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Compiled by Natalie Valios, Deputy Features Editor with Community Care.
Tackling alcohol problems has taken a back seat compared with the war on drugs being waged by the government.
We've had a drugs tsar, a 10-year drug strategy launched in 1998 replaced by an updated drugs strategy unveiled last year, local drug action teams, and drug treatment orders. On top of this, the National Treatment Agency for Substance Misuse was set up in April 2001 to increase the availability and effectiveness of treatment for drug misuse in England.
And even though the government pledged to combat alcohol in its white paper "Saving Lives: Our Healthier Nation" in July 1999, following this with an undertaking in the NHS Plan that the department of health would implement a strategy for England by 2004, alcohol remains somewhat on the backburner.
Despite the NTA's all-encompassing title, there was no mention of alcohol within its remit much to the consternation of both drug and alcohol workers. They pressed their case and there are signs that the government might relent and broaden its remit this summer, when the alcohol strategy is due, finally, to be launched.
Researchers believe the first experiences of drinking begin around 11-years-old but can be as early as eight. About 1,000 under-15s are admitted to hospital every year with alcohol poisoning. One in 13 people are dependent on alcohol, that's twice the number dependent on drugs. According to the British Crime Survey 2000, alcohol misuse is implicated in 40 per cent of violent crimes. Government figures show that it is also implicated in up to 40,000 deaths per year in England and Wales, and is directly responsible for 5,000 deaths.
In 2001 a survey by the European School Survey Project on Alcohol and Other Drugs (Espad) found that 15 to 16-year-olds in the UK drink more than their European counterparts. The Alcohol and Health Research Centre conducted the UK part of the survey. It found that 91 per cent of respondents had been drinking alcohol during the past 12 months. Over two thirds of UK pupils had been drunk in the previous year, compared with a European average of 52 per cent.
And more recent figures show that alcohol-related deaths among young women have tripled in 20 years and an average of two young men and one young woman now die every day in England and Wales from the effects of alcohol. And the trend of people dying younger from alcohol-related causes is predicted to continue.
An estimated 920,000 children live in families where one or both parents have problems with alcohol. Research has also shown that heavy drinking can contribute to anxiety and depression, and accelerate or uncover a predisposition to a psychiatric disorder or psychosis.
With all these figures to hand, why is that the government has appeared to be so reluctant to tackle this increasing problem? Alcohol is viewed as a socially acceptable substance in a way that drugs never have. Teenagers getting drunk is seen as a rite of passage. But where those teenagers who experiment with drugs are likely to give them up after five years, some young drinkers will continue to drink heavily throughout their lives, those who started drinking heavily at the same age are more likely to be hooked and to, therefore, continue.
Finally, after years of waiting for action, a Cabinet Office strategy unit was established last summer to review and analyse policy in England. It was asked by Tony Blair to examine several areas including:
In October 2002, the unit published a consultation document with the department of health called The National Alcohol Harm Reduction Strategy, designed to promote action to help people misusing alcohol and identify, prevent and manage the consequences of misuse, including disorder and anti-social behaviour. Consultation ended in January and the final strategy is expected this summer.
But, England is still bringing up the rear; in May 2000, the Tackling Substance Misuse in Wales strategy was produced, Northern Ireland published its Strategy for Reducing Alcohol Related Harm in September 2000 and Scotland announced its Plan for Action on Alcohol Problems in January 2002.
Those working in alcohol services have a wishlist of the issues they would like to see included in the strategy: treatment in communities, education, information and advice for young people, more investment to support the local delivery of services, integrated solutions, and preventive measures that don't depend on people identifying themselves as a problem drinker.
They are clear that the strategy must ensure that the effects of alcohol misuse are not played down in the efforts to deal with drug problems. They also want the strategy to include the needs of particular groups, for example people from ethnic minority communities, older people and young people who may need age-specific treatment, and those with a dual diagnosis of mental illness and substance misuse. There are concerns that the consultation document mentioned mental health just once, even though many people who present at alcohol services have some sort of mental health problem.
Alcohol is at least now on the agenda. The next concern is how much money the government is prepared to put into initiatives to tackle its misuse. In December 2002 it announced it would be investing £1.5 billion to tackle drug misuse. Unlike drug treatment and prevention services, similar services for alcohol have not received any specific central government funding. This has led to a situation where there are insufficient resources and services available.
The consultation document is available here
Useful websites:
Youth Justice and the Youth Justice Board
26 August 2008
Substance misuse
15 August 2008
Details of government consultations
21 August 2008
Private Member Bills
25 July 2008
Government Legislation
25 July 2008
