Tuesday, 15 November 2011

Counting the cost of alcohol harm: crunch time for Europe's politicians

In Alcohol Awareness Week the harm caused by alcohol is under scrutiny, being signalled by Global Risks as part of 'a global risk equal in cost to the current global financial crisis'.  But politicians under pressure from vested interests are proving slow to act.  As the architect of Ireland's disastrous deregulation of alcohol (and banking), former Taoiseach Bertie Ahern once said:  "Now what we are endeavouring to do is we know what the outstanding issues are, we know that we could argue forever about the rights and the wrongs".   Where alcohol is concerned, the outstanding issues and the rights and wrongs are very clear, so the time for 'arguing forever' is over.  Bucking the trend, incoming Health Minister Roisin Shortall is courageously promising something different.

Fiona Ryan AAI and Minister Roisin Shortall at the Where's the Harm? conference

We must, she says, tackle the issue of alcohol in Ireland head on "in a real and meaningful way".  In the last month she has promised to address the key issue of minimum pricing, discussed the harm to children of parental drinking, and promised to put alcohol in its rightful place at the heart of a national substance abuse strategy.  This week, Alcohol Awareness Week, the Minister promised to look at “the question of minimum pricing to remove that dirt cheap element from the market.”  On 16th November she supported the Alcohol Action Ireland conference 'Alcohol. Where's the Harm?' by presenting the opening address.

Where's The Harm?

The harm is everywhere, it turns out, and very costly in every sense of the word .  The conference focused on crime in particular.  Academic Sean Byrne, author of the HSE study "Costs to Society of Problem Alcohol Use in Ireland", told delegates that "€319 million is spent by three justice agencies on crime linked to alcohol, €191m is spent by An Garda Síochána, €51m is spent by the Prison Service and €77m is spent by the Courts Service.  Overall "the €319m represents 13% of the total Department of Justice budget", and as The Irish Examiner reported "the cost to the exchequer of responding to and dealing with the consequences of alcohol could be €1.6 billion per year".

60% suffer as a result of someone's drinking

But the personal cost of alcohol crime tells an even sadder story.   Discussing a survey conducted in September by Behaviour and Attitudes and based on interviews with 1,000 people over the age of 16, Alcohol Action Ireland director Fiona Ryan revealed to the conference that 'almost 60 per cent of people had been intimidated, frightened or physically assaulted as a result of someone else’s drinking.. and almost one in ten people had been assaulted or had a family member who had been assaulted by someone under the influence of alcohol'. 
"Some 45 per cent of people said they had gone out of their way to avoid drunk people in a public space, while 22 per cent had felt unsafe in a public space due to someone’s drinking. Some 20 per cent had been kept awake by drunk people outside their home, and 18 per cent had felt unsafe on public transport".
And Sean Ryan's crime figures are an under-reporting of the issue. "When they had been assaulted, 44 per cent said they did not report the assault” Ms Ryan said, blaming a culture that too readily accepts alcohol and its problems as part of 'normal' life.

Suicide is another shocking aspect of alcohol harm.  Minister Shortall told the Irish Times,“we have a serious problem with suicide in this country. It is probably the biggest problem facing our young people.  In over half the cases of suicide, alcohol is a key factor".   Young people are also in danger from other alcohol related harms as shown in the recently released HRB statistics for alcohol abuse, which show a 40% increase in the number of people seeking help for addiction, and a huge rise of 150% amongst young people in particular looking for treatment.

80% of rapists were drunk

Cliona Saidlear of the Rape Crisis Network Ireland  informed delegates that alcohol is also implicated heavily in rape and other acts of sexual violence.  The Rape & Justice in Ireland study of 596 DPP files on adult rape cases found that:
"77% of suspects had consumed alcohol on the date of the offence, 41% of suspects were severely intoxicated, 80% of complainants had consumed alcohol around the time of the offence and 90% of complainants had consumed ‘binge’ levels of 7 standard drinks".
But the danger of being raped by someone is added to by the states failure to prosecute when the victim is also drunk.  One third of those who did not report rape 'did so because they had consumed alcohol at the time (voluntarily and involuntarily)' and of the cases received in 2005 the DPP prosecuted 'only a third' because the ‘reliability of the complainants’ account was 'undermined by high levels of intoxication'. As Ms. Saidlear concluded "Irish drinking culture is one that supports a toxic mix of alcohol and sexual violence".

