The Intelligence from The Economist: So the Tory goes: Britain’s Conservatives meet

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Hello and welcome to The Intelligence from The Economist. I'm Jason Palmer.

And I'm Aura Ogumbi. Every weekday, we provide a fresh perspective on the events shaping your world.

Plenty of people take medications to cope with mental health issues such as depression,

but very few are prescribed drugs that fight alcohol addiction.

Thanks to the surprising effects of some new treatments, that may soon change.

And for something we spend a third of our lives doing, we know fairly little about sleep.

Thanks to new wearable tech, the research is improving.

We take a closer look at the data on which countries are getting the most shut eye.

First up, though.

Yesterday, Britain's Prime Minister and Conservative Party Leader Rishi Sunak took

to the stage at the party's annual conference, announced by his wife.

Now, it gives me the greatest pleasure to introduce you to a wonderful, wonderful father,

my best friend and your Prime Minister, Rishi Sunak.

Like so many party gatherings like this, it was all garish music and broad smiles.

Thank you, Uxther, for that introduction, and thank you for always being there for me,

my wife. Truly the best long-term decision for a brighter future I ever made.

But the Conservative or Tory party is languishing in the polls,

and an election isn't too far off. The Conservative faithful will be seeking

their leader's guidance more than ever. Mr. Sunak forced a confident note on the state of Britain.

Today, our union is the strongest it has been in a quarter of a century.

The forces of separatism are in retreat across our country.

But beneath the soundbites are plenty of rumblings of discontent among the Conservatives,

as my colleagues on the Britain desk Matthew Holhouse and Georgia Banjo told me.

This was a party that did not have a lot to lose because the polls have been trending

very strongly against them for months, and they needed to shape the dice and change

track and come out with something that looks like a strategy for at least attempting to

fight the next election in a way that retains as much to the real estate

electorate as they can. And I think many of them felt coming out of this conference,

they had done that, whether it will be enough is an open question.

Yeah, it was very strange mood, wasn't it? On the one hand, there were massive queues

leading outside the conference centre with people trying to get in to see

Rishi Sunak, the Prime Minister, speak. On the other hand, it felt like a very bizarre,

slightly divided group. Let's talk through how the party got to this point.

The Conservative party has been in power for more than 13 years, and it suffered a pretty

disastrous blow to its polling standing pretty much a year ago with the short tenure of Liz

Truss and the mini-budget, which did a huge amount of damage to the party standing for

economic competence, which had been one of its historic advantages over the Labour party.

So looking at the polls now, Labour still has a 19 poll lead according to the latest opinion poll

that's been out. Over 13 years, its ranking for fit to lead has been trending downwards. At the

moment, 21% of voters say it is fit to lead or fit to govern. The headwinds facing this party really

are pretty structural in terms of inflation, in terms of the condition of the health service,

in terms of the challenge of tackling irregular migration, which really is a chronic problem.

And Rishi Sunak's strategy on coming to power really was that if he could grind away at these

problems and show that he had restored a fairly old-fashioned idea of competent,

diligent, conservative administration, that would restore the party standing. Unfortunately for him,

that has not filtered through to an extent that puts him in a strong fighting position for the

next election. How was any of this manifest on the ground at the conference? And in a more

general sense, what have you been hearing people saying? It's a really strange feeling at Conference

Jason because you've head towards the centre. There's all this kind of wire mesh erected around

this big area, the sniper police standing around. You have to go through a security check.

It kind of feels like you're entering a prison, really. And so you're leaving behind Manchester,

this big Northern city. You're leaving behind all the ordinary people. You're going into this group

of quite hardcore members, lobbyists, journalists, and the odd politician that showed up. And so it

really is like moving into this alternative political reality. On the one hand, people being

quite javiel, just before Rishi Sinak spoke. And yet you also got the sense in the actual kind of

conference that people were either quite on the fringes, moving towards perhaps some of these

more extreme positions, all feeling quite despondent. So it's quite hard to get a general sense, really,

the meat of the party. And so what is it that Mr. Sunak, the Prime Minister,

proposes then to fight all of these challenges? His strategy is in many ways the only one he

can do, which is the polls are overwhelming. 86% of Britain say they want a fresh team in

charge of the country. 65% of people say that they want to change at the next election.

And therefore his strategy is to say that he is the change candidate.

Be in no doubt. It is time for a change and we are it.

Despite the fact the Conservative Party have been in power for 13 years, he says,

the Labour Party, which has not been in power since 2010, is the agents of the status quo.

