Alcohol Misuse How big is the Problem?

1. Alcohol MisuseHow big is the Problem? Michelle Loughlin Consultant in Public Health Rochdale Metropolitan Borough Council

2. Alcohol in Our Society • Touches everyone’s lives • Part of celebrations, social occasions etc. • 2/3 people drink sensibly, or not at all Key Influences: • Price: Cheaper alcohol – Supermarkets – Home drinking • Availability: Licensing Act 2003 – Flexible opening hours • Promotion: Social normalisation of alcohol misuse

4. Drinking Risk Levels in GM Greater Manchester Alcohol Survey estimated alcohol consumption in 16+ in 2010 n=1,971 15% Don’t drink 4% Dependent Suggests Most People in GM do Drink Sensibly

5. Impacts of Alcohol • Health • hospital admissions • Liver disease • Blood pressure • Stroke • Cancers • Foetal Alcohol Syndrome • Mental illness • Alcohol Dependence • STIs • Unplanned pregnancy • Inequalities • Social & Economic £ • Lower workplace productivity • Unemployment • Impacts on family & social networks • Truancy & school exclusion • Homelessness • Economic costs • Litter • Town Centre – no go areas Crime and Disorder • Domestic violence • Sexual assault • Public fear • Antisocial behaviour • Risk taking behaviour • Crime • Public Disorder Accidents • Road accidents • Other accidents • Drownings • Burns Children and Young People Offending, pregnancy, truancy, exclusion, mental illness, poor educational attainment, reduced life chances etc.

6. Alcohol Impacts – Some Numbers • 1.2 million Alcohol related hospital admissions per yr and rising • 75% for chronic conditions e.g. CVD, liver disease, cancer • 16% are for mental and behaviour disorders from alcohol use • 10,000drink driving accidents each year • 8, 750 alcohol related deaths and rising • Liver disease a rising cause of premature death in under 65s • Alcohol involved in 44% of violent incidents, 37% domestic violence • Workplace absenteeism costs the economy up to £6.4 billion annually • Total annual cost of alcohol harms has been estimated at £55 billion

7. Young People in GM (14 to 17 years) Trading Standards’ North West Schools Survey of Young People (2011) • 31% drinking at least weekly in GM • 20% binge drinking at least weekly • 22% drinking outside • 21% mainly drank in venues such as pubs • 22% bought alcohol themselves

8. GM: Number of claimants of Incapacity Benefit/Severe Disability Allowance whose main medical reason is alcoholism (Aug 2011)

9. Alcohol and Inequalities • Alcohol is strongly linked to health inequalities • People from deprived groups suffer greater harm than the more affluent • e.g. There are 4 times more alcohol related deaths among men in routine and manual jobs compared with those in professional jobs

10. Alcohol and Mental Ill Health • Alcohol is associated with a range of mental health problems e.g. depression, anxiety, suicide, risk-taking behaviours, personality disorders and schizophrenia • Alcohol is a depressant • The prevalence of alcohol dependence among people with psychiatric disorders is almost twice as high in the general population • Dual Diagnosis – group of people with complex needs • Alcohol often used as a coping strategy

11. Rochdale Alcohol Assertive Outreach Pilot: Patient Stories, Common themes HEALTH PROBLEMS & WITHDRAWAL Epilepsy, pain, ADHD, self harm, OCD, trapped nerves, anxiety attacks, avoiding the seizure threshold, onset of seizures, panic, fear, anxiety HOUSING & FINANCE • Transience, relocation, poor or unsuitable housing, sofa surfing, fear of home loss due to drinking, homelessness, eviction, loss of income, increased debt, home repossession, unemployment (although several previously had regular work), poor budgeting skills RELATIONSHIPS, CHILDHOOD PROBLEMS & ALCOHOL ASSOCIATES Marriage breakdown, new/multiple partners and children, large families (up to 9 siblings), volatile and chaotic family life, parental, peer and partner drug and alcohol use, problems in childhood including child sexual abuse, bullying, disability, learning disability, drinking onset in childhood LOSS Home, bereavement, children, relationships, jobs Multiple barriers to change – none wanted to stop drinking but were open to reducing risk & harm. Many driven by desire not to lose home.

12. Reducing Harm: Local Action(from PHE Stocktake Tool) • Understand Needs, clear strategy and investment • Licensing – Underage/illegal sales, Cumulative Impact Policies • Reduce Risk – Identification of Risk and Brief Advice IBA – Make Every Contact Count (tools on alcohollearningcentre.org.uk) • Clear Alcohol Pathways in Place e.g. Acute & MH Trusts to community, programme to support frequent attenders • Specialist Alcohol Treatment – joint commissioning between NHS / LA • Targeting and support for high risk groups e.g. Prison, MH Patients • Focus on Recovery – peer support, family work, employment, housing etc.

13. Reducing Harm: National Action(from Health First) • MUP of 50p • Health warnings on labels • Restricted sale times • Review of licensing legislation to control availability • Restrictions on advertising and promotion • All health and social care professionals to be trained in IBA to reduce risk (tools on alcohollearningcentre.org.uk) • Referrals of people with alcohol problems to specialist alcohol services for comprehensive assessment and treatment

14. Key Messages • Most people drink sensibly • Alcohol affects health, mortality, crime economy, and inequalities • Availability, Price, Promotion have impact • Issues are complex and need multi agency responses locally and nationally

15. Thankyou Michelle Loughlin Email: michelle.loughlin@rochdale.gov.uk