Equal in cost to the current global financial crisis

Culture aside, the core issues of regulation lie with governments to fix.  While the Irish government ponders the 'reputational damage' done to Ireland by its financial disaster, it is not unique in Europe in facing a major social and economic crisis with alcohol.  The World Economic Forum’s 2010 Global Risks Report identifies alcohol as a prime cause of non-communicable diseases (NCDs), and 'these are the second most severe threat to the global economy in terms of likelihood and potential economic loss.  NCDs are a global risk equal in cost to the current global financial crisis'.

The current EU Alcohol Strategy is due to end in 2012.  This week 72 European NGO's called for a new and 'comprehensive Alcohol Policy Strategy'.   In an open letter to Ministers of Health across Europe they wrote that:
Alcohol is the world’s number one risk factor for ill-health and premature death amongst the 25-59 year old age group, a core of the working age population. Europe is the heaviest drinking region of the world. Consumption levels in some countries are around 2.5 times higher than the global average (WHO 2009). Alarmingly 43% among 15-16 year old European students reported heavy binge drinking during the past 30 days (ESPAD 2007) and alcohol is the single biggest cause of death among young men of age 16 to 24.
The Committee on National Alcohol Policy and Action is meeting on 17th November and signatories urge experts to request the European Commission for a European Alcohol Strategy 2013 – 2020.  As Mariann Skar (European Alcohol Policy Alliance Secretary General) puts it:
"Alcohol use is a problem across Europe which requires a comprehensive, targeted and action oriented response... Europe is still the heaviest drinking region in the world. It is our shared European problem that needs a collective solution"’
Let's hope the time for debate is over, and the time for action has arrived.  The alcohol industry spends 44 million Euro per year on advertising in Ireland alone, which is keeping many recession bitten newspapers and TV stations afloat.  Alcohol industry lobby groups have also infiltrated governments very successfully over the last twenty years, holding back any real debate or legislative change on the issues raised at the AAI conference or by the NGO's.  Will Bertie Ahern be right for once? As he so forgettably said,  "I'm a bit disappointed that so many people have closed up on their barriers, that's why we have been very anxious to keep our position."


For all the presentations at the Alcohol Where's the Harm Conference follow the link.

Wednesday, 9 November 2011

150% rise in teenage drinking problems: Alcoholism in Ireland hits new crisis

The Irish Independent has been critical of Minister Shortall's attempts to start a much needed debate on minimum pricing of alcohol.  "Anyone expecting minimum alcohol pricing to solve the problem of alcohol abuse overnight is likely to be disappointed.  Believe it or not, overall Irish levels of alcohol consumption, while still relatively high, have been falling since the turn of the century".  That certainly is hard to believe, particularly when the HSE has published a report this month (based on National Drug Treatment Reporting System (NDTRS) returns) which indicates the exact opposite, showing a steep rise in drinking amongst the growing number of unemployed people, and a 150% rise in the numbers of teenagers seeking help for their drinking. 

Dr Suzi Lyons, senior HRB researcher with the HSE, speaking to the Irish Examiner on Wednesday 9th November revealed that "the effects of the recession are biting hard, with a massive jump in unemployment among people seeking treatment for alcohol".  The report published by the Health Research Board found 76% of people in alcohol treatment in 2010 were out of work — up from 60% in 2005.  "This suggests that prolonged problem alcohol use may lead to loss of employment, or alternatively, the factors associated with failed treatment (or chronic addiction) are similar to those associated with failure to secure or retain employment."

Youth drinking problems up by more than 150%

But the real shock comes in the HSE figures on young people and drinking.  Reported in The Examiner on 9th November the report shows "a 150% jump in the number of juveniles seeking treatment for alcohol in the last six years - over three times the increase among all age groups".  And this, said Dr Suzi Lyons, was an "underestimate" of the true figure, as they only had data for a "fair majority", but not all, treatment centres.  The rise for other age groups is equally alarming, with a 29% increase in new cases and a 42% rise overall, and "the total number of cases increased from 5,525 in 2005 to 7,866".

