Backlash against NHS scheme offering free condoms to 13-year-olds

The NHS have been heavily criticised for offering a new scheme that offers free condoms, lubricant and sexual health advice to children as young as just 13.

The new ‘C-Card’ scheme is available to anyone aged between 13 and 24 years of age that meet certain criteria, and is being piloted by Western Sussex Hospitals NHS Trust in an effort to reduce the number of teenage pregnancies in addition to the number of youngsters catching sexually transmitted infections (STIs) such as chlamydia and genital herpes.

Those in possession of a C-Card can discuss sexual health issues at clinics, pickup free condoms and advice on using them and even obtain some lubricant.

The card use is limited however, with those aged 16 or over, able to use it up to six occasions, and youngsters between the ages of 13 and 15 are only permitted to use the card three times before it has to be renewed, which should raise the flag regarding teens engaging in repeated under-age sex.

Anyone with the C-Card can go to 30 venues in West Sussex, including in Shoreham, Steyning, Hassocks, Hurstpierpoint and Midhurst. Should the venture prove to be a success, it will then be rolled out nationwide.

However, the Family Education Trust campaign group have been vocal in criticising the new program, with a spokeswoman saying: “The role of parents and carers is vital in protecting young people as they are privy to emotional wellbeing, friendship groups and unusual behaviours. They are therefore uniquely positioned to intervene and safeguard.

“The C-Card scheme denies parents the opportunity to advise and protect their children against the physical and emotional consequences of sex.”

There are also fears that because the scheme is offering condoms to teens as young as 13, it is partly encouraging them to ignore the legal age of consent (16) and break it.

Campaign For Real Education group chairman Chris McGovern said: “Sexual Health West Sussex is aiding, abetting and promoting the breaking of the law on consent and should be subjected to criminal prosecution.”

Furthermore, The Mirror’s Carole Malone was particularly scathing in her judgement of the C-Card scheme, blasting: “Am I the only one who’s incensed that NHS condoms for 13-year-olds are being advertised on a hip looking website called areyougettingit.com?…What does this say about our society and how it regards sex when a state run health service is throwing condoms at kids…”

Carole doesn’t stop there though in her anger at the scheme: “It says we’ve given up trying to teach kids how to deal with the legal, moral and psychological issues of underage sex because it’s too hard. Instead the State is just making the assumption that they’re all at it like rabbits so let’s just try to minimise the damage.”

Cutting teenage pregnancy in the UK is clearly an issue the government will have to consider curbing sooner rather than later, with Britain having the highest teenage pregnancy rate across Western Europe – the latest available statistics show that over 1,500 young people in West Sussex were diagnosed with chlamydia in a single year.

Experts warn Drunkorexia epidemic is on the rise

The colloquial term ‘drunkorexia’ is probably unfamiliar with some people as it is not technically a medical diagnostic term, but it is one that may become better known in time as the problem threatens to escalate.

Although the term is relatively new, this increasingly serious condition is not. It seems more of us are inflicting a self-imposed torturous starvation and/ or are putting ourselves through overly excessive exercising, with experts warning a higher number of people are now skipping meals, depriving themselves of food in order to ‘save’ the calories for an episode of binge drinking later in the day.

It is believed that more and more women in particularly are drastically reducing their food intake so they can drink more wine. Dieticians coined the term ‘drunkorexia’ due to the fact they believe that their work with clients demonstrates an association between binge drinking and eating disorders.
Psychologists claim it is the labels on the drinks that list the alcohol’s high number of calories is partly to blame for encouraging those with eating disorders to ditch food for drink. The disorder therefore means those who ‘save’ on food calories are drinking alcohol on an empty stomach, something ill-advised as it massively amplifies the effects of alcohol.

Adrienne Key, consultant psychiatrist at the Priory Hospital, says that although the advertising of alcoholic calorie content is in the interest of most people, it can have dire consequences for those suffering with an eating disorder.

Speaking on Monday, she said: “Displaying calorie content on alcoholic drinks has been counterproductive for a small but significant proportion of society. When I started in the profession 20 years ago you would hardly hear of calorie swapping like this. But now we come about it fairly regularly. People who have not eaten will say, “I’m saving myself for a glass of wine. People are more likely now to use this as a method to control dietary intake in a disordered way.”

