Alcohol misuse
Why is it important?
Alcohol-related harm is one of the biggest health problems facing the UK. Over 10 million adults currently
drink more than the recommended guidelines. There are approximately 2.6 million children in the UK are
living with parents who are drinking hazardously and over 700,000 are living with dependent drinkers.
Alcohol related harm costs the NHS £3.5 billion and has wide impacts on our society. Alcohol-related crime is
estimated to cost £11 billion a year.
From a health perspective, alcohol consumption is a major cause of disease and death at all levels of society. It
has a major impact on premature mortality and contributes to health inequalities. It also contributes to family
problem, violence and psychiatric disorders.
Alcohol also has an economic impact where employees have reduced productivity due to sickness,
worklessness and ‘presenteeism’ - when a person attends work but is unable to perform their duties due to a
hangover.
There are certain factors that make people more vulnerable to excessive alcohol use and consequently alcohol
harm. Abuse or neglect in childhood, life stressors such as poverty, low paid stressful employment,
relationship break down, death of a close friend or family member and traumatic incidents. Consequently
there are particular communities who are more likely to suffer from these risks including those in socially
deprived neighbourhoods, children who have been looked after, war veterans, unemployed people and those
with mental ill health.
Despite reporting similar levels of alcohol consumption the worst effects of alcohol are felt most by those who
can least afford it. People in the most deprived areas of the country are disproportionately more likely to
experience the impacts of alcohol related crime, more likely to suffer the impacts of alcohol-related health
conditions, and more likely to die from a condition caused by alcohol consumption. [1]
[1] http://www.gateshead.gov.uk/DocumentLibrary/CBS/health/DPH-Report-(August-2014).pdf
Gateshead data
See Topic sections: Alcohol Misuse
See also: Local Alcohol Profiles for England (LAPE) ; Rethink Your Drink - Gateshead DPH Annual Report 2014
Summary
Drinking Prevalence and levels of health related harm
3 out of 4 adults drink alcohol according to a local alcohol perceptions survey, which is similar to the rest of
the North East and England. On a positive note, alcohol related mortality in Gateshead has been decreasing in
recent years, narrowing the gap to England, however, mortality from chronic liver disease is increasing and
the gap to England widening. Liver disease is one of the top causes of death in England and people are dying
from it at younger ages. Most liver disease is preventable and much is influenced by alcohol consumption and
obesity prevalence, which are both amenable to public health interventions. Harmful drinking is a major risk
factor for chronic liver disease. Of particular note is the mortality from chronic liver disease rate for women,
which although starting from a much lower base than men is on the increase and is moving away from a
decreasing England average.
A local perceptions survey by Balance suggests that there may be over 65,000 residents in Gateshead who are
drinking at increasing and higher risk levels. Research by Liverpool John Moores University (Improving
accuracy in recording alcohol consumption: a survey in Greater Manchester, 2011) shows that when
completing surveys people often under report the amount of alcohol that they really drink, which may suggest
that the prevalence of high risk drinking may be even higher.
Many factors contribute to the development of alcohol-related problems. Ignorance of drinking limits and of
the risks associated with excessive alcohol consumption are major factors. Social and environmental
influences, such as customs and attitudes that favour heavy drinking, also play important roles.
Alcohol Related Crime
Alcohol is a significant factor in crime and disorder. Nationally, alcohol misuse contributes to approximately
1.2 million incidents of violent crime annually and around half of all violent incidents take place at the
weekend, when binge drinking is most prevalent, with 66% of stranger violence and wounding offences taking
place between midnight and 6am.
Strikingly, alcohol related offences committed by women have increased by as much as 1000% over the last
five years and statistics show that rates of alcohol consumption are particularly high amongst women in the
North East according to Rethink Your Drink - Gateshead DPH Annual Report 2014.
The report shows that alcohol and crime are strongly linked, with officers working on frontline services seeing
the relationship between the two on a regular, if not daily basis. National research shows that:

As alcohol consumption increases, so does violent offending

Over 570 alcohol related crimes are recorded every day in the North East

50% of all violent crime in the North East is alcohol related

Alcohol is a contributory factor in 40% of domestic abuse cases

People who drink before going out for the night are more likely to be involved in a fight
Alcohol affects the public directly, a perceptions surveys conducted in the North East showed that the
population of the North East believe there is a clear association between alcohol and crime:

