THE NORTH EAST ALCOHOL OFFICE Tackling Alcohol Harm in Durham 12 May 2015 Colin Shevills Director THE NORTH EAST ALCOHOL OFFICE

THE NORTH EAST ALCOHOL OFFICE

Tackling Alcohol Harm in Durham

12 May 2015

Colin ShevillsDirector



Tackling alcohol harm

• The problem with alcohol

• Levels of harm

• Impact on the economy

• What the evidence says

• What the public thinks

• How we can work together


The trouble with alcohol …• World’s third leading cause of ill health and

premature death

• Linked to 60 different medical conditions – same cancer causing group as tobacco

• Significant contributor to crime and disorder

• One-third of offenders in NE alcohol dependent

• Linked to domestic abuse, child protection and self-harm

• Liver disease could overtake stroke and coronary heart disease as cause of death within 20 years


British Liver Trust / ONS 2009

UK Mortality Trends


Biggest impact on vulnerable

• As many as 1 in 100 births affected by FASD

• 1 child admitted to hospital every day in NE

• Highest numbers under 18s in treatment

• Quarter male deaths 16-24 years due to alcohol

• Alcoholic liver admissions up 300% in under 35s

• Over 65 admissions doubled in 10 years

• Least affluent more likely to suffer harm• 45% more likely to suffer alcohol related death

• Almost three times more likely to end up in hospital

• 36% domestic violence cases - likely to be under -estimate


Industry vs Public Health

INDUSTRY MODEL

Problem – few bad people who can’t control themselves

Solution – partnership, education, enforcement

PUBLIC HEALTH MODEL

Problem – addictive drug irresponsibly produced, priced, promoted, sold

Solution - regulation


Impact in Durham

• 2 in 5 drinking at risky levels

• Alcoholic liver disease admissions up 46% in 6 years

• Wholly attributable admissions up 54% in 6 years

• Related admissions up 64% in 6 years

• Some improvement in last year:• Men’s specific admissions fell 8.7%

• Women’s specific admissions fell 6.4%

• Under 18 specific admissions fell 20.6%

• Effect of tax and duty cuts?


NHS: £50.35mCRIME & LICENSING: £51.82mWORKPLACE: £94.97m SOCIAL SERVICES: £16.70m

TOTAL COST+: £211.72m

+Total cost excludes crime related healthcare costs. The crime cost minus healthcare figure used for the adjacent pie chart is £49.71m

OVERALL COST PER HEAD COUNTY DURHAM: £413NORTH EAST: £419PUBLIC HEALTH ENGLAND(PHE) NORTH REGION: £413ENGLAND: £402

£98 £101

£185

£33

£102

£114

£169

£38

£88

£129

£168

£34

£77

£131

£167

£32

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DDES costs for alcohol specific admissions –• Total - £3.5m• Ave per practice - £82,114• Total admissions – 2,096

All alcohol related admissions – • Total - £11.9m• Ave per practice - £282,519• Total admissions – 7,068

Economic Impact


What the Evidence SaysAFFORDABILITY

• Alcohol 61% more affordable than 1980

• NICE: “Making alcohol less affordable is the most effective way of reducing alcohol related harm”

• MUP (50p):• Targets children and heavy drinker

• Doesn’t penalise moderate drinkers or poor –80%+ lives saved from less affluent

• Would help community pubs

• Deaths down 960; crimes down 50,700; hospital admissions down 35,100

• Deaths fell 32% in British Columbia

after 10% increase in minimum price


THE NORTH EAST ALCOHOL OFFICEBBPA handbook

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Trends in liver deaths and alcohol consumption

Liver deaths %Packaged strong lager %Cider consumption %Wine consumption %White spirits consumption %Beer consumption %Whisky consumption %

% change since 1980


Affordability driving the problem


50p

Heavy drinkers buy cheapest booze


What the Evidence Says

AVAILABILITY

• Places selling alcohol doubled since 1950s

• NICE: “…making it less easy to buy alcohol … is another effective way of reducing alcohol related harm”

LICENSING ACT• Presumption to approve

• Move to off sales, pubs closing

• More inappropriate locations – soft play, multiplex cinemas



PROMOTIONNICE: “…children and young people should be protected as much as is possible by strengthening the current [marketing] regulations”

LATEST

• 1 in 4 cinema ads for alcohol

• Children see more TV alcohol ads than adults

• Football on TV – 111 visual references to alcohol an hour

• UK has some of laxest regulation in Europe



SCREENING and BRIEF ADVICE• NICE: “NHS professionals should routinely carry out alcohol

screening as an integral part of service provision …non-NHS professionals should focus on groups that may be at an increased risk of harm”

SPECIALIST TREATMENT• Treatment effective and cost effective – 1:5 ROI

• NICE, DH, Alcohol Concern all recommend c15% dependent drinkers should be in treatment


What does the public think?

• 50% support MUP – 31% oppose

• 7 in 10 support 9pm watershed TV ban and no ads in cinema unless showing 18 film

• 45% support restricting sports sponsorship – 32% oppose

• 99% say enough or too many places selling alcohol

• 80% support health warnings on product labels


What is NHS view?

Five Year Forward View:

• “The NHS will back hard-hitting national action on obesity, smoking, ALCOHOL and other major health risks”

• “NHS … can and should now become a more activist agent of health-related social change”

• “… we will actively support comprehensive, hard-hitting and broad-based national action to include information and labeling, targeted personal support and wider changes to distribution, marketing, pricing and product formulation.”


What can we do?• Support national action on pricing, marketing,

licensing, drink driving and labeling:

• Sign up to Local Alcohol Declaration

• Write to ministers

• Contact/meet your MP

• Write to media

• Support our campaigns: alcohol and cancer

• Promote on websites and in surgery

• Act as spokesperson

• Find case studies

• Make alcohol screening integral to service provision


Tackling Alcohol Harm in Durham6 February 2015

Colin ShevillsDirector


Documents

THE NORTH EAST ALCOHOL OFFICE Tackling Alcohol Harm in Durham 12 May 2015 Colin Shevills Director THE NORTH EAST ALCOHOL OFFICE