Alcohol a public health issue Day 5 Session 3 Feb 2010

Overview Why alcohol is an important public health issue Alcohol data and report available to groups Writing a technical briefing for Director of Public Health

Units of alcohol in common drinks Source:

Sensible drinking men should not regularly drink more than 3–4 units of alcohol per day and women should not regularly drink more than 2–3 units per day British Liver Trust recommends that individuals should abstain from alcohol for a minimum of two consecutive days a week

Hazardous drinking Regular consumption of: more than 5 units of alcohol daily for men more than 3 units of alcohol daily for women In 2000, around a quarter of adults (38% of men and 15% of women) in Britain were estimated to be hazardous drinkers

Harmful drinking Women who regularly drink over 6 units a day (or over 35 units a week) and men who regularly drink over 8 units a day (or 50 units a week) are at highest risk of alcohol related harm. a pattern of drinking that causes damage to physical and mental health

Alcohol dependence a cluster of physiological, behavioural and cognitive phenomena in which the use of alcohol takes on a much higher priority for the individual than other behaviours that previously had greater value. The Psychiatric Morbidity Survey reported that 7% of adults in Britain were assessed as being dependent on alcohol in 2000 (mostly ‘mild’). Men were more likely to show dependence than women and younger people were more likely to show dependence than older groups.

Definitions Alcohol specific conditions - thought to be directly attributable to excessive alcohol consumption, such as acute alcohol intoxication and alcoholic liver disease Alcohol-attributable conditions thought to be directly or indirectly attributable to excessive alcohol consumption..

Alcohol in Europe Global estimates suggest that alcohol misuse harms more people and causes more deaths and serious illness than street drugs Alcohol is the third highest risk to health in the European Union ahead of health problems related to being overweight or obese, behind only tobacco and raised blood pressure

Alcohol misuse harms more people and causes more deaths and serious illness than street drugs

Age-standardised alcohol related death rate by sex and age-group Source: ONS

Months of life lost to women through alcohol related conditions NWPHO

Months of life lost due to alcohol by Index of Multiple Deprivation quintile, England

While there is evidence to suggest that drinking 1–2 units of alcohol per day may reduce the risk of coronary heart disease in middle-aged and older population groups with a history of infrequent lifetime alcohol consumption, the net effect of alcohol on coronary heart disease is negative. Any further increase in the prevailing (already higher than optimum) levels of alcohol consumption is therefore more likely to result in harm than good

How alcohol affects the lives of drinkers and those around them Hospital admissions (doubled ) Street violenceDomestic violence (about 40% alcohol related) Child protection Police time Ambulance service A&E Drink driving Accidents and deaths Disability benefit Work days lost Many people with mental health problems misuse alcohol Alcohol misuse common among drug misusers In agegroup 23% are hazardous drinkers and 4% dependent drinkers rate of alcohol-specific deaths is more than five times higher in the most deprived areas compared to the most affluent areas 37% of recorded violent crime depression

Key effective and cost-effective Interventions increase in alcohol prices reduce availability of alcohol, measures against drunk driving and Measures against underage drinking Based on: What are the most effective and cost-effective interventions in alcohol control?,What are the most effective and cost-effective interventions in alcohol control? WHO Regional Office for Europe’s Health Evidence Network (HEN), 2004

Alcohol price relative to retail price index, real households’ disposable income and affordability of alcohol (Indices 1980 = 100)

Alcohol-specific mortality rates by gender and region, England, 2001–2003 Source: Alcohol-related deaths in England and Wales, 2001 to 2003

Hospital admissions for alcohol-related harm (VSC26) Source: NCHOD. Compendium of Clinical and Health Indicators. (nww.nchod.nhs.uk) Projection method: Linear projections based on actual rates for inclusive. Context Charts show trends, projections and trajectories for alcohol-related admissions by South Central PCT, with ONS area classification group and South Central SHA comparators Robert Kyffin, Department of Health South East 27-Jan-10 Directly age-standardised rates per 100,000 persons

References Indications of Public Health in the English Regions 8: Alcohol Calling Time: Reducing alcohol harm in the South West - a blueprint for joint action Trends and geographical variations in alcohol- related deaths in the United Kingdom, 1991– Local Alcohol Profiles for England (