Alcohol MisuseHow big is the Problem?

Michelle Loughlin Consultant in Public Health

Rochdale Metropolitan Borough Council

Alcohol in Our Society

Key Influences:•Price: Cheaper alcohol – Supermarkets – Home drinking•Availability: Licensing Act 2003 – Flexible opening hours•Promotion: Social normalisation of alcohol misuse

• Touches everyone’s lives• Part of celebrations, social occasions etc.• 2/3 people drink sensibly, or not at all

Drinking Risk Levels in GM

 % of Sample

Males Females AllLower risk drinkers

61 76 68

Increasing risk drinkers

28 19 23.5

Higher risk drinks

12 5 8.5

Greater Manchester Alcohol Survey estimated alcohol consumption in 16+ in 2010 n=1,971

Suggests Most People in GM do Drink Sensibly

4% Dependent

15% Don’t drink

Crime and Disorder• Domestic violence• Sexual assault• Public fear• Antisocial behaviour• Risk taking behaviour• Crime• Public Disorder

Accidents• Road accidents• Other accidents• Drownings• Burns

Health•hospital admissions •Liver disease•Blood pressure •Stroke•Cancers •Foetal Alcohol Syndrome •Mental illness•Alcohol Dependence•STIs•Unplanned pregnancy•Inequalities

Social & Economic £•Lower workplace productivity•Unemployment•Impacts on family & social networks•Truancy & school exclusion•Homelessness•Economic costs•Litter•Town Centre – no go areas

Children and Young People

Offending, pregnancy, truancy, exclusion, mental illness, poor educational attainment, reduced life chances etc.

Impacts of Alcohol

Alcohol Impacts – Some Numbers• 1.2 million Alcohol related hospital admissions per yr and rising

– 75% for chronic conditions e.g. CVD, liver disease, cancer– 16% are for mental and behaviour disorders from alcohol use

• 10,000 drink driving accidents each year

• 8, 750 alcohol related deaths and rising– Liver disease a rising cause of premature death in under 65s

• Alcohol involved in 44% of violent incidents, 37% domestic violence

• Workplace absenteeism costs the economy up to £6.4 billion annually

• Total annual cost of alcohol harms has been estimated at £55 billion

Young People in GM (14 to 17 years)

• 31% drinking at least weekly in GM• 20% binge drinking at least weekly• 22% drinking outside• 21% mainly drank in venues such as pubs• 22% bought alcohol themselves

Trading Standards’ North West Schools Survey of Young People (2011)

GM: Number of claimants of Incapacity Benefit/Severe Disability Allowance whose main medical reason is alcoholism (Aug 2011)

Alcohol and Inequalities

• Alcohol is strongly linked to health inequalities• People from deprived groups suffer greater harm

than the more affluent– e.g. There are 4 times more alcohol related deaths among

men in routine and manual jobs compared with those in professional jobs

Alcohol and Mental Ill Health

– Alcohol is associated with a range of mental health problems e.g. depression, anxiety, suicide, risk-taking behaviours, personality disorders and schizophrenia

– Alcohol is a depressant – The prevalence of alcohol dependence among people with

psychiatric disorders is almost twice as high in the general population

– Dual Diagnosis – group of people with complex needs– Alcohol often used as a coping strategy

Rochdale Alcohol Assertive Outreach Pilot: Patient Stories, Common themes

HOUSING & FINANCE•Transience, relocation, poor or unsuitable housing, sofa surfing, fear of home loss due to drinking, homelessness, eviction, loss of income, increased debt, home repossession, unemployment (although several previously had regular work), poor budgeting skills

HEALTH PROBLEMS & WITHDRAWAL

Epilepsy, pain, ADHD, self harm, OCD, trapped nerves, anxiety attacks, avoiding the seizure threshold, onset of seizures, panic, fear, anxiety

RELATIONSHIPS, CHILDHOOD PROBLEMS & ALCOHOL ASSOCIATES

Marriage breakdown, new/multiple partners and children, large families (up to 9 siblings), volatile and chaotic family life, parental, peer and partner drug and alcohol use, problems in childhood including child sexual abuse, bullying, disability, learning disability, drinking onset in childhood

LOSS

Home, bereavement,

children, relationships,

jobs

Multiple barriers to change – none wanted to stop drinking but were open to reducing risk & harm. Many driven by desire not to

lose home.

Reducing Harm: Local Action(from PHE Stocktake Tool)

• Understand Needs, clear strategy and investment• Licensing – Underage/illegal sales, Cumulative Impact Policies• Reduce Risk – Identification of Risk and Brief Advice IBA – Make

Every Contact Count (tools on alcohollearningcentre.org.uk)• Clear Alcohol Pathways in Place e.g. Acute & MH Trusts to

community, programme to support frequent attenders• Specialist Alcohol Treatment – joint commissioning between NHS / LA• Targeting and support for high risk groups e.g. Prison, MH Patients• Focus on Recovery – peer support, family work, employment, housing

etc.

Reducing Harm: National Action(from Health First)

• MUP of 50p• Health warnings on labels• Restricted sale times• Review of licensing legislation to control availability• Restrictions on advertising and promotion• All health and social care professionals to be trained in IBA

to reduce risk (tools on alcohollearningcentre.org.uk)• Referrals of people with alcohol problems to specialist

alcohol services for comprehensive assessment and treatment

Key Messages

• Most people drink sensibly• Alcohol affects health, mortality, crime

economy, and inequalities• Availability, Price, Promotion have impact• Issues are complex and need multi agency

responses locally and nationally

Thankyou

Michelle Loughlin

Email: michelle.loughlin@rochdale.gov.uk