Alcohol Policy UK

'Statistics on Alcohol, England, 2015': trends remain but lags and pressures could spell change

The annual Statistics on Alcohol for England 2015 has been released, detailing national data for key alcohol-related indicators and health harms. Mainly bringing together various previously reported alcohol data releases, the current trend picture remains one of declining consumption but still rising alcohol-related harm measures.

Readers will know well the time-lag effect between consumption and health harms, but interesting questions exist over whether current trends are stabilising or could indeed soon reverse. It may be that in the near future figures will show hospital admissions starting to fall, lag-responding to the decline in consumption, but consumption potentially back on the up as spending increases.

Of course behind the general trends are many complexities - falls in consumption and binge drinking are most evident in young people in particular, but in fact rising slightly amongst older adults. Regional differences on some measures are also stark.

IAS Alcohol Alert June 2015: Loi Evin under threat, tackle cheap drink to support pubs, 'huge' growth in online sales, Welsh Health Survey

The latest Institute of Alcohol Studies (IAS) Alcohol Alert: June 2015 is now available (here for PDF version). Read the editorial here and articles below:

• NGOs quit EU Alcohol and Health Forum

• France: National Assembly votes down government over Loi Evin

• Statistics on Alcohol England 2015: Consumption falls, admissions rise

• Rising trend in alcohol-related liver disease admission rates continues

• Millions of alcohol units lost to special occasions in surveys

• Support pubs, deal with off-trade cheap drink

• UK online drinks market sees huge growth in 2015

• Study: Alcohol treatment programmes slash male reoffending rates

• Lower drink-drive limit to Scots level, urge Police Federation

• Facebook can help reduce problem drinking among fresher students

• Sturgeon: Member States need autonomy over alcohol policy

• Welsh Health Survey 2014: Older drinkers buck downward consumption trend

• Eurocare to F1 – alcohol ads must stop

• FARE unveils alcohol plan to tackle Australian domestic violence

• Balance North East launches 7 cancers campaign

Guidelines to support people bereaved by alcohol or drugs

New guidelines to support people bereaved by alcohol or drugs have been released by a University of Bath and University of Stirling collaboration. The guidelines result from a three year project which found those left bereaved after a drug or alcohol related death often receive poor, unkind or stigmatising responses which can exacerbate their grief.

Download the guidelines 'Bereaved by substance use' [PDF]

The guidelines identify the complexity of substance related deaths and the myriad of different individuals and organisations they encounter after. As such better cross-agency working could improve the experience of the bereaved, alongside improved understanding and practice by practitioners.

Lead researcher, Dr Christine Valentine from the Centre for Death & Society, said:

“The unique combination of circumstances surrounding the death of somebody from alcohol or drug use can produce particularly severe bereavements.

“The fact that many of us feel uncomfortable or unsure about how to respond to these bereaved people, how we talk about these deaths and the limited support offered, are all symptomatic of the fact that, so far, this group, though sizeable, remains hidden and neglected by research, policy and practice.

“Our research has found that, while poor responses from services adds to their distress, a kinder and more compassionate approach can make a real difference. Our hope is that these guidelines - developed for practitioners by practitioners - will provide a much needed blueprint for how services can respond to these bereaved people.”

Among the report's key messages it suggests:

- Always show kindness and compassion when interacting with a bereaved person. First impressions make a huge impression and can greatly help or hinder a person’s response to grief.

- Think about the language you use. Avoid using labels like ‘addict’; instead talk about drug use and alcohol use. Use language that mentions the person before describing their behaviour. Avoid saying ‘I know how you feel’ and ‘You shouldn’t blame yourself’.

- Treat every bereaved person as an individual. Do not make assumptions about the person who died and about how this kind of death may affect those left behind and how they will react.

- Whatever your role, do what you can to protect the bereaved person’s well-being in a difficult and stressful situation. Do not be afraid of speaking to them about the death - it is often worse when it is not acknowledged. Ask the bereaved person what will help and what they want of you. Be willing to really listen.

- Be aware of and work with other organisations dealing with this kind of death, so you can advise bereaved people about what they need to do, who they need to see next and what is going on. There may, for example, need to be a post mortem, inquest or police investigation.

 

Alcohol and breast cancer: Alcohol Concern factsheet highlights limited public awareness

Alcohol Concern have released a new factsheet highlighting the link between alcohol use and breast cancer in women. It says just two drinks a day can increase the risk of developing breast cancer by 18%.

