Alcohol Policy UK

Brief interventions not yet 'routine practice'

A study published in the Drug and Alcohol Review journal explores the limited extent of routine brief interventions in the UK, despite extensive evidence of their effectiveness. However the report suggests the recent publication of the NICE alcohol prevention guidance should act as a significant driver as the first clinical guidelines for practitioners.

The abstract of the study states:

'After 25 years of accumulated evidence in this field, brief alcohol interventions have yet to make a significant impact on routine clinical practice. While it is imperative to have good science to make the case for brief intervention delivery, this work is in vain if practitioners are unwilling or unable to use these interventions with their patients. Evidence from the alcohol field and other clinical areas indicates that national prioritisation of brief alcohol intervention activity, by a body, such as NICE, is likely to be a key driver of implementation by practitioners.'

Brief interventions have been a key plank of the Department of Health's (DoH) alcohol strategy, described as 'Identification and Brief Advice' (IBA). Online training, guidance and resources on IBA can be found here on the Alcohol Learning Centre, including the paper 'Clarifying Brief Interventions'.

Whilst GPs are incentivised to deliver brief interventions through a Direct Enhanced Service (DES) and supporting framework, a study released earlier this year identified a number of issues facing delivery in Primary Care. Scotland has set a national target to support routine delivery. The SIPS research trial will soon be releasing final findings which will inform effective practice for specific settings including Primary Care, A&E and Criminal Justice. Past research can be found here from the Findings bank or the ALC.

Britain top for cocaine use in Europe

Britain has the highest rate of cocaine use in Europe according to the 2010 Annual report on the state of the drugs problem in Europe. The report states 6.2% of Brits aged 15-34 reported using cocaine in the past year, compared to a European average of 2.3%.

The report was produced by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). It highlights 9.4% of 15-64 year olds in England and Wales have taken cocaine at some point in their life, rising to 14.9% for 15-34 year olds. Use amongst the 15-34 year old group has risen by close to 50% since 2003 with a proportional increase in related deaths (161 in 2003 to 325 in 2008). Cocaine is the second most popular illicit drug in Europe after cannabis. 

See reports in the Guardian and Telegraph, and an Observer comment piece on Why Britain tops world drug use league.

In a press release, the EMCDDA stated:

'The diverse patterns of drug use in Europe today call for treatment services to respond to a more complex set of needs than a decade ago. With more cannabis, stimulant and polydrug users now in contact with services, there is a growing call for interventions to address problems other than opioid use.'

The report said surveys found that the prevalence of heavy episodic drinking is much higher among cocaine users than in the general population. Next month the Home Office is expected to release the new drugs strategy which is expected to set out a more holistic approach to drug and alcohol treatment.

Earlier this year a briefing paper Cocaethylene: responding to combine alcohol and cocaine use was released by the AERC Alcohol Academy. It highlights a need for better recognition of the effects of combined alcohol and cocaine use through further policy and treatment attention.

The EMCDD report also highlighted the challenges faced by Europe in tackling new patterns of use and supply, including higher numbers of older drug users seeking help.

No minimum pricing for Scotland's Alcohol Bill but 'irresponsible promotions' curbed

Scotland will not be introducing a minimum unit price for alcohol as opposition parties maintained their position, MSPs voting 76-49 against it at the final stage of the Alcohol Bill. The Scottish National Party (SNP) had called for the Scottish Labour and Conservative parties to 'rise above party politics', previously offering a sunset clause as a compromise. The Bill also failed to receive enough support for raising the purchase age for off licence sales, and restricting the caffeine content in alcoholic drinks.

However the Bill will curb irresponsible promotions, introduce a 'challenge 25' age verification scheme and initiate a 'social responsibility levy' option on licensed premises. SNP Health Secretary Nicola Sturgeon welcomed the Bill as a step forward, but spoke out against Labour for failing to back minimum pricing.

The Alcohol Bill will:

• Ban quantity discounts such as 'three for two' or '25 per cent off when you buy six'
• Restrict alcohol promotions in off-sales
• Introduce a Challenge 25 age verification scheme for all licensed premises
• Pave the way for the introduction of a social responsibility levy to ensure those who profit from the sale of alcohol also put something back into the community

A range of press and media coverage includes reports from the BBC, the Guardian, and a comment piece in the Telegraph. Alcohol Focus Scotland said a 'historic opportunity had been missed', criticising the arguments made by opponents of minimum pricing. Health interests had been speaking out ahead of the final stage, the Herald reporting support for minimum pricing from high ranking doctors and police officers following the BMA Scotland publishing a statement of support from 160 key figures. 