Despite the fact that alcohol itself doesn’t contain any fat in it, it is loaded with ‘empty’ calories with no nutritional value to the human body. Add mixers like Coca-Cola into the equation and it is easy to see how the calories start accumulating, and fast.

Whilst it is responsible to be conscious about the amount of alcohol calories going into your body – and possibly using an alcohol unit calculator to do this – it is not responsible to miss out on healthy, nutritional meals, not providing your body with energy, vitamins and minerals it so sorely requires.
Charity workers say the issue of ‘drunkorexia’ could also be afflicting men, despite the fact that it is women who are more likely to speak about the problem.

Susan Ringwood, from eating disorders charity Beat said that ‘drunkorexia’ is also likely to affect those that have not been previously diagnosed with an eating disorder.

Speaking to The Times, she commented: “We do see these cases, particularly when people are binge drinking at the weekend. It is not necessarily an eating disorder, but it is a disordered approach towards eating and people can easily find themselves trapped by it. If you are trying to live off one or two hundred calories a day, people find it easier to consume small amount of alcohol and briefly feel better than eat food.”

Medical Specialists® Pharmacy are now able to actually help those with alcohol addiction through the alcohol dependency treatment Selincro (nalmefene). This medication is suited for people who are heavy drinkers, but don’t require immediate detoxification, and whom have a high level of alcohol consumption 2 weeks after the first consultation with the doctor. This is defined as more than 60g of alcohol per day for men or more than 40g of alcohol per day for women. The great news for those who are prescribed it is that there is no risk of becoming dependent on Selincro.

Selincro’s active ingredient nalmefene works by latching onto certain opioid receptors in the brain that are responsible for addictive behaviour, altering their activity, thereby decreasing the urge to continue drinking.

Medical Specialists® Pharmacy offer 6 tips for a healthy heart for National Heart Month

With Valentine’s Day less than two weeks away, the second month of the year often causes pandemonium as couples all around the world, more than at any other time, use all the love in their heart’s to make that extra effort in showing their loved one how much they care.

There could be another reason to think about the heart this month though – for those unaware, February is National Heart Month. The month-long campaign is led by the British Heart Foundation as a way to urge the nation to think more about heart health, as well as to increase awareness about heart and circulatory diseases.

The campaign is one that is annually supported by Medical Specialists® Pharmacy as heart and circulatory diseases are the leading causes of death for adults in Britain. Heart disease comprises of conditions such as coronary heart disease, heart attack and heart failure. However, there are steps to take to help prevent heart problems.

. Cut down on alcohol intake

The NHS recommends that men should not drink more than 3-4 units of alcohol a day, whilst for women the figure stands at just 2-3 units a day at most, and consuming more than this can have a detrimental impact to your heart health. Excessive alcohol intake can raise the amount of triglycerides (a type of fat) in the blood and also lead to abnormal heart rhythms, high blood pressure, heart failure, stroke and obesity from the additional calories you are taking in.  Cutting down on alcohol can be made easier through the help of Medical Specialists® Pharmacy, who have recently began to supply the alcohol dependency treatment Selincro to suitable patients, after being inundated with requests for it.

. Cut down on salt intake

It is recommended that an adult should consume no more than 6g of salt per day – around one full teaspoon. As food labels sometimes only give the figure for sodium, people might be unsure how much they are getting but the following formula from the sodium figure listed, can help: Salt = sodium x 2.5. Therefore, adults should consume no more than 2.4g of sodium per day; equal to 6g of salt. Unfortunately, many of us in the UK consume far more than the 6g limit. On average, people in the UK eat about 8.1g of salt (3.2g sodium) a day. Too much salt can increase the volume of body fluids increases and raise blood pressure. High blood pressure (hypertension) can then result in serious problems such as heart disease or stroke.

.  Cut down on sugar intake

The majority of food and drink products that contain plenty of added sugars, also contain a high number of calories, often having very little nutritional value. Consuming plenty of sugary food and drink on a regular basis can result in weight gain and obesity, thus risking health conditions such as type 2 diabetes and heart disease. Added sugars should comprise of no more than 10% of the energy (calorie intake) obtained from food and drink each day, which works out at around 70g for men and 50g for women, but can vary according to age, size, and how active a person is. Food and drink to consider cutting down on include: sugary cereals, fizzy drinks, sugary squash, cakes, biscuits, chocolate, sweets, cereal bars, cakes, ice cream, puddings and yoghurt.

