Consumer society

Whether it is the health service or education, the UK is repeatedly
accused of lagging behind the rest of Europe in quality. But there
is one aspect of life in which it has few equals: teenage binge
drinking. It is hardly an achievement to be proud of, which is why
the government plans to have an alcohol harm reduction strategy in
place next year.

It follows the 1999 European School Survey Project on Alcohol and
Other Drugs (Espad) which compared drinking patterns and drug use
among young people in 30 countries. Part of this survey looked at
drinking habits of 15 and 16 year olds over 30 days. It revealed
that young people in the UK shared third place with Ireland –
behind Malta in top spot and Denmark in second – for those drinking
alcohol 10 or more times in the previous 30 days, second place for
those drunk to the point of intoxication three or more times and
second place for those who binged (defined by Espad as having five
or more drinks in a row) three or more times.

Many observers hope that the government’s long-awaited National
Alcohol Harm Reduction Strategy will address some of these
problems. The consultation document asked for responses about the
impact of alcohol on several broad areas, including culture and
behaviour, health, crime and disorder, vulnerable groups and
education. It also considered economic costs and possible
market-based solutions. The interim analytical report published
recently relied heavily on previous research and concluded that a
successful strategy “will include a variety of interventions; use
best resources and recognise that responsibility is shared between
individuals, the supply side and government”.¹

At best, we will eventually have a harm reduction strategy endorsed
by government which recognises for the first time the immense
damage that alcohol abuse can cause. This would be a major step
forward and one that agencies feel is long overdue.

At worst, the strategy will make tokenistic gestures but achieve
little and not bring the significant funding needed to address
alcohol issues. The reasons for this are open to debate, but
cynical observers could argue that the revenue the government
receives from alcohol is substantial, and any move to limit the
harm that alcohol causes might have an unwelcome impact on
government coffers, at least in the short term.

In the meantime, Tony Blair’s much-quoted mantra “education,
education, education” appears to have gone largely ignored in the
field of alcohol. As health warnings on tobacco have gradually
increased in size to cover nearly half the packaging, you would
have to search hard to find the small logo on a can of beer or
bottle of wine indicating how many units it contains.

Government guidelines define sensible drinking as two units a day
for a woman, and three to four for a man. Yet even when someone is
motivated to assess their alcohol consumption, many alcohol workers
suspect that units are ineffective as cautionary information. Do
people really know what a unit is? Do people compare the unit
content of different drinks or work out how many units they have
consumed? Experience suggests that most people are hazy about the
unit system and often unsure of what constitutes “sensible
drinking” and what is unsafe. Is it any wonder that young people
continue to take risks with their alcohol consumption if the
pertinent information is not available or difficult to
access?

This is an unfortunate scenario, given that use of alcohol among
young people appears to be increasing. There is plenty of anecdotal
evidence that the “binge drinking” culture is now expanding from
the original weekend session to include sessions in the week. Young
people have always taken risks, but the fundamental difference
between young people today and those of the previous generation is
that the latter tended to drink gradually over the course of the
week. Pubs were shut for most of Sunday and there was limited
lunchtime opening. The fashion for the mature drinker was for men
to drink beer at about 3.5 per cent strength with women having
perhaps two to three long drinks with a non-alcoholic mixer. The
essential difference was that people drank small quantities of
alcohol over a longer period.

The drinking culture that young people are now pursuing is causing
much concern among health professionals. Some accident and
emergency departments estimate that 85 per cent of patients at peak
times are there due to alcohol-related incidents. The NHS finds it
difficult enough to cope with the pressures of reducing waiting
lists and insufficient funding but add to this the estimated
£3bn a year that alcohol-related illness and injuries cost,
and the scale of the problem becomes more apparent.²
Statistics suggest that more than 40 per cent of young people are
drinking at hazardous levels.³ And the Department of
Health’s chief medical officer for England, Liam Donaldson,
suggested in his 2001 annual report that cirrhosis of the liver is
killing more women than cervical cancer. This situation must not be
allowed to continue. If there is to be any hope to reverse this
trend, young people will need far easier access to non-judgemental
and targeted factual information. There is no magical cure; this
process will not occur overnight and if a concerted effort was
begun today, a change may take place over 10-15 years.

But alcohol services specifically for young people are rare and we
desperately need more if we are to inform, advise and educate our
young people about sensible approaches to alcohol. The Department
for Education and Skills has identified alcohol as a potential
problem in a new consultation document.⁴ It says:
“Educating pupils about the effects of alcohol and how to reduce
alcohol related harm is an important priority for
schoolsÉolder pupils are particularly vulnerable to the harm
associated with binge drinking, which is a growing pattern of
behaviour.”

Alcohol Services in Cheshire is running a young people’s project
offering counselling and education to the 11-25 age group. Yet we
are in danger of losing this service through lack of continuation
funding, which in turn is due to the lack of government money
allocated to alcohol problems. If this service shuts, more than
2,000 young people a year will lose the chance to take part in
education sessions on the impact of alcohol. So far more than 6,000
young people have used the service, and a further 65 young people
each year seek a structured counselling programme at Alcohol
Services in Cheshire (CIC).

But without a government approach and continued funding, services
like these will close, and young people seeking to address their
own problems with alcohol will flounder. 

Miles Couchman is an alcohol worker at Alcohol Services in Cheshire
(CIC)

¹ Strategy Unit, Strategy Unit
Alcohol Harm Reduction project, Interim Analytical Report,
2003

⁴ Department for Education and Skills, Drugs:
Guidance for Schools, 2003