabilities (LD). In order to meet criteria for a LD, an individual must show a significant impairment in their cognitive functioning (defined as a full scale IQ below 70, or in some classificatory systems 75), alongside a significant impairment in their adaptive functioning, both of which must have their onset during the developmental period (American Association on Intellectual and Developmental Disabilities, 2010). The closure of the vast mental health hospitals for people with LD and the implementation of policies that have social inclusion at their heart, means that most people with LD now live in the community and are likely to be exposed to alcohol or other substances in their social networks as well as consuming them (Lin et al, 2016). People with LD are considered more vulnerable than the general population. Aetiological factors which have been postulated to contribute to use of substances in people with mild to moderate LD include hyperactivity, lack of assertiveness, low self-esteem, susceptibility to peer pressure, desire for social acceptance, social isolation, early onset of drinking and lack of example setting in childhood. Substances may also be taken as a maladaptive way of relieving stress or developing relationships within local communities (McLaughlin et al, 2007). On the other hand these people might live in a supported environment that protects them from alcohol misuse. UK and USA population based studies indicate that the prevalence of substance misuse ranges from 0.5% and 2.5% (Hassiotis et al, 2008) and may be as high as 18% (Adult Psychiatric Morbidity Survey, 2014), or even 22.5% for alcohol in clinic samples (Pezzoni & Kouimtsidis, 2 |APRIL 2017 |
2014). Approximately 5% of youths in drug and alcohol services have a degree of LD (Barrett & Paschos, 2006). The commonest substances that people with mild to moderate LD tend to use are alcohol and cannabis. Those most at risk are young males with mild intellectual disability or borderline intellectual functioning (defined as an IQ between 1 and 2 standard deviations below the mean) who live independently or with minimal support in the community and are less likely to engage in activities and more likely to experience mental health problems (Barrett & Paschos, 2006; Lin et al, 2016). Previous treatment approaches People with LD have cognitive deficits that impair their ability to learn or generalise new learning. Difficulties include articulating emotional states, limited understanding of abstract concepts, delay in processing and retrieving information. Furthermore, a person with LD is likely to have reduced vocabulary, and he or she will probably be more suggestible when provided with negative feedback (Everington & Fuller, 1999). People may also try to mask their difficulty in understanding and following verbal communication by drawing on social skills and set phrases that they know are contextually appropriate responses (Hassiotis at al, 2012). In order to compensate for such impairments, psychosocial therapies, existing or newly developed, require a number of adaptations in the way that the treatments are delivered as well as in the content of the sessions. Central to the adaptations are use of role play and materials in easy read formats, appropriate language to the person’s understanding, sessions may need to include breaks and the person may need to be supported by a family or paid carer in order to complete any related homework (Hassiotis at al, 2012). A variety of approaches have been tried, for the treatment of alcohol disorders for this population, such as education about the risks
associated with substance misuse, motivational interviewing, behavioural modification, adaptation of materials by AA or similar organisations with interventions mostly delivered in group settings (Degenhardt, 2000; Mendel & Hipkins, 2002). The EBI-LD study This study assessed the feasibility of conducting an RCT to evaluate the clinical and cost benefits of extended brief intervention (EBI) and usual care for adults with mild to moderate LD. To our knowledge, this study is the first to employ a design for complex interventions to adapt and test EBI in this population (Kouimtsidis et al, 2015). The study took place in three community LD services in England. Participants aged 18-65 years with reported alcohol problems, a score >8 on the Alcohol Use Disorder Identification Test (AUDIT), and IQ8). At 8 weeks, the proportion of participants with harmful