. Stop smoking

Smoking causes damage to the lining of the arteries, thereby reducing the space for blood to travel through, with the carbon monoxide contained in cigarettes also effecting the amount of oxygen that can reach the heart and other areas of the body, forcing the heart to work much harder to supply the body with the oxygen it requires. The dangers of smoking are further explained on the British Heart Foundation’s website, but smokers are at double the risk of suffering from a heart attack compared to people that have never smoked and smoking is the main cause of a multitude of cancers and lung disease. Smoking cessation treatments such as Champix can help people quit smoking for good though and reduce the risk of heart problems.

. Keep active

Extra weight is widely accepted to be linked to increase the risk of high blood pressure, high cholesterol and type 2 diabetes, and all of these conditions then make heart disease or stroke all the more likely. For those unsure if they are at a healthy weight, body mass index (BMI) is usually one of the first port of calls to check this. A BMI of 25 to 29.9 is considered overweight, whilst a BMI of 30 to 39.9 is considered to be obese. Exercise is a great way to shed the pounds but the simple fact remains that much of the nation lives a sedentary lifestyle. The NHS recommends that one step in treating obesity is to take up activities such as fast walking, jogging, swimming or tennis for 150-300 minutes a week, but obesity treatments like Xenical – in conjunction with a healthy diet – can help with weight loss too.

. Lower cholesterol

Adopting a healthy diet and regular exercise, as previously highlighted, can lower the level of cholesterol in the blood, or prevent cholesterol levels being too high to begin with. The higher the cholesterol level, the higher the risk of stroke or heart disease and therefore the overall risk of having a heart attack. Statin medication such as Atorvastatin or Pravastatin work to lower the LDL (‘bad’) cholesterol and raise the HDL (‘good’) cholesterol, and may be prescribed to certain people with risk factors for heart conditions, such as those with high cholesterol or high blood pressure, older patients, smokers, or those with family history of early heart disease.

The British Heart Foundation’s webpage has more information about heart diseases and advice on how to beat them.  Moreover, the charity are encouraging the nation to show their support on 6 February by wearing red and hosting an event to raise funds for their life-saving research. Anyone can get involved, whether it is at the workplace, school or with friends and family, and there are loads of great ideas for fundraising and essentials such as the sponsorship form and event poster.

National Obesity Awareness Week 2015 encourages small changes now for long-term gains

Monday saw the beginning of National Obesity Awareness Week 2015, a campaign that aims to take back control of the nation’s spiralling obesity crisis, and, as many of us will have ‘weight loss’ as one of our New Year’s resolutions, there is no better time to act than now.

Alarmingly, around 25% of adults are deemed to be obese. According to NHS Choices, a BMI of 30 to 39.9 means you are considered obese, and the government claims that unless the problem is tackled, 60% of men, 50% of women and 24% of children will be obese by the year 2050.

Clearly, obesity is an incredibly serious problem that needs fighting. It effects not only our personal health – increasing the risk of problems including heart attacks, stroke, cancer, type 2 diabetes and arthritis – but can have a detrimental impact to society.

McKinsey and Company produced a report last year documenting the country’s various yearly outgoings, with their economic analysis estimating that the fight against obesity is costing the UK even more than tackling armed violence, war and terrorism. According to their calculations, the problem of obesity costs the UK in excess of £46.5bn ($73bn) a year, in comparison to the £43bn ($67bn) it costs the country due to armed violence, war and terrorism. The biggest social cost to the country though – and by some distance – remains smoking, with the impact from smoking costing a staggering £57bn ($86bn) in 2012.

On a global scale, armed violence, war and terrorism is costing the economy $2.1 trillion a year, and obesity isn’t too far behind, at $2 trillion, with the following social burden being alcoholism, costing $1.4 trillion.

Unfortunately, obesity appears to be a growing problem. Almost a quarter of children are considered to be obese upon leaving primary school, in addition to the one in four adults also obese. Over 12,000 hospital appointments are made each year because of health issues associated with obesity, placing further pressure on an already stretched NHS budget.

However, this is where National Obesity Awareness Week comes into play, aiming to promote the various methods how the government, businesses and us as individuals can implement positive steps to boost our health, with the information and resources from the campaign enabling a long-term positive change. This doesn’t mean people have to make astronomical alterations, but smaller, manageable and sustainable changes that can be kept up beyond National Obesity Awareness Week – this might be cutting down on sugar in your diet, reducing alcohol intake, or increasing the amount of exercise you do.