The factsheet highlights:

• In 2011, 3,000 of the breast cancer cases were directly attributable to alcohol consumption
• Each drink per day increases the risk in women of developing breast cancer by between 7% – 12%
• Alcohol has long been known to have carcinogenic (cancer causing) properties, and more than 50 studies have confirmed alcohol is a particular risk factor in the development of breast cancer
• The exact causal mechanism between alcohol and breast cancer is not fully known – but it is likely due to the way alcohol breaks down into toxic chemicals in our body and increases the production of the female hormone oestrogen.

Getting the message out?

Alcohol Concern say fewer than half of the British public know of any link between alcohol and cancer, and less than a third of a link between alcohol and breast cancer.

Alcohol Concern though are not the only group aiming to increase awareness of the risks - Cancer Research UK run their own 'Dry January style 'Dryathlon', and have appointed Prof Linda Bauld as their Cancer Prevention Champion. The work includes research to better understand consumer's knowledge and attitudes to drinking and how these might be influenced.

Last year MacMillan cancer support also launched a 'Go Sober for October' whilst this year's Dry January seemed to be gathering momentum, also receiving a boost from research indicating sustained reductions in many participant's drinking.

In 2013 Balance, the North East alcohol office, launched a hard-hitting health campaign warning that alcohol is in the same cancer causing category as tobacco smoke and asbestos - see the video here or visit www.reducemyrisk.tv. Scottish Health Action on Alcohol Problems (SHAAP) also released a report Alcohol and Cancer Risks: a Guide for Health Professionals [pdf].

Cancer Research UK have previously highlighted up to 40% of cancers could be prevented through healthier lifestyle choices - reducing cancer risk therefore seems to make sense as an alcohol health message.

However knowing to what extent such messages really impact behaviour change is challenging. Much is made of the limitations of 'education' based approaches, and single risk factors can be hard to isolate from multiple lifestyle behaviours and environmental influences. Nonetheless, public health bodies will be hoping that a growing understanding of broader alcohol risk factors will help sustain recent downward trends in alcohol consumption.

Events, Jobs & more: UKCTAS course returns, DrinkWise NW seminars, Alcohol Research UK jobs, liver disease & alcohol risk surveys

Events

UKCTAS Alcohol Policy and Practice CPD course returns

The second Alcohol Policy and Practice CPD course, run by UKCTAS, the UK Centre for Tobacco and Alcohol Studies, will take place in Sheffield from 1st - 4th September 2015. The module is aimed at professionals working in a range of organisations who are interested in alcohol policy and practise.

It follows the success of the first Alcohol CPD course at the University of Stirling in 2014. This years course is being held at the University of Sheffield and is taught by leading academics and practitioners from various UKCTAS institutions and includes a balance of lectures, discussion groups and debates. See the website for costs and more details.

DrinkWise North West Seminar Series

The Drink Wise Seminar Series of events is free to leads in the North West, the first seminar will be taking place on 30^th June in Manchester and will be focused on protecting young people from alcohol marketing. See full list of seminars heren [pdf].

Also..

Alcohol Concern Wales are holding a conference on alcohol and pregnancy on 21 September in Cardiff. See here for the conference agenda or register here at a £60+VAT early bird rate.

The Global Alcohol Policy Alliance (GAPA) and Alcohol Focus Scotland are to co-host the next Global Alcohol Policy Conference which will be held in Edinburgh from 7-9 October 2015.

The Society for the Study of Addiction Annual Symposium 2015 takes place 5–6 November 2015 in York. Topics will include recent findings from research funded by Alcohol Research UK, recovery and Science and politics – synergy or conflict?

Jobs

Alcohol Research UK UK Jobs, studentships and CPD support

Alcohol Research UK are recruiting two new posts:

• Director of Fund Development

The Director of Fund Development will be responsible for preparing and then delivering strategies for generating new sources of income to fund more research.

• Marketing and Communications Officer

The Marketing and Communications Officer’s role will be to ensure that we properly and fully communicate our work to all of our stakeholders.

Alcohol Research UK are also offering support through studentships and Continuing Professional Development.

Also...