The Independent is still not having it, arguing that drugs, and not alcohol, are the real problem.  The paper believes that "the fact that a fifth of all those being treated also abused other, illegal, drugs points to another possible explanation.  In modern Ireland alcohol isn't the only drug to be abused by large numbers of people. There are few people under 30 who haven't at least experimented with illegal drugs".

On the contrary, as Dr Lyons' study shows, "40% of clients were drinking daily, with a further 34% consuming alcohol two to six times a week. The majority (81%) of cases reported problem use of alcohol only".   Similarly, while fewer than 1% of drivers were stoned, over 13% were drunk at the wheel as revealed by a recent Tispol survey - seven times the European average.  Alcohol, not drugs, is the cental issue.

Alcohol industry and Government take the issue by storm

Also shocked by the findings is Katryn D’Arcy of the Alcohol Beverage Federation of Ireland, who will obviously 'be reviewing the report in detail'.  Her initial reaction as reported in the Irish Examiner is to repeat the increasingly unconvincing mantra that
"overall alcohol consumption has been declining steadily in Ireland since its peak in 2001.  Consumption declined dramatically between 2008 and 2010 and ...Irish consumption is approaching European norms". 
Is it?  The facts tell the opposite story, and this head-in-the-sand approach is not only wrong but is now proving to be positively dangerous.

The HRB report sums up very neatly what is needed to tackle the problem.  'Effective policies include: increasing the price of alcohol; restrictions on alcohol sales; minimum legal purchase age and low legal blood alcohol concentrations for drivers'.  But the government still seems unable to respond without a bit more time to ponder what it all means.  Answering questions from frustrated backbenchers on 4th November last year on the subject of rising alcoholism, Minister Aine Brady quite reasonably put the blame squarely on "The Minister for Enterprise, Trade and Employment [who] revoked the Restrictive Practices (Groceries) Order 1987 with effect from March 2006".  And that, as part of a continuing programme of deregulation begun in 1992,  is certainly the reason why Ireland has made such steady progress from being a relatively sober country in 1990 to its current position as booze-capital of the western world. 

But that hardly explains why the government has spent 20 years avoiding a reversal of those policies and hiding behind 'reports' and'consultations' to put off any defninitive action on the issue.  Instead Ministers choose to put the whole debate on the long finger, sending the house to sleep with the same long-winded responses.  Giving an identical  response to that of Minister James Reilly this summer, Minister Brady presciently described a year ago the exact situation which still pertains today:
"A Steering Group has been established to develop proposals on the alcohol element of the  NSMS. The NSMS Steering Group is examining a wide range of issues in relation to alcohol policy such as pricing (including minimum pricing), availability, treatment, prevention and marketing. The NSMS Steering Group is due to report on its findings by the end of the year. I look forward to receiving the Report from the Steering Group and considering the recommendations around the price at which alcoholic drinks are sold. My Department is continuing to monitor developments on alcohol policy in Scotland and in Northern Ireland particularly in relation to any proposals on the pricing of alcohol products".

Sunday, 6 November 2011

Drinkaware.ie praised at European Health Forum: satire dies again

As Tom Lehrer famously said, while he wasn't poisoning pigeons, 'Political satire became obsolete when Henry Kissinger was awarded the Nobel Peace Prize'.  In the same spirit, though rightly without the same fuss, drinkaware.ie was recognised for its 2011 student film competition as a 'model of best practice' at the European Alcohol and Health Forum in Brussels this month. 

Drinkaware.ie, it should be remembered, is the education wing of MEAS, an organisation funded by the alcohol industry for the Mature Enjoyment of Alcohol in Society .  MEAS's modest aim is that "we must respect alcohol when we consume it" which it promotes "with no commercial purpose".  Drinkaware.ie itself has another aim - to educate the public about the dangers of alcohol so the government doesn't have to.  In this role as an educator the alcohol industry infact has greater access to the press, to universities and teenagers to promote more of what it has cleverly renamed "responsibility when drinking". 