The campaign encourages everyone to get involved, whether it is events, activities and promotions taking place around the country, or people can even organise their own event with the online supporters’ pack.

The National Obesity Awareness Week website is also full of fantastic, useful information, such as exercise tips to help successful weight loss, an explanation of calories and the number of calories expended in an hour of doing various exercise such as running or swimming, why low-fat diets don’t always work for those trying to lose weight, healthier cooking recipes, a breakdown of the vitamins and minerals we need in our diets and their purposes, how to stay active during pregnancy and much more.


So, whatever it is you decide to do to take part, why don’t we all commit to making 2015 the year we take action with manageable and sustainable changes to turn the obesity crisis around before it is too late.

Medical Specialists® Pharmacy can also help those trying to lose weight, with our fantastic range of obesity treatments such as Xenical and Orlistat. Used in conjunction with a balanced diet and exercise, these treatments are very effective and can help people regain their confidence to enjoy a happier and healthier 2015!

Have a gut feeling it’s more than IBS? Sufferers of SIBO flock to Medical Specialists® Pharmacy

Since Medical Specialists® Pharmacy added the antibiotic Xifaxanta (rifaximin) to their range of treatments for irritable bowel syndrome (IBS), the requests for this medication – which is also used to both prevent and relieve the symptoms of traveller’s diarrhoea – has simply skyrocketed.

Xifaxanta might be unfamiliar to the majority people suffering with IBS as the drug was launched in the UK back in 2011 primarily for the treatment traveller’s diarrhoea associated with non-invasive strains of Escherichia coli (i.e. episodes not associated with fever).

However, some doctors have suggested that patients suffering with IBS should consult their doctor about being prescribed a course of rifaximin for treating their condition, with New York times best-selling author Dr Mark Hyman recommending two 200 mg tablets three times a day for seven to 10 days as one of his ‘5 steps to curing IBS’, describing this as the ‘best way to deal with the chronic bacterial overgrowth that causes bloating and irritable bowel syndrome’.

Interestingly, Medical Specialists® have noticed a burgeoning trend; a growing number of patients that come to them requesting Xifaxanta are now stating in their online consultation that they have been diagnosed with a condition by the name of small intestinal bacterial overgrowth (SIBO), also known as small bowel bacterial overgrowth syndrome (SBBOS).

SIBO occurs when an abnormally excessive amount of bacteria begin to grow within the small intestine. The colon (large intestine) is rich bacteria, but the small intestine is not supposed to be so plentiful with bacteria. In the small intestine there are around less than 10,000 bacteria per millilitre of fluid, in comparison to at least 1,000,000,000 bacteria per millilitre of fluid in the large bowel.

Why does SIBO occur?

The gastrointestinal tract is comprised of a long muscular tube responsible for transporting digesting food to the colon. The coordinated motion of the stomach’s muscles and small intestine propels food from our stomach, then passing through the small intestine and into the colon.

During this muscular function, there is also a clear-out of bacteria from the small intestine and a limit imposed to the amount of bacteria allowed to collate in the small intestine.  Unfortunately, conditions can arise that can interfere with the regular actions taking place in the small intestine, and it is this that results in SIBO, with bacteria now able to linger for longer and multiply. Without a normal muscular activity occurring, bacteria can spread backwards from the colon and into the small intestine.

SIBO is not the product of just one single type of bacteria though, but is caused by an excessive growth of numerous kinds of bacteria that are usually present in the colon.

The specific causes of SIBO are often debated, but a number of risk factors have generally been agreed upon, which are: crohn’s disease, celiac disease (long-standing), diabetes mellitus (type I and type II), IBS, low stomach acid, previous bowel surgery, taking multiple courses of antibiotics and organ system dysfunction, such as liver cirrhosis, chronic pancreatitis, or renal failure.

What are the symptoms of SIBO?

