Alcohol Policy UK

Latest from the IBA blog: Extended Brief Interventions (EBI) - losing out?; Sefton EBI case study; Talking or Testing?; IBA bullets - reducing hangovers?

The alcohol IBA blog aims to promote the delivery of IBA through news, links and ideas on IBA from a range of contributors.

Recent posts are highlighted below:

• EBI: lost in the shadow of IBA?   Over recent years there has been a strong policy focus on IBA as a simple brief intervention. A big issue though is whether Extended Brief Interventions (EBI) have been left in the shadow of simple IBA? Read more here

• An EBI case study: where are the rest?   An evaluation of an Extended Brief Alcohol Intervention (EBI) program called 'It’s Your Choice'. The aim was to reduce alcohol related harm in Sefton by providing EBI in the form of a one to one coaching service. Read more here

• Talking or Testing? Which is easier?  Following discussion about doctors objecting to IBA delivery on the grounds that it is ‘additional work', how can we get into the psyche of doctors if we want them to implement IBA? Read more here

• Brief Advice bullets: reducing hangovers?   Not everyone gets hangovers, but for those of us that are susceptible, one must assume they act as a powerful preventative agent. Is the appeal of reducing those painful after effects a useful ‘brief advice’ bullet for a risky drinker to contemplate? Read more here

See here for the June IBA blog round up or the January round up.

The blog also has specific 'About IBA' and 'IBA tools' pages and also aims to highlight other resources such as INEBRIA and the Alcohol Learning Centre IBA pages. See here for the Alcohol IBA Twitter Updates (@Alcohol_IBA).

Please get in touch if you have any IBA projects to share.  

Police chief poses privately run 'drunk tanks': a good idea?

A senior police officer last week caused a media flurry after suggesting 'privately run drunk tanks' should be considered to help deal with alcohol-related disorder.

Chief Constable Adrian Lee said the resources being used to deal with drunken revellers was "public money being used irresponsibly" and called for a debate on the idea. Making the case, the Lee said:

"I do not see why the police service or the health service should pick up the duty of care for someone who has chosen to go out and get so drunk that they cannot look after themselves."

"So why don't we take them to a drunk cell owned by a commercial company and get the commercial company to look after them during the night until they are sober? When that is over we will issue them with a fixed penalty and the company will be able to charge them for their care, which would be at quite significant cost and that might be a significant deterrent."

However the Police Federation says the plan was "neither a viable nor long-term" fix. Certainly there appears little direct evidence that such a scheme would have a detterent effect, although media snapshot polls seemed to indicate support from the majority of the public.

Indeed alcohol-related disorder does take up significant police and health resources, with alcohol a key driver for violent crime. A FactCheck analysis responded to verify the claim nearly half of all violent crime may be alcohol related. Police have also said a single drunk can take up the time of 17 officers and staff, according to a Telegraph article.

What are "drunk tanks"?

Enforced 'drunk tanks' do not exist in the UK, but schemes exist in other countries and various non-mandatory local approaches have been tried in England. According to a Guardian report, enforced 'drunk tanks' originate and still exist in Eastern Europe. However many still do not manage to cover their costs, with the number in Poland having fallen significantly to 34.

In New South Wales, Australia, both enforced and optional "sobering up centres" are being piloted after legislation was recently passed. A factsheet on the sobering up centres says that people can be admitted to the enforced centre after having failed to obey a move-on direction issued by police due to their intoxicated state. A cost recovery fee will be charged which will increase on repeat visits.

Back in England, Alcohol Arrest Referral schemes have been tried but seemingly without success; AAR's did not find measurable reductions in re-offending, although appeared to reduce drinking. Alcohol Diversion schemes have also been piloted, offering offenders the chance to reduce fines by attending an awareness course.

Drinkaware calls for evidence to inform 'binge drinking' strategy

The industry funded alcohol education charity Drinkaware has put out a call for evidence to inform a new approach to address 'binge drinking'. 

Drinkaware describes its aim as providing consumers with information to make informed decisions about the effects of alcohol on their lives and lifestyles. It says its public education programmes, expert information, and resources help create awareness and effect positive change.