drinking decreased to 60% for both groups, at 12 weeks it was decreased by 66·7% and 46·7% for the intervention and the control group respectively. The unit cost for the delivery of EBI is £430. Seven participants in the intervention group were interviewed about their experience of receiving EBI. Interviews were conducted approximately three weeks after treatment. The study service user reference group members assisted with the interviews to facilitate participant openness. With respect to the acceptability of the intervention, the participants reported gaining a good understanding of the consequences of alcohol misuse and of the strategies to avoid harmful drinking. Our participants reported that recording the quantity of alcohol consumed proved effective in reducing their intake. The lack of support from staff was reported as a barrier to homework completion. Seven carers (five professionals and two family carers) were asked to complete a survey exploring their experience of the research. Their views on alcohol misuse within people with LD was mixed. Most carers felt the research questionnaires were either very easy or easy to understand. One carer felt that the participant she supported struggled to give accurate answers, another was surprised about the amount of drinking reported. Two carers of people who did not complete therapy discussed the reasons: one felt that therapy made the participant crave alcohol, the other felt that the participant could not complete his therapy due to anxiety and depression. Conclusions The above recruitment challenges raise question whether the prevalence of alcohol misuse in people with LD is indeed low or whether those who misuse alcohol are not diagnosed as having alcohol misuse. It could be argued that service users of specialist services living in staffed supported accommodation have less
Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2014 [NS]. http://content.digital.nhs.uk/ catalogue/PUB21748 Alcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence. London: National Institute for Health and Care Excellence, 2011. https://www.nice.org. uk/guidance/cg115/chapter/Introduction American Association on Intellectual and Developmental Disabilities (AAIDD) (2010). Intellectual Disability: Definition, Classification, and Systems of Supports (11th ed.). Washington: AAIDD. Barrett, N., Paschos, D. (2006). Alcohol-related problems in adolescents and adults with intellectual disabilities. Current Opinion in Psychiatry, 19, 481-5. Degenhardt, L. (2000). Interventions for people with alcohol use disorders and an intellectual disability: A review of the literature. Journal of Intellectual and Developmental Disability, 25, 135-46. Everington C. & Fulero S. M. (1999) Competence to confess: Measuring understanding and suggestibility of defendants with mental retardation. Mental Retardation, 37, 212–220. Hassiotis, A., Strydom, A., Hall, I., et al. (2008). Psychiatric morbidity and social functioning among adults with borderline intelligence living in private households. Journal of Intellectual Disabilities Research, 52, 95–106. Hassiotis, A., Serfaty, M., Azam, K., Martin, S., Strydom, A., King, M. (2012). A Manual of Cognitive Behaviour Therapy for People with Learning Disabilities and Common Mental Disorders. Therapist Version. www.ucl.ac.uk/psychiatry/cbt/downloads/documents/cbtid-manual Kouimtsidis, C., Fodor-Wynne, L., Scior, K., et al. (2015). Extended brief intervention to address alcohol misuse in people with mild to moderate intellectual disabilities living in the community (EBI-ID): study protocol for a randomised controlled trial. Trials, 16, 114. doi: 10.1186/s13063-015-0629-x Lin E, Balogh R, McGarry C, Selick A, Dobranowski K, Wilton AS, Lunsky Y. Substance-related and addictive disorders among adults with intellectual and developmental disabilities (IDD): an Ontario population cohort study. BMJ Open 2016;6(9):e011638. doi: 10.1136/ bmjopen-2016-011638. McLaughlin D, Taggart L, Quinn B, Milligan V. The experiences of professionals who care for people with intellectual disability who | APRIL 2017 | 3
have substance-related problems. Journal of Substance Use. 2007; 12:133-143.
community service. Journal of Intellectual Disability Research, 59, 353-359.
Mendel, E., Hipkins, J. (2002). Motivating learning disabled offenders with alcohol related
Statistics On Alcohol, England, 2015. National Health Service-Digital, 2015. http://content.digital.nhs.uk/catalogue/PUB17712.
