Alcohol Policy UK

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.

Alcohol Learning Centre IBA e-learning course launched

The Alcohol Learning Centre has this afternoon launched the Department of Health (DH) Identification and Brief Advice e-Learning course.

The course, commissioned by the DH and designed by e-Learning for Healthcare is free and does not require registration to use. Users can give their details on completion to print out a record of achievment certificate if they so wish.

The course is modular and takes about two hours to complete. It covers the following learning outcomes:

• information and facts about alcohol
• understanding units
• using identification tools
• structuring and conducting brief advice
• practicing brief advice

The course includes a number of interactive assessments and video.  

Alcohol DES payments published

The Statement of Financial Entitlements (Amendment) Directions 2009 has been published, enabling the introduction of payment mechanisms for the new five clinical directed enhanced services including the alcohol DES (see section 7H).  It says:

Direction 3(1)(b) of the Primary Medical Services (Directed Enhanced Services) (England) Directions 2008(a) ..... requires each PCT to establish (if it had not already done so), operate and, as appropriate, revise an Alcohol Related Risk Reduction Scheme for its area. ....... As part of its Alcohol Related Risk Reduction Scheme, a PCT must offer to each contractor in its area the opportunity to enter into arrangements in respect of the period up to and including 31st March 2010, thereby affording the contractor a reasonable opportunity to participate in the Scheme during that period. However, before entering into any such arrangements, the PCT must satisfy itself of the matters set out in direction 3(2)(a) and (b) of the DES Directions [basically the contractor needs to be equipped ie trained to do it properly].

I confess it's the first time I've heard the DES called the  'Alcohol Related Risk Reduction Scheme' but never mind.  The bottom line seems to be that GPs will be submitting their bills for screening newly registered patients (at £2.33 a pop) after March 31st.

DfT consultation on drink driving ends 27th February

Those who want to see the drink drive limit reduced have until 27th February to respond to the Department of Transport's consultation on road safety compliance.  Last year the Chief Medical Officer called for a zero limit for under 20s, and the Scottish Parliament recently voted in support of a cut from 80 to 50mg  per 100ml of blood.  However, road safety minister Jim Fiztpatrick (left) has said he isn't keen on lowering the limit, preferring to enforce the existing one better.

From the executive summary of the consultation document:

"We believe that effective enforcement is the key to tackling drink driving. We will work to improve the efficiency and effectiveness of the enforcement process, by developing targeted checkpoint enforcement and through the introduction of evidential breath-testing equipment. At the same time, we propose to make it easier for the police to enforce drink driving by seeking a legislative opportunity to remove the option for a blood or urine test, now rendered unnecessary by the proven reliability of the breath test, and look at ways to improve our High Risk Offenders scheme to ensure that these offenders complete medical examinations before they are allowed to start driving again."

"There have been calls for some years for a lower limit of 50 mg/100 ml, or less. We have said that we will keep the limit under review.  A change in the prescribed limit would be a significant change of strategy.  We want to have solid evidence on how many deaths and injuries could be avoided by a new limit, and we want to understand the wider social implications of a lower limit.  We are therefore asking respondents to say:

• what priority they think should be given to a change in the prescribed alcohol limit for driving
• what evidence they are able to offer – and what further evidence do they consider should be obtained – to support a fullyconsidered decision whether or not to change the limit."

"We are working to improve our evidence base. The current introduction of digital breath-testers will provide detailed, accurate and timely data on the characteristics of drink drivers. We will combine this with a new roadside survey of drinking and driving in 2009. This research will support future policy and publicity on drink driving."

Further reading

• Background on the government's thinking from Timesonline here.
• Institute of Alcohol Studies Factsheet Drinking and driving
• ACPO report of Christmas 2008 drink drive enforcement campaign here
  

Licensing news and updates: Scottish Industry agreement, Guinness glass has units, Pubwatch legality issue, Trading Standards reporting initiative

Scottish Government agrees new responsible sponsorship agreement

The Scottish Government and the Alcohol Industry Partnership have drawn up a new agreement which means sports teams, celebrities or events with appeal to under 18s will not be sponsored through alcohol branding. The deal also means responsible drinking messages will also appear at points of sale for alcohol. For more see a BBC report here. The move comes after talk of tough action on the industry by the Scottish government, including an rumoured move at introducing minimum pricing and moves to make a minimum age of 21 for purchasing alcohol from off-licenses. 

Last year year the British government set out objectives for a new mandatory code that would seek to increase the responsible retailing of alcohol.

New Guinness glass shows units

Drinks giant Diageo meanwhile takes a further step in improving unit awareness; a new Guinness glass that displays a pint's unit content of 2.3. See here for more.

Pubwatch ban powers to be challenged

The legality of powers to ban people from premises through the Pubwatch scheme is to be challenged. A forthcoming case is based on the issue as to whether the action to decide if a ban is appropriate holds a sufficient review process, based on a case in Haverhill. See CRP news story here. However Drinking Banning Orders take effect this year following the introduction of the 2006 Violent Crime Reduction Act.

Trading Standards acts to encourage under-age sales reporting

South Derbyshire's Trading Standards Team have taken a proactive approach to encouraging residents to report suspected under-age sales following only one such report. The lack of reporting came despite local shops selling to under 18s in nearly a quarter of cases. In response, the Violence, Alcohol Harm and Licensing (VAL) group have produced a form available from the council website for residents to use to report a suspected under-age sale. The form can be directly downloaded as a PDF here . See Burton news story for more.