And therefore yesterday he really attempted to shape things up and therefore he announced that

he would scrap a high speed to a long delayed and very expensive railway line connecting the

north of England to London. And in its place, we will reinvest every single penny, 36 billion

pounds in hundreds of new transport projects in the north. He announced that the government

would be banning cigarettes progressively by raising the smoking age. Throughout the conference,

they struck a much more strident tone on cultural issues leaning into the cultural wars and sometimes

even dabbling in a little bit of conspiracism of the sort that you might find online.

And we shouldn't get bullied into believing that people can be any sex they want to be.

They can't. A man is a man and a woman is a woman. That's just common sense.

This is all an attempt to reinvent himself and saying that if you're looking for radical change

in the Conservative Party, are the people to do it? I think, you know, at the conference,

people are quite delighted with that. The sense I got is that they really did feel that that was

quite a kind of original speech. He talked about breaking with the consensus, doing a new way of

policies and politics and people seemed excited. I'm not so sure that will have translated

to the people at home who weren't in the bubble. Well, let's talk about that. It's all well and

good to play to the crowd at a party conference. But how is that going to land with the public?

I personally think that it's going to be very hard to sell that. If you talk to normal people,

if you aren't, in the grip of party conference season, they'll still be talking about the rising

cost of food crisis, that the health service is still creaking, massive waiting lists for

all sorts of things. And people are still talking about immigration. So the Tories have

made this a big plank of their policy. And yet ordinary people aren't necessarily sure that's

being addressed or tackled in a very serious way. We've had a Conservative government in power for

13 years. Most of us are losing track of the number of prime ministers we've had in the past seven.

And I think that's going to be a very hard trick to pull off, that this is a new government.

What do you think, Matt? I mean, it has been the secret of the Conservative party

for sustaining itself in power over the past 13 years, its capacity for internal revolution. So

you saw that Cameron to May, May to Johnson, Johnson to Truss, Truss to Sunach, every time

a different approach to government. There is a question there of just how many times you can

repackage what is effectively the same core machine as something entirely new.

And that attempt at transformation has only made harder when so many people seem to have

differing views on where the party should be going, right?

The challenge that the party has, and one of the signs that they've been in power for 13 years,

is that actually the factionalism that really defined the Brexit area has not gone away. So

on the fringes of conference, we saw the meetings of a very wide range of groups who

have their own sort of leaders, their own membership lists, their own manifestos, their own

red lines drawn from MPs who are jocky for influencer and control the agenda for government.

So we saw a new group pop up saying that they would not vote for any budget that increases

taxes as a share of GDP. We saw Liz Truss, somewhat astonishingly, some people thought

returning to the fray, not withstanding her mini-budget, insisting that her cause of tax cuts

was right all along. Remarkably, she does actually claim to have the support of 60 MPs.

On the other side of the party, you saw the One Nation group gathering,

talking about their strategy. So the big picture is that this sort of decomposition

of the parliamentary party into a series of individual pressure groups has not abated.

This is the big challenge for the party, whether they remain in government or whether they go

into opposition. Can anybody unwind this position of entrenchment and bring the party together,

more as a fluid, collegiate body? Or does this trend actually accelerate and become a harder party

to manage and ultimately to form a government with?

Yeah, I mean, you totally get that sense. When during a round, you could identify the Liz Truss

fan club, Nigel Farage, based name for spearheading the campaign for Brexit, was there. He had lots

of supporters. Wherever you went, you got a sense of the more liberal conservatives Matt

spoke about. They had their own little group and they felt they were defending their corner.

So really, you did get that sense. It did feel that people were sharply divided.

I had some fun at the sheeting club where they had their own particular agenda. It was quite

splintered. As an outsider to this, what's really striking is just how striking to the message is,

how much culture war stuff, how much serious anti-immigration stuff. This is a party that

is putting forth a very strong message on stuff that's to the right of the party.

Yeah, I think one of the standout moments of the conference was Soella Bravman's speech.

That's the home secretary, her speech talking about the levels of immigration that Britain was

experiencing. The wind of change that carried my own parents across the globe in the 20th century

was a mere gust compared to the hurricane that is coming. She talked about the country being too

scared of looking racist to bring order to the chaos. It was really quite sinister and she made

some comparisons with American cities like San Francisco and Seattle, suggesting that Britain

could really end up in a very dire state if levels of immigration continued.

The big picture is that this is a party wrestling over what direction it takes, whether it embraces

this much more radical right-wing politics or whether actually it hues to an older,

more socially liberal, more heterogeneous idea of conservatism. What choice it makes

would ultimately have really profound and long-term consequences for the broader politics of the UK.