problems: a pilot study. British Journal of Learning Disabilities, 30, 153–155. Pezzoni, V., Kouimtsidis, C. (2015). Screening for alcohol misuse within people attending a psychiatric intellectual disability
Enough of the blame; lets talk about shame Dr Francesca Sawer, Dr Kate Gleeson and Dr Paul Davis- University of Surrey
W
hile alcohol is often marketed as a luxurious and glamorous product, the over-consumption of alcohol tends to be viewed negatively
Media campaigns aimed at targeting ‘problem drinking’ tend to portray heavy drinkers as lacking self-control and as coming from a working-class background (Watts, Linke, Murray & Barker, 2015). A prominent public health campaign in 2008 portrayed people with ripped clothes, covered in vomit and urine accompanied by the strapline ‘you wouldn’t start your night like this, so why end it that way?’ Whilst this advertisement was presented as ‘warning’ of the dangers relating to binge drinking, it was ultimately conjuring an image of public shame and humiliation of those who drink to a point of no control. Likewise, whilst celebrities are portrayed in glamourous contexts consuming alcohol, where alcohol addiction becomes visible they experience a humiliating fall from grace. Is society’s attempt to shame and blame the person who overconsumes alcohol an effective strategy to tackle alcohol abuse? As psychologists much of our work involves trying to help people overcome feelings of self-blame and criticism; or in other words undoing the damage that can be caused by blame. We often find ourselves feeling infuriated by the blame and criticism culture and instead start to try to understand what is behind the addiction and ask why a person has arrived at where they are now. Over the past few years we have taken the time to speak with those who are in recovery from alcohol dependence and given them the opportunity to tell their story of what contributed towards their development of an addiction and what factors they believed helped and hindered them during the process of their recovery. In a recent research study conducted by the authors, a comprehensive narrative analysis explored both what was talked about and also how these stories were told, by those in the recovery process (Sawer, Gleeson & Davis 2016). Whilst this method was very much focused on the idiosyncratic nature of people’s narratives, we found that there were also some striking similarities across narratives in relation to shame. Within the literature, shame has often been proposed to increase a person’s vulnerability to developing an addiction to substances (Dearing, Stuewig & Tangey, 2005) and our study would also suggest that shame is likely to play an important role in alcohol dependence. Unlike previous research, however, that has suggested that alcohol addiction is maintained because of the ‘shameful’ things one does whilst intoxicated (Wiechelt, 2007), our study found that shame was much more deep rooted. Shame was not about behaviour (feeling bad about something you did is guilt, not shame), but rather an internalised view of themselves as being unworthy, abnormal and inferior to others. It was an entrenched view about who they were as a person rather than about what things they had done. We found that shame usually predated the use of alcohol, but alcohol was a powerful tool in helping mask painful feelings associated with shame. On exploring the process of recovery, again we found stark similarities in relation to overcoming shame. All participants in the 4 |APRIL 2017 |
study attended Alcoholic Anonymous (AA), which provided a safe and secure base in which the exploration of oneself could begin. Everyone spoke about how acknowledging their shame was part of their recovery; however we found that being able to do this in a forum that was non-blaming was vital. AA was described as a place which provided a connection to others who have been through the same experiences and living with the same daily challenges. It was understood as a place that removes judgement, stigma and most importantly the blame. When there is no blame it seems that people are able to acknowledge their shame and start to see themselves as worthy; someone who is not defined by their addiction alone. Psychological Interventions for overcoming shame also exist outside of AA; for example Gilbert and Procter’s (2006) “compassionate mind training for people with high shame and self-criticism”. The results from this study suggest that treatments for shame could easily be incorporated into general treatment programmes for alcohol dependence. So, instead of blaming, it makes more sense to see those who are addicted to alcohol as people who are most likely to be experiencing painful internalised feelings of shame and who do not need to be made to feel worse about this. Perhaps public shame, humiliation and blame are factors that maintain someone in alcohol addiction rather than motivate them to change their behavior. Could future public health campaigns help people to better understand their own behavior, rather than increase their need to avoid thinking about it? References Dearing, R.L., Stuewig, J., & Tangney, J.P. (2005). On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use. Addictive Behaviors, 30, 1392-1404. Gilbert, P., & Procter, S. (2006). Compassionate mind Training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy, 13, 353–379. Sawer, F., Gleeson, K., & Davis, P. (2016). The role of shame in alcohol dependence; Narratives from those in recovery. Poster presentation at the Society for the Study of Addiction annual conference, York. Watts, R., Linke, S., Murray, E., & Barker, C. (2015). Calling the shots: Young professional women’s relationship with alcohol. Feminism & Psychology, 0, 1-16. Wiechelt, S.A. (2007). The spectre of shame in substance misuse. Substance Use and Abuse 42 (2-3), 399-409.
