Alcohol Policy UK

'Protecting People, Promoting Health: A public health approach to violence prevention for England'

A new report has been released by the North West Public Health Observatory (NWPHO):

'Protecting People, Promoting Health: A public health approach to violence prevention for England' [pdf]

'The report describes the major roles public health and health care services can play in reducing levels of violence across the country alongside their functions in dealing with the impacts of violence on health. The documents contain new figures on the cost of violence, estimating national costs to the NHS of £2.9 billion annually and a wider cost to society of £29.9 billion each year.

The report draws on the latest evidence that many of the key risk factors that make individuals, families and communities vulnerable to violence are changeable. Interventions are now available to reduce violence through improving childhood and by adapting the cultures and environments in which we live, learn and work. The report details:

• The extent and nature of violence
• Its impact on short and long term health and wellbeing, education and antisocial behaviour
• Risk and protective factors for involvement in violence
• The range of evidence based approaches we now have for preventing violence
• Related national policy and programmes'

As recently reported, an e-learning resource - Reducing Violence in your Community: Emergency Department Datasharing - was released alongside an ED Datasharing report and a number of data sharing case studies.

The Department of Health also recently released broader guidance on Information Sharing to Tackle Violence (pdf). It highlights how Community Safety Partnerships (CSPs) can reduce violence in their community by encouraging A&Es to collect and share information on time, type and location of assault.

Briefing released to support Police and Crime Commissioners with election campaign policies on alcohol

Alcohol Concern have released a briefing for Police and Crime Commissioners (PCCs) candidates to help them form policies on alcohol-related issues in their election campaigns.

From November 2012 PCCs will be elected in each of the 41 police force area in England and Wales, and will be responsible for local police and crime plans as well as rewarding grants to organisations that reduce local crime. They have previously been highlighted as having an important role to play in alcohol-related crime and influencing wider alcohol issues and partnerships.

The briefing includes a summary of policy recommendations for PCC candidates including:

• Take an active role in licensing decisions
• Ensure tougher enforcement of alcohol free zones, under age sales, serving people when drunk
• Prioritise drink driving campaigns and clampdowns
• Use budgets to invest in alcohol treatment services and signpost offenders (e.g. cautioned) to alcohol treatment services
• Liaise effectively with A&E
• Campaign for minimum pricing

It also highlights the imapct of alcohol on crime, particualy violent crime and domestic violence.

A recent Drugscope briefing also assessed the role of PCCs for the field.

The Home Office has produced guidance to support interested parties. The Local Government Association (LGA) have also highlighted a list of useful publications relevant to the PCCs and local partnerships.

RCGP release GP guidance on domestic abuse

The Royal College of General Practitioners (RCGP) has released guidance to help GPs respond more effectively to patients at risk of domestice abuse. The guidelines advocate that a senior member of each primary care team is tasked with co-ordinating an effective response to patients at risk of domestic violence. See RCGP press release.

The ability to respond to patients effectively remains a Department of Health strategic priority. Each practice should explore local service provision and engage with relevant services. It should commission training for staff to help all members of the primary care team to be able to recognise the signs and symptoms of domestice abuse, to be able to raise the issue and to respond sensitively to the patient.

Clear pathways into local sevices should be developed, alongside information sharing protocols.The practice should also identify a designated person, who may be a domestic abuse expert or a suitably trained member of the healthcare team. This person is responsible then for carrying out risk assessments, having a case load, referral on to further specialist support and for ensuring the team have clarity around child protection issues.

At a strategic level the RCGP recommends that the Clinical Commissioning Groups have an overview of the commissioning and co-ordination of services which all form part of the jigsaw of recognition and support for people suffering from domestic violence. These services will include A&E, alcohol specialist services, maternity services and child protection services.

The guidelines are supported by Identification and Referral to Support Safety (IRIS) and by Co-Ordinated Action against Domestic Abuse (CAADA). See this link for the Home Office's definition of domestic abuse.

Alcohol Concern have produced an Embrace knowledge resource on domestic abuse.

