Alcohol strategy is ripe for refreshment

Time is of the essence in overhauling the alcohol strategy, says the Drugs, Alcohol and Justice APPG. DDN reports.

‘We were asked by government, “what should be in the alcohol strategy?”,’ said Dr Richard Piper, chief executive of Alcohol Research UK – a question he passed on to the Drugs, Alcohol and Justice Cross-Party Parliamentary Group.

Alcohol strategy is ripe for refreshment – and there is plenty of evidence on which to draw, says ARUK chief exec Dr Richard Piper.

The last alcohol strategy was in 2012 and last year’s drug strategy ‘only made passing reference to alcohol’, he pointed out. But Public Health England’s 2016 evidence review had shown that there was a large pool of evidence on which to draw.

‘Any alcohol strategy should be developed with health inequalities in mind,’ he said. It should also be impact based and ‘clear about the difference we are trying to make’.

The strategy had to aim for reduc­tions in alcohol-related attendance at A&E, mortality, and crime, said Piper. Its content should have three key themes – support and interventions; the consum­er side; and ‘other’, which included considerations such as drink driving.

Children and families needed to be central to considering interventions – ‘both as victims and part of the solution’. Mental health was also a critical part. ‘We need to understand more about dual diagnosis,’ he said. ‘When does mental health trigger a problem and vice versa?’ He also reminded the group that the cost of not treating people was much higher than treating it.

Dr Richard Piper of ARUK: Attitude of ‘let’s wait and see if people die’ is indefensible.

On the consumer side, minimum unit pricing (MUP) was evidence based and necessary. ‘Evidence supports it,’ he said. ‘Saying “let’s wait and see if people die” is indefensible.’ Advertising and sponsorship should no longer be targeted at young people; online sales should be addressed (including very easy alcohol sales on eBay); local communities needed to be able to get involved in licencing decisions more easily; and alcohol labelling should be revised to include ingredients, calories and information about health harm.

Alison Douglas, chief executive of Alcohol Focus Scotland, took up the issue of MUP. Scotland intended to implement minimum unit pricing imminently she said, adding ‘it is not a standalone policy, it is part of a package of measures’. Three things stood out – price, availability and marketing – and it was clear that a ‘whole population approach’ was needed.

‘There’s a huge cost in misery and loss of life years and the impact is felt by all of us,’ she said. ‘It’s not just a health problem, it’s fundamentally undermining the fabric of society.’

The logic behind focusing on MUP was that it was an ‘exquisitely simple and targeted measure’. ‘It’s not based on any one product, but applies to all premises that sell alcohol and targets the cheapest high-strength alcohol,’ she said. In answer to the argument that MUP penalises the poor, she said that they were most likely to benefit: ‘Harmful drinkers in the poorest groups are the ones most affected by MUP.

‘We want to see it extended to all of the British Isles because of the benefits to public health and communities,’ she added.

Julie Breslin brought her experience as head of Drink Wise, Age Well, a lottery-funded programme led by Addaction, which helped people over the age of 50 to make healthy choices.

The aging population of the UK consumed more alcohol than other age groups and ‘must be considered in any strategy refresh’, she said. Harmful attitudes relating to alcohol were increased by living alone, chronic illness or disability, while contributory factors could be retirement, bereavement and lack of a sense of purpose as people got older. The long-term health impact of drinking too much was ‘significant’.

The Drink Wise, Age Well programme helps people over 50 to make healthy choices.

The treatment sector was failing to respond to the needs of this age group, Breslin reported. Three-quarters of rehabs had an arbitrary age cut-off and there was ‘a perception that you can’t teach an old dog new tricks’. The new strategy should incorporate age as a cross-cutting theme, with an advisory panel convened to give guidance, she said.

The benefits of the Drink Wise, Age Well programme were illustrated by Vince, who shared his personal story. ‘I’ve always enjoyed a drink with colleagues and friends,’ he said. ‘Then I was signed off work with ill health and this was when drinking became more of a problem. I used it to cope with pain. I saw my GP, and while we discussed the need to cut down my drinking, he didn’t refer me for help.’

Being referred to Drink Wise, Age Well led to being referred to a detox unit, followed by support at home. Peer support meetings became a ‘crucial part’ of his recovery and he became a volunteer helping to facilitate them.

‘If it wasn’t for support, I wouldn’t have had the strength to do it on my own,’ he said.

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