Alcohol Policy UK

Housing and drinking in the home: 3rd London practitioners forum

The Third London Alcohol Practitioners’ Forum was held on Thursday 20th May at City Hall with the theme of alcohol related housing problems and drinking in the home. The Alcohol Practitioners' Forum is an information sharing and networking group that provides a pool of knowledge, skills and expertise to support the Joint Action Group (JAG) on Alcohol - established to deliver the Regional Statement of Priorities on Alcohol. Presentations from the day:

Session 1: Homelessness/Access to housing

• Alcohol floating support/homeless prevention, Brian Watts, Equinox
• Community Alcohol Detox with homeless people, Dr Merlin Wilcox

Session 2: Support within housing/Drinking in the home

• Working with Older Drinkers- Greg Scott, Foundation66 Community Alcohol Support Service
  
• Domestic violence and Alcohol Use – Embrace Project, Don Shenker, Alcohol Concern

Session 3: Unacknowledged Drinking in the Home

• Harmful drinking in the home- James Morris, Alcohol Academy
  
• Royal Geographic Society Alcohol Research, Dr Steven Toole
  
• Specialist floating support for BME groups-Foziha Raja, EACH

Session 4: The London Drink Debate

• Introduction the LDD and its aims and feedback from the LDD initial report, Matthew Andrews, RPHG

Further presentations on alcohol and housing issues can be found here.

Presentations from the previous forum on the Night Time Economy and Community Engagement can be found here.

What awaits the white cider market as White lightning de-listed and tax rises loom?

Heineken plans to de-list its infamous 'White lightning' cider brand, reportedly to 'reinforce its stance on responsible drinking and drive more value into the cider market'. The news is likely to be welcomed by groups and organisations who have spoken out against the damage of high-strength white ciders, as we previously discussed here.

Over recent years homeless charity Thames Reach have campaigned  against high-strength beers and ciders, prompting a recent call to the Chancellor from Labour MP Martin Linton to increase the tax on such drinks. According to the Morning Advertiser, Linton told MPs that these “extraordinarily powerful and destructive drinks” are the “most dangerous addictive drug”, based on information from Thames Reach. He also stated:

“It is a fact that the great majority of sales of super-strength lager and cider are to alcohol-dependent people who are often vulnerable and homeless,” said Linton, during a private members debate in Parliament. “For them, the defining attraction is not the taste, but the price per unit of alcohol. Super-strength affects not only health, but behaviour.” He also pointed out that that a 500ml can of super-strength lager contained 4.5 units - more than the daily recommended guidelines for men.

However there have been objections to further tax rises on ciders, which currently have a lower tax rate. This seems to raise an issue of lack of tax differential between more 'traditional cider' (i.e made with apples), and the high-strength 'white ciders' (reported as having nothing to do with apples - Wikipedia reports it as made from 'fermented corn syrup'). According to Cider UK blog, 'the duty on a mass produced white cider at 7.5% is currently only around a quarter of that on beer of a weaker strength'. They ask 'What are the implications for high quality, 100% juice, craft ciders? At present these have the same alcohol duty advantage as the mass produced industrial imposters'. See here for a summary of alcohol duty rates.

Nonetheless duty on alcohol will still rise (or not fall when VAT goes up, as explained here) and the Conservatives have pledged targeted tax hikes at high-strength beers and ciders. However organisations such as Alcohol Concern, whilst welcoming increased taxes on such high-strength drinks, have urged that this will not stop supermarkets continuing to sell alcohol below cost price as a 'loss leader', instead advocating a minimum price approach.

There is some further interesting history to White Lightning; in 2004 producers stopped selling the special value 3 litre bottles which caused a dramatic 70% drop in sales, followed by rises in sales of the remaining own brand versions. See the 'Cheap Strong Ciders' section on the Wikipedia Cider page for more.