Study shows naltraxone helps primary care management of alcohol dependance

Interest in naltrexone as a treatment for alcohol misuse seems to be on the rise (see previous post). Drug and Alcohol Findings has published a bulletin highlighting the efficacy of naltrexone in supporting GPs  to manage patients' alcohol dependence. The findings, based on a US study, indicated that naltrexone effective for low-level management of dependant drinkers in primary care.  When also combined with Cognitive Behavioural Therapy type approaches, its efficacy and longevity was increased, even for abstinence based support. Naltrexone is typically believed to have most value in assisting controlled drinking goals amongst clients.

Applying the findings to the use of the drug in the UK, the report states:

"Its suitability for controlled drinking programmes should make it more acceptable in Britain, where major studies have provided greater support for naltrexone than for acamprosate. However, its unlicensed status in Britain has probably limited naltrexone's usage and with it how comfortable doctors feel prescribing the drug."

See here for a wider report on the pharmacotherapy of alcohol dependence.

Regional Alcohol Manager, Nottingham

We're getting the NHS job alerts now so we hope to bring you NHS jobs as soon as they come up:

Regional Alcohol Manager for East Midlands, Nottingham

• Salary: £37,106 to £44,527
• Band 8a on secondment from the NHS or Fixed Term Appointment
• 1 year Secondment or Fixed Term Appointment (with the intention to extend)
• Directorate of Public Health for East Midlands, based in Nottingham
• Closing date18th February
• Details here

Foetal Alcohol Spectrum Disorder information and conference dates

The charity Foetal Alcohol Aware Syndrome UK has launched dates of two conferences aimed at raising awareness and responses to issues relating to Foetal Alcohol Spectrum Disorder (FASD). The low-priced conferences, entitled “What is it? How it happens.  Its impact on education” will take place in Manchester and North Wales on the following dates:

• Manchester: Thursday 19th March 2009 FASD Manchester flyer and info leaflet
• North Wales: 27th March 2009 FASD North Wales flyer
  

For further details or information please contact FASawareUK:
Phone: 01942-223780
Fax: 01942-223780
Email: [email protected]

Previous post on alcohol in pregnancy including guidance documents from the BMA and the Royal College of Obstetricians and Gynaecologists here.

Data from the latest Adult Psychiatric Morbidity Survey (APMS): decline in alcohol dependence in men

The Adult Psychiatric Morbidity Survey (APMS) series provides data on the prevalence of both treated and untreated psychiatric disorder in the English adult population (aged 16 and over. Last week the NHS Information Centre for health and social care published findings from the third survey in a series conducted by the National Centre for Social Research in collaboration with the University of Leicester.

Sally McManus, one of the editors of the report, has kindly submitted the summary below to Alcohol Policy UK.

One chapter in the APMS 2007 survey report presents prevalence estimates of hazardous and harmful drinking and of alcohol dependence in the adult general population, and compares these with rates from the APMS 2000 survey. A survey of the household population such as this is likely to under-sample dependent adults, who are more likely to be homeless. Moreover, dependent drinkers who do live in private households may be less available, able or willing to participate in surveys.

Hazardous and harmful drinking were measured using the AUDIT (Alcohol Use Disorders Identification Test), administered by self-completion. An AUDIT score of eight or more indicated hazardous drinking, and 16 or more indicated harmful drinking. Alcohol dependence was assessed by the self-completed SADQ-C (Severity of Alcohol Dependence Questionnaire, community version). A SADQ-C score of four to 19 indicated mild dependence; a score of 20 to 34, moderate dependence; and a score of 35 or more, severe dependence.

• The prevalence of hazardous drinking identified by APMS 2007 was 24.2% (33.2% of men, 15.7% of women). This included 3.8% of adults (5.8% of men, 1.9% of women) whose drinking could be categorised as harmful. In men, the highest prevalence of both hazardous and harmful drinking was in 25 to 34 year olds, in women in 16 to 24 year olds.
• The prevalence of alcohol dependence was 5.9% (8.7% of men, 3.3% of women). For men, the highest levels of dependence were identified in those between the ages of 25 and 34 (16.8%), for women in those between the ages of 16 and 24 (9.8%). Most recorded dependence was categorised as mild (5.4%), with relatively few adults showing symptoms of moderate or severe dependence (0.4% and 0.1% respectively).
• The prevalence of alcohol dependence was lower for men in 2007 (9.3% of 16-74 year olds) than in 2000 (11.5% of 16-74 year olds). It remained at a similar level in women.
• Alcohol dependence was more common in white men and women than in those from minority ethnic groups. There were no significant variations in the prevalence of dependence by region or income. However, the likelihood of being a hazardous drinker did vary between regions.
• 14% of alcohol dependent adults were receiving treatment for a mental or emotional problem. Dependent women (26%) were much more likely than dependent men (9%) to be in receipt of such treatment.

Regional alcohol manager, London

This job advert slipped under the radar - sorry for short notice in posting it here.  We knew it was coming up but thought it would appear in Society Guardian, as is the norm for these jobs.

Regional Alcohol Manager in the Regional Public Health Group – London

• Salary: – £44,681 - £59,961
• G7 Civil Service Band 8a (AforC)
• Two-year secondment
• Closing date 4th February 2009
• details here