But Scottish Labour Party Health spokeswoman Jackie Baillie said “Minimum unit pricing was rightly rejected by MSPs because it is effectively a tax on the poor”. She was backed by SABMiller, Diageo and the Scottish Whisky Association (SWA) who said MSPs should now 'build consensus around alternative, more effective, legal tax-based measures to address alcohol misuse.'

In England, minimum pricing had been called for by the Chief Medical Officer in 2009 but was rejected by Labour, who instead implemented the mandatory code (also banning 'irresponsible promotions'). The Lib Dems had appeared to support minimum pricing prior to forming the Coalition, which is now reviewing measures including a ban on below cost sales and changes in taxation to 'tackle problem drinking'.

Alcohol Concern 2010 conference 'Is drinking damaging childhood?': presentations and DDN report

Presentations are available here from the recent Alcohol Concern 2010 conference 'Is drinking damaging childhood?'.

The latest Drink and Drugs news includes a feature report on day. The DDN editorial reads:

This issue’s cover story makes a very good case, not just for intervention, but early enough intervention. A 32 per cent increase in alcohol-related hospital admissions among the under-18s within just five years. Why isn’t there more of a public outcry?

Young people are more sophisticated than many would give them credit for, but regulation is inevitably rendered impotent by the proliferation of new media. The goal of achieving a 9pm watershed for alcohol advertising on TV is suddenly dwarfed by the reality of the omnipresent internet and mobile devices. How can we keep a step ahead? The professionals that deal with the effects of alcohol on children keep coming back to the same conclusion – that no real progress will be made without tackling the power and influence of the industry. Until then, all we can do is make sure frontline workers are as well informed and resourced as possible, says Alcohol Concern’s Don Shenker.

Alcohol Concern released a series of reports relating to children and young people as part of Alcohol Awareness Week 2010. Two reports on alcohol use and young people were also recently released by the JRF. See the the Alcohol Learning Centre for a full list of alcohol-related documents and resources on children and young people.

DDN has recently ran a series of features on alcohol; the alcohol debate featured in the 11 October issue, prompting a number of letters in response (see page 8). The 27 September issue featured an exploration of the future of alcohol policy within the changing substance misuse and public health agendas.

Home Office structural reform plan: licensing overhaul imminent but below cost ban may wait until 2012

The release of the Home Office business plan 2011-2015 states that legislation in respect of alcohol pricing will be introduced in May 2012 - but only "if necessary". However the Police Reform and Social Responsibility Bill to overhaul alcohol licensing will be completed by December 2010.

The plan states on page 15:

ii. Develop proposals to change alcohol pricing to ensure that it tackles binge drinking, including options to ban below-cost sale of alcohol, working with other government departments. Pricing options must be enforceable, compatible with EU trade law and easily implemented by business - end date April 2011

vi. Introduce legislation, if necessary, in the second session of Parliament to implement changes to alcohol pricing - end date May 2012

The Publican reported that the 'below cost ban has been delayed until May 2012 and will now only be introduced “if necessary”.' The below cost ban has previously been under the spotlight, raising questions over how it would be defined and implemented.

The HM Treasury business plan states the alcohol taxation review 'to tackle problem drinking' will conclude in March 2011. All Government department's business plans can be found here.

JRF studies explore family life and alcohol

Two new studies funded by the Joseph Rowntree Foundation (JRF) exploring issues around family life and alcohol have been produced.  

• Pre-teens learning about alcohol: drinking and family contexts 
• Alcohol consumption and family life

A piece in the JRF blog says 'the findings tell us that home is the place where children learn about alcohol. And, even at an early age, young children have a pretty sophisticated understanding of alcohol and its effects which mostly comes from observing their parents or other adult relatives.' 

Gaps in what children learnt from home were identified, such as the health risks of drinking and the potential risks of drinking outside of the home. The research found that childhood experiences are crucial to forming future drinking habits. The home is an important source of learning about alcohol - young children anticipate modelling their future behaviour on parent's drinking styles.

Last year the Chief Medical Officer released guidance on the consumption of alcohol by children and young people. This was followed by a campaign earlier this year called why let the drink decide?, encouraging parents to talk to children about alcohol. However it was reportedly pulled by the Coalition but a Young People and Alcohol page is still available. Alcohol Concern recently released a report on alcohol strategies relating to children and young people calling for more interventions and support for young people around alcohol.