Georgia, Matthew, thank you very much for joining us.

Thank you.

Thanks, Jason.

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Nearly 30 million Americans suffer from alcohol use disorder, meaning that alcohol has a

significant negative impact on their lives. Each year, 140,000 of them die from alcohol-related

causes. Drugs do exist that might help, but a recent discovery about medications known for

other reasons might do a far better job. Before I started my reporting on alcohol use disorder,

I had absolutely no idea that there were drugs out there that were FDA approved to help people

with alcoholism. Tamara Julks-Bor is the economist's U.S. policy correspondent.

Unfortunately, these drugs are rarely prescribed by doctors, despite them being so useful.

And this is absolutely devastating for people who are suffering with alcohol use disorder.

But some researchers are hopeful that this might change soon.

So let's wind back a bit to the drugs that I have to say I didn't know about either.

What drugs are already out there?

There's three drugs that are FDA approved, and they've been around for a while,

and they have been found in clinical trials to work really well.

The first one is dysulfuram, also known as Antibus, and it was approved way back in 1951.

Unfortunately, it makes people pretty ill when they drink, so it's not the greatest for the user.

But a few decades later, two other drugs were approved.

Naltrexone was approved in 1984, and Acamprasate was approved 20 years later.

And they are a bit better because they help reduce cravings and they make withdrawal

more manageable. And in some cases, patients can even learn to use alcohol moderately,

rather than having to abstain entirely. And then there are other drugs that are used off-label,

which means that doctors prescribe them for reasons beyond their approved use by the FDA.

And you say that these existing drugs, some of which have

been around for more than half a century, they work?

They do work. One specialist that I spoke with at NYU Grossman School of Medicine

told me that these drugs work fairly well, if not dramatically well in most patients.

And some say that these drugs are as effective for treating alcoholism

as selective serotonin reuptake inhibitors, such as Prozac, are for depression.

But despite all of this, only 2% of people with alcohol use disorder in the U.S.

actually use the medications. And it's really surprising when you think about it,

because if you compare it to other conditions like opioid use disorder,

in that situation, 22% of patients actually use drugs to help them with their addiction.

And to kind of go to a different example, over half of patients with depression

take prescription drugs.

So why aren't there similar numbers when it comes to people with alcoholism?

So my source has told me that these medications are not

Harvard, usually in medical school. And that means that a lot of medical practitioners

just lack the knowledge and the training and the confidence to prescribe these medications.

And also, even though there are three, there are not many FDA-approved drugs to choose from.

With only three drugs, doctors can't mix and match them or tailor them to patients' needs

and help them manage side effects. Unlike other medical conditions like depression,

there are many more drugs to choose from, so doctors have more to work with.

On top of that, many sufferers fail to even try to get help.

Only 7% of people get any treatment, whether it's drugs or counseling or support groups.

Many people just do not seem to know that there are even drugs out there

that can help them with their alcoholism.

Well, as you say, there aren't very many, but you suggested that there might be more soon?

Yes. So this is where things get really interesting.

There is a popular drug out there that it seems like everyone is using these days

to help with things like managing diabetes, but also to help lose weight.

And now, scientists are wondering if they could help curb alcohol use.

And you're probably realizing that I'm talking about

semaglutide or semaglutide, depending on how you say it,

which is more commonly known as ozempic or wegovi.

And some patients that are currently taking the medicine for diabetes or for obesity,

they are reporting reduced alcohol cravings while taking the drug.

So scientists are beginning to wonder whether or not it could work and they're testing it out now.

But is the issue the number of drugs available?

Or is it maybe whether people actually want to avail themselves of those drugs?

It's possible that adding ozempic and wegovi to the list of drugs for alcohol use disorder

could really change things.

One scientist that I spoke with said that this could be the

prozap moment for addiction medication.

And what he meant by that is that before prozap,

depression drugs were used really only for the most serious cases due to their side effects,

which were pretty rough.

But when prozap came along, doctors were much more comfortable with prescribing it

because the side effects were just more manageable.

And patients also began to request prozap because it became part of pop culture.

So now fast forward to ozempic and wegovi and they're already there in popular culture.

Celebrities are all over social media talking about how they've used these drugs for weight loss.

Side note, ozempic is not actually FDA approved for weight loss,

but many doctors are prescribing it off-label.

But these drugs are really popular.

And if they're found to reduce alcohol cravings,

it could destigmatize using these drugs to help with things like alcohol abuse.

But you say it's not FDA approved yet.

