The health select committee recently reported that government alcohol
policy should move beyond public order in town centres and increase its
focus on health.
DDN
reports
News focus |
Analysis
DOES A PREOCCUPATION WITH BINGE
DRINKING MEAN THE HEALTH ASPECTS
OF ALCOHOL ARE BEING OVERLOOKED?
6 |
drinkanddrugsnews
| August 2012
www.drinkanddrugsnews.com
The press loves a good ‘binge Britain’ story,
especially if its moralising tone can be
accompanied by pictures of young women
in various states of undress on a night out.
But, when it comes to policy, is there a risk that the
public order aspects of our alcohol culture are in
danger of eclipsing public health?
The House of Commons health committee thinks
so, with its report (see news, page 5) on the
government’s alcohol strategy (
DDN
, April, page 4)
stating that, while its attempt to bring a coherent
approach to tackling the issues is welcome, the
strategy’s focus on public order ‘overshadows the
health issues’. Although binge drinking and related
public disorder and anti-social behaviour are certainly
important, said committee chair Stephen Dorrell MP,
‘the health impact of chronic alcohol misuse is in our
view also significant and greater emphasis needs to
be placed on addressing that impact’.
As well as calling for a ‘re-examining’ of alcohol
advertising regulations, including the possibility of a
version of the French ‘Loi Evin’– which is designed
to restrict children’s exposure to alcohol advertising,
including viral marketing (
DDN
, June 2011, page 21)
– the committee wants to see a central role in
developing policy objectives given to Public Health
England, adding that the controversial ‘responsibility
deal’ (
DDN
April 2011, page 4) is ‘not a substitute
for government policy’.
Many treatment organisations have issued
statements agreeing with the committee’s findings,
with Addaction and Turning Point both calling for
more investment in early intervention and specialist
treatment. The Royal College of Psychiatrists stated
that it expected the Department of Health’s planned
guidance on the development of alcohol services to
‘highlight the strong evidence base supporting
screening and brief intervention’, particularly in
primary care, but it also wants to see separate
guidance issued on the capacity of services.
‘The health committee described the state of
alcohol services in England as “dire” in 2010 and we
see no evidence that this situation has changed,’
said a joint statement from chair of the college’s
faculty of addiction psychiatry, Dr Owen Bowden-
Jones, and Scottish chair Dr Peter Rice.
What liver disease charity the British Liver Trust
wants to see to address this situation is far more
investment in alcohol specialist nurses, with the
one-million-plus annual alcohol-related hospital
admissions meaning that 70 per cent of all alcohol
costs to the NHS are incurred in hospital. Existing
good practice models could easily be translated
into routine care for alcohol-related conditions, the
trust believes.
Given the intense cost pressures on the NHS,
however – £20bn of ‘efficiency savings’ needed by
2015 and even more expected to be announced
after that – how likely is it that the government will
actually take the message on board and employ
more specialist nurses?
‘The government has committed itself to
delivering an effective alcohol strategy, and with
respect to specialist alcohol nurses the figures
speak for themselves,’ the trust’s chief executive
Andrew Langford told
DDN
.
‘So far, they have been bold with minimum
pricing so I am hopeful they'll take on board the
evidence. We know that alcohol treatment services
have been the poor relation when compared to the
investment in drug services – a specialist alcohol
nurse would go some way in bridging that gap.’
Employing specialist staff would save money in
the long run, but presumably that means policies
need to be fundamentally reformulated to bring
more of a focus on long-term strategy? ‘With
regards to addressing preventable liver conditions
as a whole, yes they do,’ he says. ‘Alcohol is a
public health issue which requires a long-term
attitude and a consistent approach. We have spent
decades making alcohol cheaper, more available,
allowing it to become a normal part of everyday
living – to reverse that and to inform a generation
who are used to such a relaxed approach to alcohol
will take time.’
The trust has repeatedly stated that the impact
of chronic alcohol misuse isn’t given the
prominence it deserves, citing data from Liverpool
PCT that almost all (90 per cent) of its hospital
admissions related to alcohol are actually for
chronic conditions.
‘There is no denying that binge drinking has
preoccupied the media, however it's the chronic
and habitual drinking, often in the home, that is our
biggest problem,’ says Langford. ‘I still don't believe
that people are able to make an informed decision
on how much they drink and, importantly, the health
impact it might be having, which is why measures
such as health information on packaging should be
better. We are also faced with an often-
symptomless condition, with the liver not showing
signs of complaint until late on in disease
progression. Sadly, and probably the most difficult
message to drive home, is that preventative action
is the way to protect yourself from a preventable
liver condition.’ DDN
The press loves a good
‘binge Britain’ story,
especially if its
moralising tone can be
accompanied by pictures
of young women in
various states of
undress on a night out.