See here on the Alcohol Learning Centre for a full list of alcohol-related documents and resources on children and young people.

New cider definition to end 'white cider' tax break?

Updated 19.4.11: new report identifies importing of apple content for white cider production.

'White ciders' may no longer enjoy the lower tax rate afforded to cider under a new definition which stipulates a minimum 35% juice content.

Traditional cider makers have welcomed new rules which mean cider or perry with less than 35 per cent fruit juice content will face a higher rate of tax (see here for alcohol duty rates). White ciders will now be classed in the higher 'made-wine' duty bracket. See reports from the Morning Advertiser and The Publican.

The change comes within the Alcoholic Liquor Duties (Definition of Cider) Order 2010 - see here for an HMRC briefing [pdf] and here for the parliamentary committee debate.

The move is seen to form a part of the Government's alcohol proposals which included a commitment to 'review alcohol taxation and pricing to ensure it tackles binge drinking'. Speaking at the committee debate, Treasury MP Justine Greening acknowledged the new duty impact on "industrial ciders" stating "Our broad concern is to ensure that we have an alcohol duty regime that starts to go further in addressing the problems associated with problem drinking." Outcomes from the Treasury taxation and pricing review are still to be announced.

Industrial or 'white ciders' and 'supers' have been a recurring topic given concerns over the level of associated harm. See our recent story 'Super stength beer and white cider under fire'.

Alcohol & Young People: a toolkit for supporting vulnerable young people

Calling Time, the South West Alcohol Improvement Programme (AIP) has published Alcohol and Young People: A Toolkit [pdf]. The toolkit aims to inform and guide professionals and carers concerned with looked after children and young people with special educational needs. It was produced in partnership with Alcohol Concern and builds on relevant policy, research and guidance and is informed by consultation with a number of professionals and young people from across the South West and in particular from Torbay.

A recent report on alcohol harm reduction strategies for all young people was released by Alcohol Concern as part of Alcohol Awareness week 2010.

See here for more alcohol resources for children and young people and more on the South West AIP.

Lancet study says alcohol causes greatest overall harm

A study published in the Lancet suggests alcohol is the most harmful drug when factoring in the cost to society as well as individuals. Drug harms in the UK: a multicriteria decision analysis, was co-authored by Professor David Nutt who hit the headlines last year after he was sacked from his advisory role to the last Government.

The findings develop on an earlier study by Professor Nutt which called for the classification system of drugs to be reviewed in line with harm. Nutt is continuing to call for a change in Government policy; "The Misuse of Drugs Act is past its sell-by date and needs to be redone."

See reports from the BBC and the home editor's comment. A Guardian story outlines Professor Nutt's ideas around a new classification system.

 

The new Lancet study claims to have taken a more advanced approach to assessing harms, using a wider range of 16 criteria. These include an assessment on each drug's affects on users' physical and mental health, social harms including crime, family problems, environmental damage and economic costs. "Overall, alcohol is the most harmful drug because it's so widely used" Nutt has said.

Licensing news Nov 2010: DBOs extended, Licensing Reform tensions & new Community Pubs Minister

Drinking Banning Orders extended

The power to impose Drinking Banning Orders (DBOs) on conviction has been rolled out to a further 25 local justice areas, the Home Office has announced. DBOs are designed to tackle persistent alcohol related anti-social behaviour, allowing magistrates to attach conditions such as banning people from drinking in public or visiting licensed premises. The orders can last from between two months and two years and breaching can result in a £2,500 fine. See here for DBO guidance [pdf].

Licensing reform proposals in the news

The somewhat controversial Home Office Licensing Reform proposals have continued to hit the news, today sparked by backing for the reform from Open All Hours, a network of civic societies and residents groups. The Telegraph reported 'Passive drinking' blighting town centres in response to a press release from the civic movement group. However many sections of the licensed trade have spoken strongly against the proposals and the consultation process.

It is still unkonwn whether many components of the proposals will be adopted, such as powers for health authroities to make representations or how a 'below cost ban' would be implemented. See here for a new comment exploring class and the licensing review and an exploration of policy from The Publican.

Community Pubs Minister appointed

Conservative MP Bob Neill has been appointed as Community Pubs Minister, the Morning Adverstiser reports. Trade groups such as CAMRA and the BBPA welcomed the appintment after the former post of Pubs Minister had been scrapped along with the £4.3 community pubs fund.