The initial symptoms of SIBO are almost identical to those associated with IBS, and include: abdominal pain/discomfort, bloating, constipation, diarrhoea, excessive wind and indigestion.
If the bacterial overgrowth is severe and prolonged, it could be detrimental to the digestion and absorption of food, leading to a deficiency of vitamins and minerals. Weight loss can sometimes then follow as a result of this and symptoms unconnected to the gastrointestinal tract, such as fatigue and body aches. The symptoms are often chronic and a person suffering with SIBO can expect to have symptoms that can drastically vary in severity over the course of months, years or even decades before they are given a diagnosis of small intestinal bacterial overgrowth.

Diagnosing SIBO

As the initial symptoms of SIBO are non-specific and almost identical to irritable bowel syndrome, it may take a long period of time before SIBO is considered as the cause of the symptoms by the doctor or health care professional.

Instead, it is usually health problems linked to a malabsorption of proteins, fats and vitamins that will raise the alarm for any possibility of SIBO, and the patient will probably be made to have blood tests to determine any reasons for anaemia, electrolyte imbalance and vitamin deficiencies.

Next, the patient will usually have to undergo breath-tests which look for the by-products of digestion, in particularly those associated with intestinal bacteria. The common tests include a hydrogen breath test, bile acid and D-xylose. The results can help to determine if the patient’s symptoms are due to SIBO and thus the patient will not have to have a biopsy or endoscopy.

Treating SIBO

To treat SIBO, doctors and health care professionals will usually discuss with the patient ways at managing and treating any possible underlying health problems, as it is not always sufficient merely to target the excess bacterial growth. In addition, effective methods of controlling the symptoms of SIBO will be discussed as it cannot always be ‘cured’.

Antibiotics are typically prescribed to the patient as one method of controlling the excess bacteria, with the most common antibiotic prescribed for this purpose being the previously mentioned Xifaxanta. Whichever antibiotic is prescribed to the patient will not remove all bacteria though, as some are still needed to aid a normal digestive function.

So whether you suffer from IBS, SIBO, or other stomach and bowel problems, click here to go to the stomach and bowel area of the Medical Specialists® website, which is full of helpful information, links and different treatment options.

Mutating flu viruses linked to havoc at A&E departments

Flu rates have now reached their highest level than at any time in the previous three years, and doctors are blaming mutated forms of the flu virus that are not being protected against with the seasonal winter flu jab.

Strains of flu virus commonly naturally mutate, with changes being witnessed this year already within the US and Australia.

The primary flu virus rife this winter has been found to be influenza A type H3N2, appearing to disproportionately impacting the elderly.

On Wednesday David Cameron was speaking in Manchester and highlighted an increasing number of elderly patients as one of the main causes of pressure on hospital A&E departments, with one hospital even drafting in help from the Red Cross, as NHS capacity is pushed to its limits.

The prime minister noted how it was “particularly striking” that over a million more over-65s were seeking help at A&E in comparison to just four years ago, blaming a lack of “clarity” regarding GP access.

Cameron’s comments came as the latest GP Patient Survey for England show that almost 15% of patients could not get an appointment with their GP at the previous time of trying, though 78% of people who completed the survey still claimed they would recommend their GP surgery.

The US Centres of Disease Control has released a warning that half of the H3N2 viruses they have analysed were discovered to be “drifted strains” from the one covered by the winter flu jab. Public Health England (PHE) have tested 24 samples so far, with five found to be drifted strains. This means the flu type has mutated, resulting in the vaccines becoming less effective.

PHE say that more hospitals and GP surgeries are reporting a larger number of flu cases in comparison to that of the peak periods of the last three winters. It is this massive spike which is probably responsible for the severe pressures felt by hospitals up and down the country this week, but health officials believe the problems could continue to worsen for another eight weeks yet.

Dr Richard Pebody, head of seasonal flu surveillance at Public Health England, commented: “Overall, levels are now higher than the peak of flu activity observed in the last three seasons, but have not reached the levels seen in the last notable seasons of 2010/11 and 2008/09.”

Dr Ben Marshall, a specialist in respiratory medicine at Southampton General Hospital, says the number of patients admitted into hospital with respiratory illnesses has now doubled.
Asthma and COPD are two respiratory problems which can be significantly worsened by flu, sometimes resulting in serious complications that need hospital treatment.

The injected flu vaccine is available free of cost on NHS to those deemed to be high risk. This is to protect them against flu and the serious complications that can arise from it.
Those that qualify for a free flu jab include:

. People 65 years of age or over.
. Pregnant women.
. People with certain medical conditions.
. People living in a long-stay residential care home or other long-stay care facility.
. Those receiving a carer’s allowance, or the main carer for an elderly or disabled person who could. be at further risk if the carer was to become ill.
. Healthcare workers with direct patient contact or a social care worker.