Recently Drinkaware released a 2012 impact report, detailing activities and reported impacts on target groups. Earlier this year an independent audit gave Drinkaware a mixed review of its impact over recent years.

Drinkaware are calling for evidence from all interested parties to inform Drinkaware’s future approach to binge drinking. In particular they are interested in "factors which drive ‘binge’ drinking, with an emphasis on evidence of relevance to Drinkaware’s work on alcohol education, consumer information campaigns and local partnerships." See here for further information on specific areas of interest. The research will inform a report to be published in February 2014.

Submissions should be received by Friday 11th October. They can be made either by e-mail to the researcher Simon Christmas at [email protected] or by post to the research company at Simon Christmas Ltd, 31-35 Great Ormond Street, London WC1N 3HZ.

Recent Findings bulletins: no late night entry tried to reduce disorder; LSD as treatment; treatment staff skills matter & more

Recent bulletins from the drug and alcohol bank:

Australia tries bar lockouts to curb alcohol-related disorder

For drinkers and businesses it sounds like a relatively painless solution to one form of alcohol-related disorder: instead of cutting outlets and hours, raising prices and controlling serving, simply ban late-night drinking venues admitting customers during final opening hours. The aim is to prevent disturbance-generating movement between bars without restricting business and drinking hours. The tactic has become popular in Australia and in one distinctive area it may have worked, but generally the evidence is weak. Perhaps there is no gain without some pain.

LSD 'as effective' as approved alcoholism medications

Could a single LSD trip provoke such a radical re-evaluation of their lives that it precipitates remission among dependent drinkers? According to this synthesis of the research, across six randomised trials it can and it has, and the results rival approved medications. Nevertheless, LSD seems unlikely to be welcomed in to the alcohol treatment pharmacopeia.

Treatment: staff do matter

For most research, the impact of the therapist is noise in the system – a nuisance to be adjusted out of the analysis in order to focus on the therapy. This risks sacrificing what matters for what so often does not, so we stretched our hot topics to an issue which arguably ought to be sizzling in the research, offering a reminder of lessons from the past and from general psychotherapy.

Feasible intervention for short-sentence heavy drinkers

Short sentences precluding lengthy treatment are common among female prisoners, but often a single brief intervention session could be fitted in, a tactic tried by this US study to moderate the drinking of very heavy drinking women prisoners. The surprise was not that there were few benefits, but that there were some, especially after a reinforcing session usually conducted after the prisoners' release.

See the Alcohol Learning Centre, Alcohol Research UK, NHS Evidence alcohol page or NICE alcohol guidance and resources for further resources and information.

News & updates Sep 2013: Asda and Co-op under fire; CSJ report; energy drinks; red wine good or bad (again); 'dry bars'; alcohol free sales on the rise & more

Here's some of the recent news since the August round-up:

Asda have ended its pledge to stop promoting alcohol in its foyers after other supermarkets had not followed suit, the Grocer reports. Asda announced the measure in 2011 following the controversial Responsibility Deal alongside £1million of funding for community projects. However Asda CEO Andy Clarke said the Government needed to do more and wasn't prepared to operate in an unlevel playing field.

The Co-op has also come under fire for offering students 10% discount on alcohol - Telegraph report. Students presenting a NUS card can get the discount on all groceries including alcohol, but the scheme has been criticised by Alcohol Concern. Meanwhile students spend 19 hours per week drinking, equivalent to 93 days during a three-year degree, the Huffington Post reports.

The Centre for Social Justice's (CSJ) report No Quick Fix caused a stir for its portrayal of drug and alcohol problems in Britain. The report is critical of the Government's failure on minimum unit pricing and calls for a “treatment tax” to pay for Britain's high levels of dependency compared to Western Europe. But the report itself was not without criticism - see Guardian and Politics of Drinking responses.

People who drink and smoke too much in Edinburgh are being refused emergency hardship payments to help with the impact of the bedroom tax on their benefits - the Telegraph. A DWP spokesperson said the councils had discretionary policy over administering the payments.

Alistair Campbell has been speaking out on alcohol policy following publication of a new book - in a Telegraph article and an interview with the Independent he says 'Britain is a problem-drinking country' and calls for minimum pricing and tighter marketing.