Bulls - eye

The competition which earned them praise asked students to make a film about home drinking.  Incase its benefits were missed, drinkaware.ie reminded participants that 'Home drinking ranges from people enjoying a couple of drinks in their family home to house parties with large numbers of guests in attendance. In recent years, drinking in home settings has become increasingly popular: more than half of the alcohol consumed in Ireland is now purchased in the off-licence trade, rather than in pub settings'.

"Specifically targeting 18- to 24-year-olds, with a bulls-eye of 22-year-olds" the drinkaware.ie campaign placed "a stronger emphasis on the use of social media as a promotional and communications tool".  Said  Fionnuala Sheehan, Chief Executive, “The way we see it, the competition not only gets students thinking about drinking, but also offers them a valuable opportunity to meet people working in their chosen careers; to network with them; and to develop contacts and skills that will stand to them in the future.”  A good job this is education and not advertising, because the industry's own code on advertising prohibits associating drinking with social success or targetting the young.  A bulls-eye indeed.  

"Mortifying memories" and "slippery nipples"

Drinkaware.ie is not new to advising students on how and when to drink.  Its website offers 'myth busting' messages in which 'we don’t set out to lecture to students, or to patronise them. Instead, we aim to engage with them as equals'.  An essential part of the message is to play down the effects of drinking by being funny about them. For example:
"For those with something better to do, remember that just one drinking session can result in the most embarrassing and mortifying memories. For each pint you drink, you have more of a chance of falling victim to the beer goggles effect. Add a slippery nipple or two and you'll be waking up next to a face you will try to spend the next few years forgetting".
According to drinkaware.ie another myth to bust is that drinking impairs your abilities.  In fact it just promotes a carefree attitude, they say. 
"Canadian volunteers were asked to press a button when prompted by a computer screen but told not to press it if a red light also appeared. Those drinking were more likely to press the button when the red light was shown. However, when drinkers were offered a small reward they performed just as well as sober volunteers. Funny that".
Does drinkaware.ie think alcohol causes you to do to things you wouldn't have done sober?  No.
"The alcohol made you do it? Oh purrr-leease. The lamest excuse in the book. Its up there with the dog ate my homework. Researchers around the world have proved that it is possible for people who have been drinking to control their behaviour if they want to.  No matter how hard you might convince yourself otherwise".
The "dangers" of drinking too little

And the most dangerous myth is apparently that it is important to cut down the number of times we drink.  Far from it, we should be careful to drink more often.  If you only drink at the weekend
"You are flooding the brain with large amounts of alcohol, then subjecting it to a sudden cold turkey withdrawal, then doing the same again next weekend, which seriously messes with your brain cells.  So think ahead. [Instead, just] have a couple of alcohol free days during the week"
And on the five nights a week you are drinking simply "Pace yourself with water or a soft drink after every alcoholic drink and you’ll sparkle all night long".

Drinkaware.ie ads left on the toilet floor

This is apparently the message that the students want to hear. "What they want are the facts on how to ensure they don’t miss the best part of the night, avoid hangovers and fall victim to the beer goggles effect. The Booze Myths campaign is a fun way to deliver these facts."

Another drinkaware.ie campaign familiarised students with the effects of drink by placing 'images of drunk students sprawled on the ground pasted to the floors of college toilets as part of a hard-hitting campaign on the dangers of alcohol'.  Against research which shows that single issue shock tactics are ineffective and in-fact tend to reinforce drinking norms, drinkaware.ie claims that the images were 'designed to warn third level students enjoying RAG Week events of how their night could end if they abuse alcohol'.

Jessie J without beer goggles

Sadly you no longer need to go to the toilet to see drunk students on the floor, as singer Jessie J found at her Trinity Ball gig this year.   "Just came off stage at trinity ball" she tweeted . "Probably one of the hardest gigs to date. To see so many people so drunk they couldn't even stand. Girls unconscious and literally trampling on each other. It wasn't easy."

The singer, who has risen to fame over the past year, later posted: "I'm not upset they weren't all listening. It upset me to see so many young people so not with it. I'm not used to it. It's hard to sing when I just wanted to go into the crowd and help all the crying girls who were being squashed." 

Drinkaware's university campaign obviously isn't working, or is it?