Wise up

With awareness of the damaging effects of alcohol still nowhere near where it should be, DDN looks at some recent attempts to educate the public about the risks most of us still tend to ignore.

The third week of last month was Alcohol Awareness Week, which this year took the theme of alcohol and mental health (DDN, November, page 5). While the long-established week complements other annual initiatives like Dry January and Sober October, the public’s awareness around alcohol remains stubbornly low.

When the government launched its consultation on labelling all alcohol products with calorie information it was revealed that despite 3.4m people consuming an extra day’s worth of calories each week in the form of alcohol, around 80 per cent of the public were unaware of the calorific content of their drinks (DDN, October, page 4). And while most people probably know that excessive drinking can cause liver damage, awareness levels of the links between alcohol use and cancer tend to hover around the 10-13 per cent level, depending on which survey you look at, with awareness of the links with conditions like high blood pressure and heart disease also remaining low.

None of this is helped, of course, by the fact that self-regulation means that inclusion of health risk information on alcohol labelling is still voluntary, and the industry has in the past even been accused of deliberately misrepresenting the evidence about alcohol-related cancer risks (DDN, October 2017, page 4). What’s more, there hasn’t been a new UK alcohol strategy for almost a decade, and it’s unlikely to be near the top of the list of government priorities anytime soon. With the added impact of the COVID-19 lockdowns on people’s drinking habits, the need has arguably never been greater to make sure people are armed with as much knowledge as possible.

Coping mechanisms

And that impact seems to have been significant. More than a quarter of drinkers said they drank more during the first lockdown, with half of this group saying they’d probably keep drinking at the same levels after it lifted (DDN, July/August, page 5). And lockdowns have significantly exacerbated existing problems of loneliness and isolation, both of which can mean people increasing their alcohol intake.

A YouGov survey commissioned by Turning Point found that more than one in ten people who experienced loneliness were turning to alcohol to cope (DDN, March, page 5), while new research from With You (We Are With You) has revealed that more than 4m over-50s were binge drinking at least once a week during lockdown (see news, page 5). The same survey found that 5.2m over-50s were drinking alone because of the restrictions, with 1.9m drinking earlier in the day.

While it’s long been apparent that many older people increase their alcohol consumption as a result of things like retirement and boredom, it’s clear that lockdowns are significantly worsening these problems, as head of With You’s Drink Wise, Age Well programme, Julie Breslin, tells DDN. ‘We did a survey at the start of the programme about five years ago of nearly 17,000 people and identified things like loss of sense of purpose as factors that led to increased alcohol use for people over 50,’ she says. ‘What we’re seeing is that those similar factors as a result of lockdown – loss of routine and, very sadly for some, bereavement – are going to make that a lot worse for people.’

Reaching out

In response, With You has launched a free, national and confidential over-50s alcohol-specific helpline, available seven days a week. The idea was partly to try to reach out to people who would normally be unlikely to consider accessing treatment services, she says. ‘We already know that only about one in five people who are alcohol-dependent are in treatment anyway, and we feel that would be even less as people get older. There are more and more barriers to treatment as we age, which is down to lots of things – individual stigma, system-level stigma, and ageism. We really need to look at the design of our services and whether they’re age-inclusive. So the helpline is very much about being as accessible as we can for people who maybe want to start having that conversation about changing their alcohol use.’

But even among those who have already accessed treatment COVID-19 restrictions are having an effect, with a peer-led survey by Kaleidoscope finding that 34 percent of dependent drinkers receiving support in Wales had relapsed during first lockdown.

Raising awareness

There is still a huge amount of work to be done in terms of getting vital health information out there, Breslin stresses. ‘That level of awareness around wider health conditions really needs to be increased. People very much think of alcohol in relation to liver disease, they don’t think of the other factors – cancer, heart disease, dementia, cognitive impairment. People need to understand the wider implications.’

Change Grow Live has now launched a short online alcohol advice quiz to provide people with fast and accurate evaluation of their drinking and the kind of support they might need (www.changegrowlive.org/advice-info/alcohol-drugs/alcohol-drinking-levels-quiz-self-assessment), with executive director Nic Adamson stating that unless the government acts to address the recent increases in people drinking at risky levels the long-term implications for public health would be ‘disastrous’ (see news, page 5).

Alcohol Awareness Week also saw Turning Point organise an online forum focusing on areas such as mental health and alcohol’s effects on relationships and loved ones, as well as sharing additional content on the Recovery News Channel with videos from Swindon & Wiltshire IMPACT and its Leicester, Leicestershire and Rutland ‘Dear Albert’ services. The charity also used its Twitter account to highlight different aspects of its available support throughout the week.

‘It is estimated that 82 per cent of dependent drinkers are not in treatment and that hospital admissions due to alcohol have risen almost a fifth in the last decade,’ said Nat Travis, Turning Point’s national head of public health and substance misuse. ‘There is still a long way to go, but occasions like Alcohol Awareness Week are a great opportunity to open up the dialogue and start making changes.’

Recovery, rights and respect

So when an alcohol strategy does finally come along, what should be in it? ‘What I’d like to see is a strategy that’s much more focused on human rights and health promotion,’ says Breslin. ‘When you look at the Scottish strategy compared to the UK’s it’s really focused on recovery, rights and respect. I think we need to have much more of a focus on the issues that people are actually experiencing, whereas up until the now the strategy has very much been around the criminal justice side of things. Obviously, regulation is crucial – things like MUP – but what I would like to see is a much more compassionate strategy.’

Next issue: Mike Ashton looks at ‘controlled drinking’ and some of the most controversial studies seen in alcohol treatment


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