Protect children from alcohol misuse: Turning Point call for early intervention

The health and social care provider Turning Point has said alcohol misuse within families is an escalating concern in its new report "Bottling it up: the next generation". It says early screening and identification of families is needed urgently to prevent the ‘inter-generational cycle’ of alcohol misuse which blights the lives of children and undermines their life chances. 

Up to 2.6 million children live with parents who drink at "hazardous" levels and around 700,000 children are thought to live with dependent drinkers. As picked up in the Daily Express, pressure put on women to be "supermums" was felt to be increasing alcohol use as a coping mechanism. Turning Point said more than 5,000 people who used their alcohol treatment services last year were parents. 

The report says children of parents who misuse alcohol are more at risk of depression, anxiety and increased anger. Turning Point also highlighted JRF research which found that children who see their parents drunk are twice as likely to get drunk themselves. Children living with drinking parents are also more likely to experiment at an early age with alcohol and drugs, increasing the risk of their own later life substance problems. 

In the report Turning Point call on the Government to place a duty on Local Authorities to develop strategies that take into account the harms to family life and children's development. They also advocate the development of services which are more family focused and home-based, better liaison between adult and children's services, and more information available to help affected children.

The charity Adfam exist to improve the quality of life for families affected by drug and alcohol use - and have a find help here page. Alcohol Concern's Embrace project was set up to develop better policy and practice around alcohol and children, families and domestic abuse. Embrace pilots aimed to develop a more family-focused approach to their clients and to take account of domestic violence and abuse throughout their work.

Further alcohol-related reports and guidance related to children and young people can be found here on the Alcohol Learning Centre, including the CMO guidance or see the Drinkaware web-page for parents.

Mayor's report proposes 'alcohol sobriety scheme' for London

Members of the Metropolitan Police Authority (MPA) have received a report from the Mayor on the proposal of an alcohol sobriety scheme for London:

'The compulsory alcohol sobriety scheme is an enforcement approach providing specific powers for the court to order sobriety as an order for alcohol related violence offences. The Mayor is tabling an amendment to the Police Reform and Social Responsibility Bill for changes in the current law to enable the courts to make this order. The compulsory alcohol requirement will involve twice daily testing and failure of the test will result in immediate breach and sanctions, such as custody.'

'It is based around some key principles:

• The judges opt to use compulsory sobriety as a sentencing option instead of choosing to incarcerate offenders.
• The convicted individual is required to check into a designated venue twice daily to be breathalysed for alcohol consumption.
• If the terms of the sentence are breached, the individual is arrested, put into a police cell over night and presented to the judge the following day. The judge has the discretion to decide what happens to the offender, for example incarcerate them, put them back on community sentence etc.
• Individuals pay for their testing.'

The Evening Standard reported the news, highlighting high levels of alcohol-related violence in the capital. However the idea attracted scepticism when announced last year; Don Shenker of Alcohol Concern said he was "dubious about the long term success", instead suggesting alcohol arrest referral programmes required further funding.

Currently Alcohol Treatment Requirements (ATRs) are often used as a voluntary alternative to custodial sentences for those with alcohol dependency. See here for full guidance on addressing alcohol-related offending, and recent documents on IBA for offenders.

Grasping the nettle: alcohol and domestic violence factsheet

An updated factsheet Grasping the nettle: alcohol and domestic violence [pdf] has been released by Alcohol Concern. Authored by Dr Sarah Galvani, it provides an updated overview of the research on the association between alcohol and domestic violence and a clear outline of the implications for policy and practice.

See here for information on Alcohol Concern's children, families and domestic abuse Embrace project.

Cocaethylene: responding to combined alcohol and cocaine use

A briefing paper 'Cocaethylene: responding to combined alcohol and cocaine use' has been produced by the AERC Alcohol Academy. The paper assesses the current understanding, data, trends and implications for public health and alcohol policy.

The briefing identifies that combined alcohol and cocaine use appears to be increasingly popular despite indications of significantly increased health and social risks. Combining alcohol and powder cocaine can form cocaethylene in the liver, a unique metabolite that can enhance the user's experience but significantly increase the risk of heart attack or sudden death. Its use has also been linked to other conditions and an increased risk of violence.