2017 Nurses Symposium Date: Tuesday, 12th September Location: Friends House, 173 Euston Road, London NW1 2BJ CPD: 4 (TBC) Cost to Attend: £50 (MCA Members) / £55 (Non Members)
Nurses and Alcohol: What should we be doing for our patients with alcohol related health harm? Alcohol affects patients in every part of the health service. Nurses have an increasingly important role to play in hospitals, in specialist services and in the community in caring for these patients, but often opportunities for action are missed. It is important to make every health care contact count. The Medical Council on Alcohol is an independent educational charity. Our vision is to have a workforce of health professionals educated and supported to reduce health harm from alcohol. For the first time we are running a conference aimed particularly at nurses from all specialties, in recognition of the vital contribution this group can make to improving the lives of patients with alcohol related problems. This conference will present material for all nurses to improve the care they offer to patients with alcohol-related problems. We will focus on the whole patient, including public health and prevention, physical aspects especially the liver, mental health and dual diagnosis and engaging harder to reach groups. This is a unique educational event for nurses from all backgrounds in an area which is frequently neglected. 09.45 - 10.00
Registration & Morning refreshments
10.00 - 10.15
Welcome, Dr Dominique Florin (MCA Medical Director) & Mr Adrian Jugdoyal
10.15 - 10.45
Alcohol & Public Health (Keynote Speech), Ms Joanne Bosanquet
10.45 - 11.00
Mid Morning refreshments
11.00 - 11.30
NCEPOD Report – 3 years on, have we made a difference?, Dr Anne McCune
11.30 - 12.00
Alcohol & Liver Disease, Ms Lynda Greenslade
12.00 - 13.00
Lunch (Great chance to meet the exhibitors)
13.00 - 13.30
Interactive Q & A
13.30 - 14.00
The complexity of addressing the needs of people with dual diagnosis, Daniela Collins
14.00 - 14.15
Afternoon Refreshments
14.15 - 14.45
Taking the opportunity to make a difference, Mr Adrian Brown
14.45 - 15.15
Reaching patients who don’t use Alcohol Services, Dr Mark Holmes
15.15 - 15.30
Final Word, Dr Dominique Florin (MCA Medical Director) & Mr Adrian Jugdoyal
To book you can...... [1] Book via the website (www.m-c-a.org.uk) and pay via Paypal [2] Download and fill in a booking form from the website and return it to the MCA via e-mail (
[email protected]) or post to MCA, 5 St Andrews Place, London, NW1 4LB along with a cheque [3] Download and fill in a booking form from our website and return it to the MCA via email (
[email protected]) then the MCA can invoice your organisation (remember to include a purchase order number) | APRIL 2017 | 5
2017 Symposium Date: Wednesday, 15th of November Location: BMA House CPD: 4 (TBC) Cost to Attend: £75 for MCA Members) / £95 for Non Members £85 for non member nurse or PAM / £40 Student or Retired
Alcohol & Medicine; past present & future The MCA holds an annual symposium on an aspect of alcohol related health harm. Over the years we have covered a wide range of topics from alcohol related brain damage to alcohol and the elderly to occupational health and many others. The numbers of attenders has grown every year from a widening range of disciplines. On 15th November 2017, on the 50th anniversary of the MCA, we are holding a symposium on Alcohol and Medicine; past present and future at BMA house in London. In keeping with our approach, we are delighted to have world class speakers covering the key areas of alcohol related harm and effective management. The opening talk will be given by MCA president Professor Sir Michael Marmot on public health and epidemiology. The Max Glatt memorial lecturer will be Professor Jonathan Shepherd who has had a ground-breaking career linking from accident and emergency departments to other sectors to prevent alcohol related harm. During the day there will talks by leaders in their fields on the liver, on medical treatments, on psychological therapies and on neuropsychiatric approaches in relation to alcohol. A unifying and unique feature of the MCA symposium is its appeal across specialties and across disciplines, to practionners, researchers and students. This historic symposium will be of interest to health professionals from all backgrounds who are interested in addressing alcohol related health harm.
Why Attend? Great networking potential with a range of different healthcare professionals with an interest in alcohol related health harm CPD approved educational event Cross-specialty programme delivered by internationally known expert speakers Meet a range of exhibitors showcasing the latest products and innovations To book you can...... [1] Book via the website (www.m-c-a.org.uk) and pay via Paypal [2] Download and fill in a booking form from the website and return it to the MCA via e-mail (Emma.
[email protected]) or post to MCA, 5 St Andrews Place, London, NW1 4LB along with a cheque [3] Download and fill in a booking form from our website and return it to the MCA via email (Emma.