Health

The harms caused by mixing alcohol and energy drinks may have been downplayed, a BMJ comment piece argues - also reported in the Daily Mail. It suggests although links between heavier consumption, violence and injury have been demonstrated, the area is under-researched and reports may have been affected by industry influence. In 2011 Alcohol Concern published a briefing paper warning of the effects of mixing alcohol and energy drinks.

Shock rise in thirty-something women with liver disease due to alcohol, reports the Metro. In London hospital admissions for liver disease caused by drinking among the under-thirties have risen by 112 per cent in the past decade.

Following reports that a glass of wine every day may be good for mental health, an NHS piece explores Can a glass of wine a day reduce depression risk? As for the more widely reported health benefit, a Drinkaware page explores Is alcohol good for the heart?. Meanwhile a BBC report looks at Red wine - what's behind its healthy reputation? 

Doctors call for alcohol guidelines to be halved for pensioners, reports the Daily Mail following a study into older adult's drinking. It echoes a 2011 call for lower guidelines for older adults.

Trade and pubs

Why are sales of non-alcoholic beer booming? asks the Economist. It suggests growth in the market is a result of people becoming more aware of the damaging effects of alcohol as well as the increased production of low and no alcohol beers.

A report that 'health ministers want to take the alcohol out of wine'-indicates policy support for increasing low strength drinks - The Telegraph. A Government spokesperson said "“We will continue our efforts to change EU wine rules, to allow all wine producers to make and market lower alcohol products. This will help to help promote healthier choices".

Are Dry Bars the next big thing? asks a Guardian piece, also the subject of a BBC radio 4 report on Booze Free Bars in which the presenter visits 'dry bars' across the country and meets the owners and drinkers inside.

Pubs are in perilous decline in some parts of the UK, the BBC reports. The biggest threat is across the North West of England, with Bolton, Oldham and Preston all in the top 10 of towns and cities with highest closure rates.

Pre-loading not just about price, reports the Morning Advertiser responding to a Plymouth study on the broader reasons behind young people drinking before going out.

A scheme to ban the sale of super strength alcohol in parts of Wakefield has been given the go-ahead. The scheme follows other areas that have reported success with similar approaches.

Scotland

Scots 'drink too much' despite fall in alcohol per person sold - see BBC and Herald reports. Addaction and Asda are teaming up with a specialist youth agency in Dundee to identify young people at risk of developing serious alcohol problems and offer them help.

To get regular media reports you can sign up to the alcohol e-shot or Drugscope Daily. For the Alcohol Policy UK newsletter email [email protected]

National alcohol survey data to be axed? ONS consultation

As forecast, the Office for National Statistics (ONS) has opened a consultation on axing some of its statistical products, including:

• General Lifestyle Reports (Smoking and Drinking; General Health; Households, Families and People; and Marriage and Cohabitation) and associated data
• annual statistical bulletin on Alcohol related deaths in the United Kingdom
• Decennial Analysis of social inequality in alcohol related causes of death by NS-SEC and sex

The ONS needs to save £9 million over the next two years. The consultation questionnaire lists each option for saving and asks about the impact these possible reductions could have on you and your work. A pdf version of the questionnaire is provided for information and discussion purposes. Responses should be submitted via the online questionnaire by 31st October 2013. 

The General Household Survey/Lifestyle Report is an important source for monitoring trends in alcohol consumption, annually released since 1971. Drinking data from the Survey are widely used by universities and health organisations. The Public Health Observatories (PHOs) use the data on drinking to produce model-based estimates of alcohol consumption at local authority level to inform local decision making.

ONS could save between £100,000 and £500,000 by stopping the Survey. Chopping the bulletins on alcohol-related deaths could save £10,000 to £50,000 each. These savings are small beer compared to the £21 billion a year alcohol-related harm is estimated to cost the UK. ONS aims to publish a summary of the findings of this consultation in early 2014.

Alcohol Research UK have called for those in the alcohol field to respond to the consultation.

Local 'minimum pricing' returns as Newcastle steps up licensing condition approach

Since the Government dropped its pledge to introduce minimum pricing, local approaches are being re-kindled in a number of areas. According to the Morning Advertiser, Newcastle City Council have requested all new licensing applications and variations include a voluntary condition not to sell alcohol at below 50 pence per unit. Premises who do not agree and are linked to alcohol-related problems will then have a license review instigated by the council.