Services that manage the care needs of drunk and incapable people: a review of the literature

The Scottish Government have released a review of the literture on 'Services that Manage the Care Needs of Drunk and Incapable People'. From the summary page:

'The main focus of this report is on "sobering-up services" - services which provide an overnight place of safety for people who are identified as intoxicated (either with alcohol or drugs) in a public place, and who are incapable of looking after themselves because of their intoxication.

The aims of this review were:

• To identify services that exist in other countries (outside of Scotland) to manage the needs of drunk and incapable people and;
• To identify good practice in providing these services.'

The review may be relevant to those commissioning or providing services that respond to street drinkers, homeless or older people with alcohol problems.

Whose cider you on?

We have highlighted concerns about white cider before in connection with its impact on homeless people.  At our seminar, Housing Continuing Drinkers on Friday, the issue came up again when St Mungo's services users talked about trying to prevent the off-license next to their hostel from sellling the stuff, saying "it kills people" and is highly addictive. 

Who, apart from alcohol dependent drinkers, buys white cider?  Impoverished students perhaps.  Should it be banned, or is there a legitimate place in the market for it?  Is white cider worse than (stronger) super-strength lagers; if so why?

An article in Health Service Journal on health and homlessness earlier this month quoted community nurse and alcohol worker Jackie Conarty:

"It's 7.5% alcohol and it's never seen an apple in its life. You can buy a two litre flagon for under £2 and that would knock most people out.  It should be banned.  Strong white cider is cheap because it is taxed at a much lower rate than other alcoholic drinks.

The drinks industry cannot justify creating a drink whose sole market is addicts. We did liver toxicity tests on people who drank white ciders and people who drank beers like Tennents Super, which is strong, but is basically malt, water and hops. White ciders are just chemicals. The liver functions were worse in those who drank white ciders."

Anecdotally people often say to us that white cider kills people and that it rots the stomach but where is the evidence?  We would like more information; please send us what you know so we can put the facts to policy makers and the manufacturers of white cider.

Cheap, super-strength lager and cider killing homeless drinkers

Peter Mansfield-Clark, who runs the Three Bridges homeless hostel Crawley Open House, has spoken out against super-strength lagers and ciders and their effect upon sections of the town's homeless community. He told Crawley News

These drinks are gut-rot. They are lethal. The worst thing is that they are so incredibly cheap.

He is calling for shops to act more responsibly and stop selling super-strength drinks to the homeless.  According to Mr Mansfield-Clark, around one in three of his homeless clients have problems related to alcohol, and he wants to see prices raised sharply so homeless people cannot buy so much alcohol with so little money.  

Crawley News investigated prices of super-strength lagers and ciders at a selection of town shops and found the cheapest deals were:

• a four pack of 440ml Tennent's Super cans for £5.00 (9% abv, ie 32p per unit)
• White Ace cider in 500ml cans for just 69p each (7.5% abv, 18p per unit)

See also homeless charity ThamesRreach's One can is all it takes 2005 briefing paper on cheap super-strength drinks, and this real-cider fan's view of white cider. 

Interesting to contrast this with the furore over JD Wetherspoon's 99p pint (which is 50p per unit) promotion.

New report links homelessness to early relationships

The Salvation Army in the UK has produced its fourth report , The Seeds of Exclusion, that works to understand the indicators in early life which can lead to future problems of social exclusion, including mental health, addictions and relationship breakdown. The report aims to understand the nature, complexity and severity of problems for those suffering from social exclusion. Findings show early relationships to be at the heart these issues.

Commissioner John Matear introduces the report:

Press release and background information here
Download The Seeds of Exclusion (2008)

Joseph Rowntree Foundation announce calls for proposals on 'Multiple Exclusion Homelessness'

A collaboration of key agencies have announced a 680K call for proposals to 'ensure that policy and practice responses to multiple exclusion homelessness are better informed by robust evidence.'