I mean, how much is that a stumbling block if prescribing it off-label is okay?

I mean, when are we going to see it sort of behind the counter for that particular use?

So we should definitely hold our horses and not use these drugs yet for alcohol addiction,

preclinical trials on rats and monkeys, and anecdotal evidence is showing that

these drugs may reduce alcohol cravings.

But that doesn't mean that we should start using them on humans yet.

The NIH, the National Institutes of Health and Oklahoma State University,

have started randomized clinical trials on humans.

So we will know pretty soon.

But if someone is listening right now and they're thinking, wow, this is so amazing,

I could really use help or a failing number could really use help with their alcohol addiction,

there's no need to wait for Ozempic and Bogoby to be approved to start treatment.

Anyone who is struggling with alcohol addiction right now, they have options today.

They can turn to their doctor and doctors can turn to the drugs that are already FDA approved

for alcohol use disorder and that have been available for decades.

There's no need to wait for a miracle drug because it's already here.

Tamro, thanks very much for joining us.

Thanks for having me.

Sleep is essential for our health.

It takes up around a third of our lives and yet very little is known about it.

Doug Dawson is a data journalist at The Economist.

Understanding how sleep varies between countries is especially limited.

Surveys show that some countries are full of night owls whereas others are full of early birds.

But we don't know why that's the case.

Now a new paper is trying to fill in some of the gaps.

So Doug, tell me about this new research.

How is it filling in those gaps?

Yeah, so historically sleep research has relied on survey data.

So this would be questionnaires asking people things like when did you go to bed last night?

When did you wake up?

But this new paper by researchers from the National University of Singapore

and a Finnish sleep tech company called Aura Health used data collected from a sleep tracker

that Aura puts out called the Aura Ring.

This apparently the device used by Kim Kardashian and Gwyneth Paltrow.

And this gave the researchers a big data set to work with.

Their sample included more than 220,000 people in 35 countries.

And the data they were able to collect was really high quality too.

Sleep trackers can measure a lot of data about your sleep,

about how you move, your heart rate, body temperatures, things like that.

And so using all this really sophisticated data, what did researchers find?

So they found that sleep patterns vary quite a bit across countries

with some countries sleeping as much as an hour more per night than others.

The best sleepers tend to be in northern European countries.

So that includes Estonia, Finland, Ireland and the Netherlands.

And also Australia and New Zealand.

So people in these countries all average about seven hours a night.

And the worst sleepers tend to be in Asian countries.

So Japan and South Korea ranked at the bottom.

And this isn't because people in Asia are early birds.

They actually tend to wake up around the same time as people elsewhere.

But rather because they go to bed about 35 minutes later.

To see a visualization of this, go to the graphic details section of Economist.com.

But as we all know, it's not just about how much you sleep, right?

It's also about how well.

Right. The sad thing is that the countries that log the fewest hours of sleep a night

also tend to have the worst quality sleep.

So previous research has shown that when people are given a shorter window of time to sleep,

so when they're kind of restricted in the times that they sleep,

they actually tended to sleep better.

But this study found the opposite.

The data showed that people in Asia not only went to bed later and slept less.

They also tended to have lower quality sleep,

meaning they spent more time tossing and turning and slept less consistently.

What's more, you might expect that less sleep during the week

would naturally lead to more sleep on weekends.

But in fact, Asians tend to enjoy less of this kind of catch-up sleep

on weekends than Europeans, for example.

So why do sleep patterns vary across the world so much?

The authors of this paper seem to think that culture matters quite a lot.

So in the same way that the observance of the dawn prayer in Muslim countries

may hinder sleep and afternoon siestas may affect sleep in countries like Spain.

Cultural practices may also help explain why people in Asia tend to sleep less.

The authors hypothesize that work may actually be pretty important.

They point out that time-use surveys show a strong relationship

between longer worker hours and shorter sleep.

For example, after accounting for holidays,

South Korean workers log 36 hours of work per week on average,

compared with just 27 hours for the Dutch.

And it's a little wonder that, according to this study,

Koreans get 40 minutes less sleep per night than Dutch sleepers.

So, you know, it's hard to know definitively why

some people in some countries sleep more or less than others.

But these authors seem to think that culture matters quite a bit.

And in the case of Asian people, it might be their work culture.

Doug, thank you so much for joining us.

Thanks, Ori.

That's all for this episode of The Intelligence.

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We'll see you back here tomorrow.

Oh, that would be so beautiful.

I could use that.

I appreciate it.

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Random act of helpfulness.

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To find the helpful SoCal Honda dealer near you,

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