1. How Big is the Alcohol Problem Locally? Jess Mookherjee Consultant in Public Health Kent.

4. How Big is the Problem?

8. Scope and Scale of Problem Alcohol is More affordable & More Available Consumption has increased – by 121% between 1950 and 2000. Accounts for 9.2% of disability-adjusted life years (DALYs) worldwide with only tobacco smoking and high blood pressure as higher risk factors (Prime Minister’s Strategy Unit 2004). Alcohol-related death rates are about 45% higher in areas of high deprivation. Liver disease represents one of the few diseases where the inequalities gap is increasing.

9. Pattern of Consumption in UK UK populations spends 18Billion £ per year (18% of all food & drink) on Alcohol. UK Tax revenue from Alcohol is £9billion (2% of total revenue) Consumption of Beer and Sprits have decreased – wine and cider have increased considerably in last 10 years.(price is key issue) More bought in supermarkets and off licences and less in pubs. National Policy is important but hard to challenge locally

14. Alcohol Use Disorders: Prevalence Drummond et al., 2005 26% of the adult population have an alcohol use disorder (AUD) Includes 38% of men & 16% of women aged 16-64 23% of the adult population are hazardous or harmful alcohol users (7.1 million people in England) 272,258 people in Kent 21% of men and 9% of women engage in binge drinking: in Kent - In Kent, it is estimated that 173,410 people binge drink Prevalence of alcohol dependence is 3.6% overall, 6% among men, and 2% among women (1.1 million people in England)

16. Alcohol in Kent Many positive aspects from alcohol use - majority of people in Kent use alcohol responsibly Excessive consumption of alcohol is a growing problem in Kent and across the Country In UK; - 1 million alcohol related crimes, 1.2 million alcohol related hospital admissions nationally, Wider costs are estimated to be around £22bn - £11bn crime, £7.5bn lost production, £3.5 NHS 23.1% of the population over 16 years old that are estimated to be either increasing or higher risk of drinking across Kent = 272,258 people

17. Percentage of Abstainers in Kent 17 % Thanet 17% Gravesham

18. In 2007-2009 there were: 15431 deaths directly attributable to Alcohol in England 2006 deaths in South East and 329 deaths in Kent

19. Linked to Deprivation and Vulnerability in Kent Thanet has the highest alcohol specific mortality rates in Kent for both males (22.59 per 100,000) and females (7.68 per 100,000). The Thanet rate for males is more than double the average for the South East of England (10.16) Thanet also has the highest mortality rate for chronic liver disease – alcohol-related liver disease accounts for over a third of all liver disease deaths. The number for Thanet males’ months of life lost is almost two and a half times the number for Ashford males. For Liver mortality, the Thanet rate is almost four times the Ashford and Sevenoaks rates. Thanet also is significantly worst on most indicators in comparison to nearest neighbours.  White Men aged over 35 who work in an unskilled or manual field or are unemployed living in poor areas. Offenders, those with mental health problems and LGBT are also high risk.

23. CRIME

24. Hospital admissions

25. Alcohol Service Use in Kent 272,258 people are expected to need alcohol treatment Number receiving structured treatment in 2010 was 1,808, and 1,354 were new starters for treatment- mostly all referred via criminal justice system. Overall the outcomes measures for Kent alcohol treatment are slightly better then national average.

27. What we need to do better in Kent… Raise Awareness Primary Care Identification, brief advice and referral IBA in Pharmacy Alcohol Liaison Nurses / workers at A&E Better referral routes in Criminal Justice Better pathways for Dual Diagnosis