Alcohol is killing too many of us
It gets ever cheaper and now it’s linked to over a million hospital admissions a year. Minimum unit pricing would be a good start
Man drinking a pint
‘Availability of alcohol has multiplied far beyond the local pub.’ Photograph: Johnny Green/PA
In 2011-12, there were over 1.2m alcohol-related hospital admissions in England, according to figures released last week – more than twice as many as a decade ago. There has been a 500% increase in deaths from liver cirrhosis, mainly due to alcohol, in the past 40 years.
Alcohol costs our country £25bn each year, due to its impact on health, crime and society, the workplace and the family. Alcohol exacerbates health and social inequalities. The most socially and economically deprived have up to 10 times greater alcohol-related mortality and admissions to hospital. Approximately a third of all A&E attendances are alcohol-related, reaching up to 80% at weekends. Something has to be done.
Traditionally, we associate alcohol-related harm with the middle-aged, and it is true that this age group, especially men, have the highest rates of liver disease. However, liver specialists are now caring for teenagers with cirrhosis, or life-threatening necrosis of the pancreas, after just five years of sustained, heavy binge drinking.
Young women are especially vulnerable, since they have less body water than men, resulting in higher blood alcohol concentrations for the same amount of alcohol drunk. I have seen five women in their 20s die from cirrhosis due to alcohol.
Alcohol misuse can lead to high blood pressure, strokes and cancers. Doctors are now caring for increasing numbers of young people in their 30s with permanent alcohol-related brain damage. Many of these people require long-term, supervised care, of which there is a major shortage.
So what has changed in the last decade to cause such a rapid increase in admissions? Availability of alcohol has multiplied far beyond the local pub – most is sold in off-licences and supermarkets, where it is often deeply discounted as a loss leader to entice customers into the store.
Alcohol is often much cheaper than bottled water. It is 45% more affordable than it was in 1980, hence it is the cheap, high-strength lager and cider in particular that is drunk in large quantities – especially by the most socioeconomically deprived, the very people we most need to protect. The government had intended to introduce minimum unit pricing for alcohol, but this now appears to be under threat.
The introduction of a 50p minimum unit price in England could bring a nearly 7% reduction in average alcohol consumption and prevent more than 3,000 alcohol-related deaths and 98,000 hospital admissions each year. In addition, it could reduce annual alcohol-related crimes by more than 40,000, including 10,500 violent crimes.
In British Columbia in Canada, a 10% increase in alcohol prices led to a 32% reduction in alcohol-related deaths and a 22% fall in the consumption of higher strength beers.
The minimum unit price works as it targets the problems caused by cheap, high-strength alcohol but does not adversely impact moderate drinkers, who would spend an average of just 28p extra per week . Its introduction is supported by the medical profession, the police, children’s charities and emergency services. Many parts of the global alcohol production industry are opposed.
David Cameron and the coalition committed to minimum pricing in March last year. However, the absence of this policy from last month’s Queen’s speech clearly reflects that corporate interests have got to other members of the cabinet. In 2010, the House of Commons health select committee concluded in its report on alcohol : “It is time the government listened more to the chief medical officer and the president of the Royal College of Physicians and less to the drinks and retail industry.”
And further action is needed. Currently, treatment services are not adequately equipped to cope with the nation’s alcohol problem. Only one in 18 dependent drinkers access treatment services per year, compared with one in two dependent drug users.
Specialist care can pull people back from the brink of the most devastating consequences of alcohol misuse, especially alcohol-related liver disease, give them back their self-respect and restore them to their families and communities. The development of high-quality, integrated prevention and treatment services for those with alcohol-related disease would be a wise investment for the future health of our nation, especially that of our young people.
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