[email protected]) then the MCA can invoice your organisation (remember to include a purchase order number) 6 |APRIL 2017 |
Symposium Programme 9.00- 9.35 9.30 – 9.35 9.35 – 9.45 9.45 – 10.15 10.15 – 10.45
10.45 – 11.05 11.05 – 11.15 11.15 – 12.05
12.05 – 12.15 12.15 – 14.00
Registration & refreshments (tea, coffee & pastries) Welcome, Professor Colin Drummond Alcohol & Medicine; past present & Future, Dr Iain Smith (Chair) Alcohol and inequalities in health Professor Sir Michael G Marmot Alcohol and psychological interventions Professor Alexandre Copello Mid-Morning Break (Lutyen Suite) Welcome, Professor Colin Drummond Max Glatt Lecture: From Alcohol Harm Reduction to Government Reform Professor Jonathan Shepherd Max Glatt Medal presentation Lunch (Lutyen Suite)
Events during lunch: Anderson Room 12.15 – 12.45 MCA Regional Advisors Meeting Events during lunch: Great Hall 13.30 – 14.00 MCA AGM (Great Hall) *MCA members only Events during lunch: 13.00-14.00 Support for health professionals with substance misuse and in recovery. Details TBC 14.00 – 14.15 14.10 – 14.15 14.15 – 14.45 14.45 – 15.15
15.15 – 15.45 15.45 – 15.50 15.50 – 16.20
Tea & Coffee (Great Hall) Welcome, Dr Iain Smith Alcohol, liver disease and dinosaurs: evidence and alcohol policy Professor Nick Sheron Characterising the neuropharmacology of alcoholism to inform treatment Professor Anne Lingford-Hughes Alcohol treatment and mental health Dr Jane Marshall Close of Symposium, closing address by Dr Iain Last chance to see exhibitors and have refreshments in the exhibition hall | APRIL 2017 | 7
2017-18 NAAD Competition Alcohol: cancer’s best kept secret?
How to Submit an article We welcome articles from all healthcare professionals. If you would like to submit an article please either email the article to
[email protected] or contact us directly:
POSTER COMPETITION
Tel:
The competition is to design a poster for the general public which shows the link between alcohol and cancer. The posters need to be in JPEG format and high resolution to size (300dpi). Full details are on our website.
By Post: MCA, 5 St Andrews Place London, NW1 4LB
*Entrants must be current medical or nursing students in the UnitedKingdom.
The winning entrants will receive: 1st Place
£500
2nd Place
£400
3rd Place
£300
Runners Up (max 3)
£100
0207 487 4445
Latest ‘Alcohol & Alcoholism’ Journal News Assertive Community Treatment For People With Alcohol Dependence: A Pilot Randomized Controlled Trial By Colin Drummond, Helen Gilburt, Tom Burns, Alex Copello, Michael Crawford, Ed Day, Paolo Deluca, Christine Godfrey, Steve Parrott, Abigail Rose, Julia Sinclair, and Simon Coulton https://academic.oup.com/alcalc/article/52/2/234/2660942/Assertive-Community-Treatment-For-People-With
Call for Regional Advisors
The MCA will print the top 6 posters on A2 and there will be an exhibition of these posters at the MCA Annual Symposium. All winners will be given a free place at this event.
The MCA has a network of Regional Advisors across the country. The RA’s are academics and clinicians linked to the medical schools in their area and are a vital part of the MCA remit to ensure good education of alcohol related issues to students. At present the MCA is looking for RA’s for the following areas:
Deadline: 1st of July 2017
East Anglia
To apply send your poster entries to:
Leeds
[email protected]
Leicester
In your email please remember to include the following:
London (Kings College Hospital) London (St George’s Hospital)
Full name University/ Medical School / Nursing School Name of course and year of study Contact telephone number Contact address
Plymouth If you would like to know more about the role please contact the Medical Director via email:
[email protected] (You do not have to be an MCA member to volunteer for this role)
Alcoholis, the quarterly bulletin for health care professionals, is published by the Medical Council on Alcohol. Views expressed by contributors are not necessarily those of the MCA. We welcome any articles or comments from other parties which may be published. Registered Charity Number 265242.
5 St Andrews Place, London, NW1 4LB T: 020 7487 4445 F: 020 7935 4479 E:
[email protected] www.m-c-a.org.co.uk MCA London
@mca_med | APRIL 2017 | 8
