I spent four years working as a nurse on an alcoholic liver disease ward in a city hospital on the south-east coast. It was the mid-2000s, and at that time we saw more men than women, from all social strata, with the youngest I remember being a woman in her mid-30s who died of alcohol-induced cardiac failure. Their ages always felt so shockingly young to be at such an advanced stage of the disease.
I now work in public health for a community trust in East Anglia. Latest statistics from child and adolescent substance use services across England show an 11% increase in alcohol misuse this year, with one in five dependent drinkers being diagnosed at 18. This still remains more of a male than female problem, at a ratio of 3:2.
Current NHS alcohol unit guidelines, which were originally published in 1995 and are now woefully out of date, confuse and mislead. They say that one unit of alcohol is equivalent to 125mls of 8% alcohol by volume (ABV) wine, half a pint of 3.5% ABV beer, or 25mls of spirit. Yet most wine is now 12-14% ABV (only Weightwatchers wine is 8%), many beers are closer to 5% ABV and most bars use 35ml spirit measures. So, these guidelines need urgent review.
The last alcohol and public-health position statement, published by the Faculty for Public Health in 2008, stated that “a reduction in alcohol consumption at population level is needed, together with focused programmes aimed at specific risk groups such as young binge-drinkers and older harmful drinkers”.
Public Heath England offers a free NHS health check to people aged between 40 and 74, which looks for type-2 diabetes, kidney disease, heart-attack and stroke risk. If it recognises that a specific risk group is older, harmful drinkers why is this population not screened for liver disease? It is just another simple blood test that could be done at the same time.
During pregnancy women are told that after the first three months they are allowed to drink one glass of wine a week. If you drank a 250ml glass of 12% wine, which seems standard today, you would actually be drinking more than three units. Within antenatal clinics there are many posters warning of the dangers of smoking during pregnancy but very little information regarding drinking.
Raising awareness through education in schools and clear public health guidelines are paramount. This is bigger than alcohol pricing, “drunk tanks” and fines.
Statistics suggest we are staggering blindly into potentially the biggest public health issue since smoking. Tobacco advertising used to make smoking appear just as glamorous as alcohol advertising makes drinking look today. Yet now the health risks of smoking are well publicised and cigarettes are hidden from view in supermarkets and advertising has been banned.
Conversely, shops and supermarkets are filled with cheap alcohol. It is an addictive substance just like nicotine and we need to put alcohol and the industry under the spotlight in the same way that we did with cigarettes.
Many of us do not realise that we are drinking too much, particularly when it seems so socially acceptable. Yet there are online resources, such as the youth-driven campaign website, It’s the Drink Talking and communities including Soberistas and Tired of Thinking about Drinking that can help raise awareness. But it’s not enough.
Why is it that the Stoptober – smokefree October – campaign encourages smokers to give up for the month with the aim of stopping permanently, whereas with Dry January, the challenge is only to go booze-free for 31 days and no more?
Day 53 🙂