The Economic & Social Research Council (ESRC) have joined up with the Joespeh Rowntree Foundation, the Department for Communities and Local Government (CLG), and voluntary sector agencies such as Homeless Link to invite for proposals.

The specific objectives of the research have been announced as:

• to develop a scientifically rigorous account of the relationship between homelessness and other dimensions of 'deep' social exclusion;
• to attain a theoretically-informed understanding of the causes of multiple exclusion homelessness; and
• to shift thinking on multiple exclusion homelessness away from ‘a priori’ organisational categorisations, towards inductive analyses which start from the perspectives of people with relevant first-hand experience.

The deadline for receipt of applications is 4pm on 7 August 2008 though a launch event will be taking place on the 25th of June.

For more information or to book a place on the launch event see here

London network on street populations from the new EU accession states

James Morris wishes to contact practitioners with an interest in A8/A10 street population issues within London. He writes: some of you I have had contact with already as we are currently halfway through a 6 month pilot in Hammersmith and Fulham (H&F) in which we are working with the Barka foundation (a Polish social inclusion charity) and the Broadway centre. The pilot is a 6 month project that offers reconnection and further support to A8s on the streets of H&F who are vulnerable but not entitled to the support or services in H&F that Barka can offer.  See previous post for details.

I am proposing a network for London so that we can share information, ideas and any good practice relating to A8 street populations. Additionally, current evaluation of the Barka pilot highlights that whilst positive results are being achieved, longer term this project should not operate in isolation as this would potentially create a magnet effect to the borough and therefore a pan-London response could be a more effective approach. A number of authorities have already taken some moves to develop similar work with Barka and it is also within the recommendations of the recently released report 'Beyond Boundaries' to work towards  "...the development of a Europe wide 'Reconnections' programme.  Thereby engaging with migrants and encouraging the most vulnerable to return home to resolve problems in the area where they have greatest social capital." 

Therefore I am inviting you to be part of this network and for any comments or suggestions. I am also proposing a meeting for those interested in working on a pan-London response so once I have an indication of interest I will send out further details.

Contact details: James.Morris@lbhf.gov.uk

Broadway Healthy Living Centre evluation - alcohol-related needs of rough sleepers

Broadway’s Healthy Living Centre (HLC) opened in London in October 2001 with the support of a five year grant from the Big Lottery. The project was specifically designed to meet the health needs of rough sleepers, the street population and vulnerably housed people. It was also hoped that it would enable local health service stakeholders and a frontline service for homeless people to explore joint ways of working to meet the health care needs of this group.

HLCs, by means of a wide variety of innovative activities and services, deliver solutions to help reach public health objectives with regard to obesity; smoking; alcohol; sexual health and mental health. In addition, because of their location and locally targeted delivery (80% of HLC users live in areas of high poverty and deprivation), HLCs seek to address the causes of health inequalities, such as social exclusion, lack of access and socio-economic deprivation.

Activities are targeted to reduce social isolation and promote greater community involvement, more in line with a ‘first step’ approach rather than through the provision of directly health related services. Evaluation research of the Broadway HLC has recently been published.  Measuring the Impact of Broadway’s Healthy Living Centre for Homeless People adds to the body of knowledge about the alcohol-related needs of rough sleepers.   

Of service users seen by the HLC nurse:

• 233 (84%) had a recorded alcohol support need
• 72 (26%) had a recorded drugs support need
• 28 (10%) had a recorded mental health support need.

Service users were surveyed for the research, and were asked if they knew of other places to access health services and whether they were using these services instead of those provided at the Centre.  Of those responding, more than two thirds of the knew where they could access a GP elsewhere. However 80% did not know where they would be able to access drug or alcohol services and nearly 60% did not know where they would access mental health support.

More info

• Big Lottery Fund Health Living Centres programme
• Addressing the Health Needs of Rough Sleepers (Homelessness Directorate)
• Wet Day Centres in the United Kingdom: A Research Report and Manual (King's Fund)