Shake it up Speakers called for a fresh look at policy and new ways to engage drinkers at the European Alcohol Conference, held at the Guildhall last month. ‘In policy terms, it’s a relatively new drug on the block,’ began Colin Drummond, consultant psychiatrist at the National Addiction Centre. He emphasised that there was a ‘policy vacuum’ where alcohol was concerned, comparing it to tobacco, which had been tackled much more successfully. In 2012, the EU alcohol strategy had expired, and the European Commission had neither reinstated the old strategy nor brought out a new one. The House of Lords had published an EU alcohol strategy report, laying out the need for policy to be entirely independent, free from ‘vested interests’, and without influence from the industry – which ‘had no place at the table when designing policies,’ he said. Statistics provided by the AMPHORA research project identified a huge variation of access to treatment throughout Europe, said Drummond – for instance, 23.3 per cent of problem drinkers had access in Italy, compared to 6.4 per cent in the UK – with similar variances across local authorities within the UK. In London, for example, things were ‘beginning to get better,’ said Dr Helen Walters, head of health at the Greater London Authority (GLA). London alcohol death rates weren’t as bad as other places in the country – but alcohol-related crimes had a much higher rate. She said that the GLA had focused on keeping alcohol on the public and government agenda. We could change how people were drinking, she said, ‘partly by changing politics, partly by changing public outlook.’ Putting alcohol policy within a cultural context, James Nicholls from Alcohol Research said that ‘there are lessons to be learned from the history of alcohol policy.’ Consumption levels had gone up and down throughout history, with the most significant recent reduction in consumption among young people – not just in the UK, but right across the board. ‘Something is happening here’ said Nicholls, ‘but we don’t know what it is.’ ‘Drinking cultures aren’t static,’ he said – they have changed and changed quite quickly. Policy impacts were unpredictable, and changes occurred differently in different populations and generations. There was a need to develop more advanced theories – policy worked within a cultural environment, and would have different effects depending on the culture around it, he said. When thinking of new ways to engage drinkers, ‘being honest about the pleasure of drugs and alcohol is important,’ said Dr Adam Winstock, director of the Global Drugs Survey. There were a wide variety of different relationships to alcohol across Europe, he said. The UK, for example, had the highest rate of turning up to work hungover, but also had one of the highest rates of awareness of drinking guidelines. The countries that tended to drink more were the ones that wanted help to drink less – but were also reluctant to change their behaviour. ‘We underestimate our personal vulnerability to harm,’ said Winstock – pointing out that individuals not only enjoyed drinking, but rationalised and normalised their behaviour when it suited them, so they were more likely to accept the harms of drinking and drug taking. The UK had the highest rate of ‘normative misconception’ in the world, with most people with alcohol dependence going undiagnosed – people didn’t know they were alcoholics. We needed a different way to engage people, he said. The idea of stopping completely was difficult to understand, whereas simply reducing the amount consumed was more palatable. ‘We need to start a dialogue with people who drink so they just drink a little bit less,’ he said.