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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

² Royal College of Physicians, Alcohol: Can the NHS Afford It?, 2001

³ National Statistics, Psychiatric Morbidity among Adults, 2000

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