Alcohol Services

Figures in August 2006 show that while 3.5 million people used drugs in the last year, 8.2 million people have an alcohol disorder. Meanwhile, the government Information Centre for Health and Social Care revealed that alcohol-related illness has reached record levels. In-patient care for people with mental health or behavioural disorders resulting from alcohol misuse increased by 75 per cent from 1995 to 2005, and from 72,500 admissions to 126,300, it said. Numbers admitted to hospital with liver disease due to alcohol have more than doubled over the past 10 years.

No wonder then, that in January 2005 the government published its Drinking Responsibly consultation document aimed at curbing underage and binge drinking. And an independent charitable trust aimed at changing the UK’s drinking culture is expected to be up and running in the next few months. The Drinkaware Trust will be voluntarily funded by the alcohol industry. It will bring together industry, charities, lobby groups, medical experts and professionals in the field to address alcohol misuse across the UK.

Licensing laws
Historically, though, tackling alcohol problems has always taken a back seat compared with the war on drugs being waged by the government. And there are fears that any progress could be scuppered by the new licensing laws introduced in England and Wales in November 2005 which offer the potential for pubs and clubs to stay open 24 hours a day, seven days a week. Greater availability of alcohol encourages increased consumption and those in the alcohol treatment sector fear it will lead to more people needing specialist support.

As it is, an average of just one in 18 problem drinkers in England can access the treatment services they need, according to Department of Health figures in February 2006. In the north east the proportion falls to less than one in 100. This prompted the charity Alcohol Concern to bemoan the “shocking lack of services”.

Perhaps this is why, in September 2006, ministers announced that information about drug and alcohol abusers will be shared by the police, health and social services under new proposals to fight crime and help those most at risk.

The government first pledged to combat alcohol misuse 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.

But England was 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.

Back in England, a Cabinet Office strategy unit was established in 2002 to review and analyse policy in England. In October 2002, the unit published a consultation document with the Department of Health called The National Alcohol Harm Reduction Strategy. Consultation ended in January 2003.

The strategy unit’s interim analysis estimated that alcohol misuse was costing about £20 billion a year. This is made up of alcohol-related health disorders and disease, crime and anti-social behaviour, loss of productivity in the workplace, and problems for those who misuse alcohol and their families, including domestic violence.

It said that the annual cost includes:

• 1.2 million violent incidents.
• 360,000 incidents of domestic violence are linked to alcohol.
• Increased anti-social behaviour and fear of crime.
• £95 million on specialist alcohol treatment.
• Over 30,000 hospital admissions for alcohol dependence syndrome.
• Up to 22,000 premature deaths annually.
• At peak times, up to 70 per cent of all admissions to A&E departments.
• Up to 1,000 suicides.
• Up to 17 million working days lost.
• Between 780,000 and 1.3 million children affected by parental alcohol problems.
• Increased divorce.

The alcohol harm reduction strategy
But, after much anticipation, the alcohol harm reduction strategy was unveiled in March 2004. It set out a cross-government approach that relies on creating a partnership at national and local levels between government, the drinks industry, health and police services, and individuals and communities to tackle alcohol misuse.

It has four key aims:

• To improve the information available to individuals and start a process of change in the culture of drinking to get drunk: for example, providing alcohol education in schools; reviewing the code of practice for TV advertising to ensure that it does not target young drinkers or glamorise irresponsible behaviour.

• To better identify and treat alcohol misuse: for example, piloting schemes to see if earlier identification and treatment can improve health and also have longer-term savings; better help for vulnerable people, including homeless people, drug addicts, people with mental health problems and young people.

• To prevent and tackle alcohol-related crime and disorder and deliver improved services to victims and witnesses: for example, greater use of the new fixed penalty fines for anti-social behaviour.

• To work with the industry in tackling the harms caused by alcohol: for example, at national level there will be a social responsibility charter for drinks producers and at local level, a new code of good conduct scheme for retailers, pubs and clubs, led by the local authority. Initially, participation in these schemes will be voluntary.
Progress on the strategy will be measured regularly against indicators and the government will take stock of how things are going in 2007.

All these measures show that alcohol is now on the agenda. However, whether the government puts as much money into tackling alcohol misuse as it has into drug misuse is unlikely. For example, in December 2002, it announced it would be investing £1.5 billion to tackle drug misuse.

However, while the new alcohol strategy mentions funding for pilot schemes to find out whether earlier identification and treatment of those with alcohol problems can improve health and lead to longer-term savings – a move that many in the field feel is a waste of money anyway as the answer is obvious – it makes no mention of how much money the government is prepared to put into treatment services. And without the back-up of funding, the new strategy will make little difference.

Facts and figures
Researchers believe the first experiences of drinking begin at about 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.

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. In August 2006, academics and 11 charities including Turning Point and Alcohol Concern, wrote to children’s minister Beverley Hughes calling for urgent action to tackle the misery of 1.3 million children affected by parental alcohol abuse. They called on the government to launch a national inquiry into the impact of parental alcohol abuse and to develop new services for children and parents.

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.

Useful websites

• Action on Addiction:
• Alcohol Misuse information
• Alcohol Concern
• Alcohol Focus Scotland
• Drugs and alcohol information for professionals in Northern Ireland
• Institute of Alcohol Studies
• London Drug and Alcohol Network
• Medical Advice on Alcoholism
• National Association for Children of Alcoholics
• National Treatment Agency for Substance Misuse

Contact the author
 Natalie Valios