However awareness about cocaethylene and associated risks appears low; the paper recommends that both further research and policy recognition are needed. It identifies a role for alcohol and drugs policy to better respond to poly-use, both within the health & treatment and community safety fields. Although there is little evidence of specific treatment or intervention approaches for combined use, it appears there is scope within existing approaches to better respond to combined use. There may be opportunities particularly within the alcohol field and through the delivery of brief interventions (or 'IBA'), whilst primary powder cocaine treatment indicates positive outcomes for combined users.

The Academy has been developing a cocaethylene training course to develop knowledge and explore treatment responses for combined users, and is working with experts to explore and develop further research on the subject. If you are interested in training or have further information on combined alcohol and cocaine use, please get in touch.

News & reports in brief: holiday units; local alcohol pricing; social work survey; Stella project news; children with binge drinking parents

8 drinks a day is average Briton's holiday alcohol consumption

A Know Your Limits survey has revealed 27% of holidaymakers drank three times or more than usual whilst away this summer, equating to 80 drinks over the course of the average holiday, or well over 200 units of alcohol. But 70% of the 3,500 adults that partook in survey said they planned to make September the 'new January' by cutting back. See BBC and News Rage UK reports for more.

Tackling alcohol related disorder: alcohol summit & local price probe

The BBC have reported that a summit to discuss ways of addressing alcohol-related disorder in Aberdeen has been agreed by the local licensing board. Local councillor Bill Cormie said he wanted the police and health authorities, the licenced trade and the community to discuss the problems to help determine whether a 'culture change' or an excess of licensed premises was responsible.

Authorities in Swindon will be organising extra patrols to gather evidence to check for a link between cheap offers and anti-social behaviour. The move comes following indications that rises in anti-social behaviour may be linked to 'irresponsible' drinks promotions that have increased since the recession, the BBC reports.

Alcohol survey for social workers

Alcohol Concern are carrying out a survey of social work professionals in order to better understand the effects of parental alcohol misuse on children, as part of their research for Alcohol Awareness Week 2009.

Estimated 30% of children live with at least one binge-drinking parent

Action on Addiction have generated estimates from secondary analysis of 5 household surveys that shows a large number of children live with parents who drink excessively, use drugs, have mental health problems or some combination of the three. The estimates found that approximately 30% of children under-16 years (3.4 - 3.5 million) in the UK lived with at least one binge-drinking parent.

See the Alcohol Concern's Supporting children affected by parental alcohol misuse: a toolkit for guidance.

Stella Project summer newsletter

The Stella Project, which promotes good practice and supports direct service providers across the drug, alcohol and domestic violence sectors in Greater London, has released the Stella Project Quarterly Newsletter Issue 3, 2009 (pdf)

Embrace Project: acting together on alcohol, children, families and domestic abuse

Alcohol Concern's National Lottery-funded domestic abuse and families project Embrace has published a newsletter with all the latest project developments, and a 'resource supplement' that lists key journal articles, websites, sources of leaflets and posters, and policy documents.  Well worth a look.

Tackling Violence Action Plan Implementation Guidance 2008

The Home Office has released guidance to assist local Crime and Disorder Reduction Partnerships to deliver action plans to reduce violent crime. The Tackling Violence Action Plan Implementation Guidance focuses on a number of key violent crime types in addition to alcohol-related violence, including gun crime and gang-related violence, knife crime, domestic violence, youth crime and sexual violence.

The document provides guidelines on the strategic framework for implementing local plans to reduce violence and links to a range of key documents and supporting strategies. The report states for alcohol-related violence and PSA 23:

It is recognised that grievous bodily harm (GBH), both with and without intent, can be used as a proxy for the prevalence of alcohol related violent crime because success in tackling all types of alcohol-related violence should be manifested through improvements in the number of GBH offences. Progress on the alcohol-related violent crime outcomes sought both through PSA 25 as well as PSA 23 will be measured using this indicator.

Further guidance on tackling alcohol related violence can be found in the Home Office and Dept of Health Alcohol Strategy Local Implementation Toolkit.

The report also links to the Home office practical guide for dealing with alcohol related problems, which provides an overview of the main measures and legislation to address issues relating to licensed premises, street drinking and individuals.

We have expressed concern about reliance on proxy measures recently, and would prefer to see alcohol flagged better in crime records.