Alcohol-Related Liver Disease survey

A survey on alcohol-related liver disease (ARLD) has been released by the Alcohol-Related Liver Disease Priority Setting Partnership, and gives patients, carers, clinicians and family members affected by ARLD an opportunity to have their say and influence future work. The survey is available at www.psp.nihr.ac.uk/alcohol-related-liver-disease/survey

Consumer survey on communication of alcohol associated risks

A European survey is seeking more UK responses to help map consumers’ opinions on communication of alcohol associated risks. Led by the European Union Joint Action on Reducing Alcohol Related Harm, the survey wants to learn more about the mixed messages the public receive on alcohol consumption and risk. UK responses sought here.

Developing Alcohol Care in London's Hospitals and Beyond - PHE event report and slides

Public Health England (PHE) have released a conference report following an event earlier in the year exploring the role of Alcohol Care Teams (ACTs) in London. The event follows PHE ACT guidance released last year and also aimed to showcase best practice whilst exploring funding issues and the business case for investing in ACTs.

Download 'Developing Alcohol Care in London's Hospitals and Beyond' [doc] - slide links included within the document.

Presentations were given by a number of speakers including Sir Ian Gilmore, who gave overview of the current harm caused by alcohol in the UK and the case for ACTs. This followed an opening address by Professor Yvonne Doyle, London Centre Director for PHE, outlining the picture of alcohol harm in the capital.

Professor Colin Drummond detailed the case for ACTs and factors that need to be taken in to consideration when commissioning an Alcohol Care Team. Jo Roebuck, from PHE London's Alcohol and Drugs Team presented on the recent PHE guidance and value for money tools.

As an example of ‘Commissioning a Best Practice Alcohol Care Team’, former Ealing Public Health Commissioner Elizabeth Offer presented on the business case used to commission the service, as well as the links with local outcome frameworks and governance.

Adrian Jugdoyal, Alcohol Liaison Nurse in Ealing Hospital identified that additional investment through the Ealing ACT produced exponential outcomes, better safeguarding, and significantly reduced the rate of alcohol related hospital admissions. He also stated that the basic requirements for an alcohol care team are four staff with administrative support covering seven days a week plus evenings.

Adrian Brown, Alcohol Liaison Nurse at Northwick Park hospital, also presented a comprehensive generic care pathway whilst key messages from workshops on commissioning and local planning for ACTs are also detailed.

See the conference report for links to all the presentations, here for PHE's ACT review and PHE guidance to improve support for young people in A&E. See here for a 2014 Alcohol Research UK report, A national study of acute care Alcohol Health Workers.

No EU alcohol strategy sees health groups resign from Alcohol and Health Forum

Earlier this month twenty-one health groups announced they were withdrawing from the EU Alcohol and Health Forum after its commissioner said there were no plans to establish a new EU Alcohol Strategy.

A collectively signed letter outlines the group of NGOs “deep concerns” about the neglect of public health and the prioritisation of alcohol industry interests. The signatories include the heads of UK organisations such as the Institute of Alcohol Studies (IAS), Royal College of Physicians and Scottish Health Action on Alcohol Problems (SHAAP).

The NGO's say they have decided to withdraw from EU Alcohol and Health Forum as its purpose was to support implementation of an EU strategy, and that the Forum has not been effective.

No EU level strategy had been in place since 2012 and instead the European Commission's Dr. Andriukaitis, Commissioner for Health and Food Safety, recently set out plans to include alcohol within a wider framework for tackling chronic disease. However the signatories of the letter say this means action on key alcohol harms such as drink driving, domestic abuse and child sexual exploitation will therefore be overlooked.

Nina Renshaw, Secretary General of the European Public Health Alliance (EPHA), said, "the Forum has proved worse than useless, a free PR front for the industry" and that "the Commission even endorses the industry introducing drinking culture to young kids by promoting 'responsible' drinking in primary schools."

However SpirtsEurope issued a press release stating the resignations were "premature" given no clear details of the forthcoming framework had been released, also rejecting the charge that the Forum had lacked efficacy. It also said it would continue to work on "meaningful actions" with European partners and had a "commitment to change social norms for the better."

The walkout parallels that of England's Responsibility Deal, where health groups walked out at various stages, unhappy with the commitments being made and broader alcohol policy decisions such the u-turn on minimum pricing.

Eurocare, the European Alcohol Policy Alliance, had been campaigning for a comprehensive EU alcohol strategy and in April the European Parliament (EP) adopted a Resolution calling on the Commission to adopt a new strategy.