Dr Tristan Clark, a specialist in infectious diseases and respiratory viruses at Southampton General Hospital, said: “We can sometimes predict what a flu season is going to be like based on the activity in the southern hemisphere before it reaches north of the equator and we know countries like Australia had a bad year.

“Unfortunately, since the vaccine was prepared, the influenza A H3 strain has changed significantly, making the vaccine less effective at protecting against the virus – something we occasionally see.”
People are still being advised to get vaccinated to offer some degree of protection, especially those with chronic illnesses who have yet to get the jab. Moreover, antiviral treatment Tamiflu is still active against all strains of the flu and works to lessen the severity of symptoms, particularly when taken early at an early stage of the condition.

Medical Specialists® Pharmacy inundated for Selincro requests for Dry January

Now that the festive work office party, Black Friday, Christmas and New Year’s Eve are firmly out of the way, many will now be taking stock of exactly how much alcohol they have drank during the last few weeks, with some people undoubtedly thinking about cutting down on drinking.

With the beginning of a New Year, there is never a better time than now to put into action the process of reducing alcohol intake, or even stopping drinking for good, and much of the country will no doubt have ‘cut down on boozing’ near the top of their list of resolutions. Another popular choice of resolution is ‘lose weight’ and reducing alcohol intake can actually help to reach this goal due to the high amount of calories in alcohol.

In addition to January being the month when the nation usually kick-starts their resolutions, the first month of the year is also known as ‘Dry January’ due to the annual campaign of the same name, pioneered by the small national charity Alcohol Concern, who challenge all drinkers to abstain from booze for the entire 31 days of January.

Yes, that means no quick cheeky pint after work with colleagues, or an ‘unwinding’ glass of wine with an evening meal, or a heavy session out on the town with mates. It should be remembered though that this is an awareness raising campaign and a fundraiser for Alcohol Concern. It is not a medical detox programme and those with severe drinking problems may need to go to a hospital or clinic to detox as the withdrawal symptoms will be severe and probably require specialist treatment.
For those that do undertake the Dry January challenge, there will be plenty of benefits to be felt in the short-term. Abstainers could look forward to better sleep, weight loss, a boost in skin and hair quality, and let’s not forget all the money saved from not spending it on alcohol – just think of all the other things that can be bought with the extra pennies! As it is only a month off the booze, it is unlikely that any major change in liver function will occur in the 31 days though.

However, everybody needs a break at times, and the human body is no different. Therefore, Medical Specialists® Pharmacy encourage the nation to get on board with Dry January and it may even have a positive effect to future drinking habits. Research has shown that those who successfully complete the challenge actually manage to cut down on their drinking in the future, drinking less alcohol each day, getting into a drunken state less frequently and having more willpower to be able to say “no” to having an alcoholic drink.

It is not just members of the general public though that are seemingly embracing Dry January. One famous face has surprisingly decided to test himself and see if he go 31 days without any alcohol. UKip leader Nigel Farage is the famous face in question, deciding to go teetotal for the first month of the year.

Farage is possibly the most surprising celebrity banishing the booze for a month considering the controversial politician – even during campaigning – is often snapped joyously at the pub with a glass of ale in his hand, perhaps helping his image as a more approachable and jolly party leader. However, like many of us, Farage has admitted to a season of overindulgence and has now temporarily given up drink. Speaking to Sky News, he said: “I started before the New Year. I’m not being particularly virtuous, it’s just I need a break. It does us all good to have a break now and then.”

Medical Specialists® Pharmacy are fully behind the Dry January campaign, and have already witnessed a huge surge in the requests for alcohol dependency treatment Selincro during the last few weeks especially, as thousands around the country prepare for a dry month. However, we understand that this can be difficult for some to achieve without some motivation, which is why Alcohol Concern have provided a unit calculator on their website. All people need to do is tally up the number of drinks they have consumed, say on a typical Friday or Saturday night out, and see the probable alarming number of units and calories this equates to. As many look to lose weight in the New Year following the Christmas excesses, seeing the shocking total calories that drinking adds will no doubt provide the final motivation to truly achieve a completely dry January!