53% of people think alcohol is a major cause of crime

97% associate alcohol with anti-social behaviour

97% associate alcohol with assaults and violence

95% associate alcohol with domestic abuse
The DPH Annual report highlights a perceptions survey conducted with frontline police officers across the
North East that shows frontline officers estimate 60 to 70% of their weekly workload is spent dealing with
alcohol related crime. Alcohol is also considered as a big risk factor in the job of front line policing and is seen
to account for 80% of the risk faced by officers performing duties.
Drink Driving
In the five years to 2011 there were more than 1,600 alcohol related road traffic accidents in Gateshead,
which resulted in more than 2,400 casualties. 1 in 10 of all fatal and serious road casualties in the North East
were as a result of a collision where an intoxicated driver was involved, although casualties from drink drive
collisions have generally been decreasing over the past five years.
Economic harm
Economic harm from alcohol is particularly concerned with the level of disruption to the economy as a result
of alcohol misuse. From the economic perspective alcohol is considered as contributing to the economy in
terms of creation of jobs at a local level, revenue from sponsorship and taxation at a national level. This
aspect is often used as the argument for not imposing further restriction on alcohol availability, price and
promotion however what isn’t often considered is the balance of harm and positive impacts for the economy.
Evidence suggests that alcohol related harm costs the economy around £336 per head of population every
year.
Alcohol related hospital admissions
The rate of alcohol-related hospital admissions in Gateshead is significantly higher than both the regional and
England averages. There are around 1,200 alcohol related admissions each year. Alcohol related conditions
include those specific to alcohol such as alcoholic liver disease or alcohol overdose and those conditions that
are caused by alcohol in some but not all cases e.g. stomach cancer and unintentional injury.
The number of hospital admissions for alcohol related cancers has seen a dramatic increase of almost 70% in
recent years. This is largely driven by increases in female admissions.
Mental Health
More than 250 hospital admissions for alcohol related mental and behavioural disorders due to the use of
alcohol were made in a recent year. As a rate this is significantly higher than the England average.
According to the Adult Psychiatric Morbidity Survey (APMS) 2007 it is estimated that 8.3% of Gateshead
residents aged over 16 years are dependant drinkers. This equates to around 13,500 dependent drinkers.
Groups most at risk
Age & Sex
Nationally there has been a fall in average weekly alcohol consumption among young adults. Yet despite an
overall decline in recent years, over one in five young men (22%) and one in five young women (17%) are still
binge drinking (ONS, 2012)
Deprivation
Harmful drinking of alcohol is closely associated with deprivation and residents in the most deprived wards
Gateshead are more likely to die from an alcohol specific condition.
Other drugs/Poly misuse
Smoking, drinking and drug taking often co-exist. There is high prevalence of alcohol and poly misuse among
the prison population; between 12% and 21% have at least four mental disorders simultaneously (including
drug and alcohol dependence, personality disorder, neurotic disorder and psychosis); between 35% and 52%
are dependent on opiates, stimulants or both; and 20%–30% are severely dependent on alcohol (NICE, 2007).
Alcohol in Pregnancy
Alcohol consumption by an expectant mother may cause foetal alcohol syndrome and pre-term birth
complications which are detrimental to the health and development of unborn children (WHO 2011).
Foetal Alcohol Spectrum Disorders (FASD) is an umbrella term for several diagnoses that are all related to
prenatal exposure to alcohol (i.e. while the baby is still in the womb). As well as the immediate risks to the
unborn child such as spontaneous abortion, research shows that parental alcohol misuse can have a
considerable negative effect on children, young people and the family.
Homeless
Alcohol dependency is more prevalent among the homeless population especially rough sleepers. Drug and
alcohol abuse especially when combined with a mental illness are linked to homelessness as causal risk factors
but also as the consequences of being homeless.
See also: Evidence Review of the Costs of Homelessness
Impact on Children & the Family
Alcohol is associated with many serious social and developmental issues, including child neglect, violence and
abuse.
Alcohol misuse is linked to around half of all violent crimes and around a third of domestic violence incidents
(NICE 2010).
What are we doing and why?
Prevention
In the North East, research led by Balance is leading to a to a better understanding the individual drivers for
the population drinking at levels likely to result in significant harm and the perceptions the population have
about alcohol use.
The work highlighted a lack of knowledge re recommended safe drinking guidelines and lack of knowledge as
to what constituted a unit of alcohol. This insight was used to develop responsive health related messages to
educate specific populations in drinking within recommended guidelines.
Campaigns such as Dry January, Do what Sam says, Cheap alcohol is harming our kids and Alcohol is a group 1
Carcinogen, have all been used to raise awareness. There has also been extensive lobbying work on minimum
unit price and the need to curb proxy sales – adults buying alcohol for young people.
Treatment
Evidence shows that significant reductions in drinking and alcohol-related problems can follow from brief
interventions. For every eight people who receive simple alcohol advice, one will reduce their drinking to
within lower-risk levels. This compares favourably with smoking where only one in twenty will act on the
advice given. Evidence considered by NICE suggests that even very brief interventions may be effect ive in
reducing alcohol-related negative outcomes. Patients who received an alcohol brief intervention in A&E made
fewer visits to A&E during the following 12 months.
The community alcohol service in Gateshead provides tier 2/3 prevention and clinical treatment in a
community setting. The service acts as a hub for treatment of alcohol problems, receiving referrals from GPs,
community nurses and other providers as well as self-referral. Following assessment and treatment, clients
may be referred into a range of support services.
What would success look like?
Prevention
• Raise awareness of the health risks associated with drinking above the recommended limits.
• Reduce the number of your young people who use alcohol harmfully.
• Targeted campaigns based around a more detailed understanding of drinkers in Gateshead.
Treatment
• Improved access to opportunistic interventions and brief advice
• Improve the effectiveness and capacity of specialist treatment
• Improve the targeting of high risk and vulnerable alcohol misusers
Safety
• Reduced alcohol related crime and disorder
• Promotion of a safe and sensible drinking culture across Gateshead
• No drink drive related incidents
Challenges
There is a culture of acceptance of alcohol in the North East which needs to be challenged in order affect the
social norms around alcohol in Gateshead.
Funding for community safety and policing is being reduced due to national budget constraints.