Earlier this year a House of Lords committee report had also called for key EU level action to reduce alcohol-related harms, rather than relying soley on efforts by member states. It highlighted the need in particular for reform on alcohol tax structures and labelling legislation, and clear measurable actions and evaluation on future actions.

Findings alcohol bulletins: Measuring alcohol harm and the £21 billion?, minimum pricing impacts, IBA & pregancy, web based IBA for students

Recent bulletins from the drug and alcohol bank:

Measuring and reducing alcohol-related harm

Alcohol-related harm is said to cost the UK £21 billion, but the assumptions behind this calculation and decisions about what to include mean the figure can vary wildly. Even a seemingly simple statistic like alcohol-related hospital admissions has been redefined, cutting the total in England by over a third. In the mix for reducing this burden are universal prevention, price rises, screening and brief advice, and treating the worst cases.

Poor heavy drinkers most affected by minimum price

With this first UK survey providing data on price paid for alcohol plus consumption and income, the evidence is converging on the conclusion that poor heavy drinkers would be most affected by a minimum per unit price, gaining most in health, but losing most either in having to spend more or cut back on their drinking

Identifying risky drinking in pregnancy

Heavy drinking by mothers-to-be threatens their unborn child – but for that very reason, women may shy away from admitting to it. This review found several brief screening questionnaires showed promise in identifying mothers who might need to cut back, while others seemed unsuitable for the antenatal care context.

Web-based drinking feedback barely dents student ‘binges’

Findings from this multi-university study (said to be “as near to a real-world evaluation in a population of university students as is likely to be achieved”) in New Zealand seem an example of trials of brief alcohol interventions as they would be implemented in routine practice failing to match more promising findings from trials in less ‘real world’ circumstances.

Alcohol-related hospital admissions for 2014 - not so simple

Alcohol-related hospital admissions have continued to rise in England, although rates for under 18 admissions have fallen sharply since 2006. See the PHE press release or the statistical reports.

The majority of alcohol-related hospital measures show rises, despite a general pattern of falling alcohol consumption since 2004. However previous decades of rising consumption lead to a 'lag effect' for many related long term health conditions, whilst falls in young people's drinking appears to show more immediate impacts on hospital figures. PHE report a 41% fall in alcohol-related hospital admissions for under-18s since 2006. However between 2002 and 2007 they increased by 32%, according to an Alcohol Concern report.

Alongside under 18's admissions, unintentional injury conditions and chronic liver disease mortality also fell on last year. However the majority of alcohol-related indicators continued to rise including alcoholic liver disease, mental and behavioural disorders and related cardiovascular disease. Alcohol related mortality rates remained stable.

Remember the headlines?

Announcement of the new figures no longer appear to generate significant media attention following changes to the reporting of the data. Total alcohol-related admissions for England reached over one million in 2009/10 with subsequent annual releases generating mass media coverage. However last year a change of focus to a new 'narrow' measure of alcohol-related admissions has seen admissions data announced as part of the Local Alcohol Profiles for England (LAPE) updates.

As such, total alcohol-related hospital admissions for adults in England only appear as a rate per 100,000 population for the 'old' broad measure (where the primary or any secondary reason for admission relates to alcohol). With this rate at now its highest, total adult admissions under the broad measure are likely to total around 1.25 million, nearly double the 644,700 recorded for 2004/05. 

Under the new headline narrow measure, a small 1.3% rise on last year takes the figure to 333,000. In fact a fall was shown in the previous year (2012/13) for the narrow measure, indicating a much smaller trend rise over the recent decade.

PHE say the last year's rise was most significant amongst women - a 2.1% increase whilst only up 0.7% for men. PHE also highlight large regional variations with rates in the most deprived areas 55% higher than the least deprived.

News & updates May 2015: alcohol research, football fans, Formula 1, night time economy

Selected media stories since the April roundup

Alcohol research stories

Binge drinking as a teenager causes long-lasting changes to the regions of the brain that control learning and memory, according to new research reported in the Daily Mail

Teenagers who mix energy drinks with alcohol are more likely to binge drink and abuse alcohol later in life, again according to new research reported in the Daily Mail

The Express asked whether weekend wine could be ruining your waistline (it could).

The Independent looked at how alcohol makes you friendlier – but only to certain people, whilst according to a new study published in the Journal of Sex Research, which included 18 females, booze is a total killjoy when it comes to getting it on and really getting off, reported Metro.