Newcastle City Council first introduced the approach last year on two city centre bars awarded a license subject to a minimum price of £1.25 per unit of alcohol. The city's Pubwatch chairman backed the move saying it would be good for pubs whose trade is undermined by "strong alcohol at pocket money prices".

However licensing lawyers have questioned the approach, although Oldham first adopted it in 2009 seemingly without legal repercussions. According to a This is Money report, a spokesperson for the British Beer and Pub Association said that there were ‘significant competition policy implications for what Newcastle is proposing’ and that it was seeking guidance from the Office of Fair Trading.

Newcastle are also planning to restrict the display areas in off-licenses; a measure in place in Scotland and previously called for by Alcohol Concern.

Meanwhile councils in Greater Manchester are reportedly re-considering a bye-law approach that had received the Prime Minister's backing in 2010.

Alcohol Research UK announce new funding opportunities

Alcohol Research UK have announced its 2014/15 studentship scheme and a new flagship initiative on linking harms caused by alcohol to drinking behaviours. The research charity offers a number of grants, and previously funded work can be accessed via the alcohol library.

For the new flagship scheme, a call for proposals has been made to investigate the link between specific harms caused directly by a distinct pattern, level and duration of alcohol drinking at key stages in the life-course. It is co-funded by the MRC and ESRC and aims to inform public health policy and the design of interventions.

Between £200,000 and £500,000 is available for each flagship project. Full information, including how applications may be made, can be found on the Medical Research Council's website.

Research Studentship Scheme

Universities are invited to apply for one of three jointly-funded research studentships. These studentships will be awarded for studies commencing in the academic year 2014/15 and offer £7,000 per year match funding for three years, to enable a student to undertake research in the alcohol field leading to a PhD.

Please see the prospectus for full details. The deadline for receipt of applications is 4^th November 2013.

PHE release 'alcohol stocktake self assessment tool'

Public Health England have released an Alcohol stocktake self-assessment tool [doc]. It allows local areas to take a systematic review of their strategy for addressing alcohol-related harm in the adult population. See here for a slides overview [ppt] of the tool.

The resource allows local areas to check activity against 7 key domains:

1. Needs assessment and Data
2. Finance
3. Pathways
4. Population Level Actions
5. Targeted Interventions
6. Hospital-based Alcohol Services
7. Specialist treatment

The tool aims to address the integration of activity by all local partners across all levels of prevention and covers interventions that are thought to be most effective. It is in line with NICE guidance, which previously produced detailed benchmarking tools. NICE also recently released Public Health Guidance for local authorities.

A host of other alcohol-related guidance has also been released in recent years, and the Alcohol Learning Centre also includes pages highlighting data tools and commissioning.

Domain 1: Needs assessment and Data

Domain 2: Finance

Domain 3: Pathways

Primary Prevention Section

Domain 4: Population Level Actions

Secondary Prevention Section

Domain 5: Targeted Interventions

Hospital-based Alcohol Services Section

Domain 6: Hospital-based Alcohol Services

Tertiary Prevention Section

Domain 7: Specialist treatment

Latest IAS alcohol alert; DDN; newsletters

The latest Alcohol Alert Issue 2 2013 from the Institute of Alcohol Studies (IAS) is now available. See the cover story Government reads last rites over alcohol strategy or also in the issue reports on:

• Birmingham City Council withdraws from 'Responsibility Deal'

• Sheffield alcohol research group attacks 'below cost strategy'

• Round the clock alcohol home delivery service

• Hospitals missing opportunities to intervene early in care of people with alcohol-related illness - unnecessary deaths being caused

• Balance North East attacks alcohol licensing of cinemas

• Limited use of new licensing powers

• Alarm over prospect of motorway pubs

• Drink drive deaths up by a quarter

• Underage drinkers “turning to online retailers to buy alcohol”

The latest Drink and Drugs News issue can be found here, including a feature on the Findings Drug and Alcohol Matrixes.

See here for the latest Alcohol Concern newsletter or NWPHO alcohol e-shot.

The latest Alcohol Focus Scotland (AFS) newsletters can be found here.