In 2006, AAI commissioned a survey[1] of public attitudes towards alcohol. 1093 adults aged 18 and over were polled. The results illustrated a high degree of recognition that we have a problem with alcohol in Ireland and that the experience of the negative effects of alcohol are felt beyond the individual:

• 82% of people believed that our current alcohol consumption levels are a problem
• 85% felt that our cultural attitude to alcohol needs to change
• 66% knew someone who is a problem or dependent drinker
• Significant numbers of people (44%) had been injured, harassed or intimidated as a result of someone’s use of alcohol

One of the areas of everyday life where alcohol related harm is most highly profiled is through the maintaining of law and order in society. Alcohol plays a part in low level crime, vandalism and violence with 88% of public order offences deemed to be alcohol related. Between 1996 and 2004 the number of public order offences has more than tripled from 16,000 to 51,000.

One of the most visual and highlighted areas of alcohol related harm is seen in relation to drink driving.  Alcohol is a factor in a significant proportion of road deaths:

• Alcohol is a contributing factor in 38% of all road deaths
• 54% of drivers who die in road accidents have consumed alcohol
• Alcohol is a contributing factor in 38% of all pedestrian deaths on the road

The past decade in Ireland has revealed staggering statistics relating to the health implications of increased alcohol consumption. In the period 1992 to 2002, alcohol mortality increased significantly:

• Alcohol acute conditions: + 90%
• Alcohol chronic conditions: + 61%

In the same period, overall mortality rates in Ireland have actually fallen by 14%.

Alcohol consumption is one of the critical factors associated with suicide and deliberate self harm. The estimated risk of suicide has been reported as being 8 times greater in the presence of alcohol abuse than in its absence.  Alcohol can be said to provide false courage before a suicidal act and it can lead to increased impulsiveness. Prolonged abuse of alcohol is in itself a major contributory factor in depression and suicidal behaviour.

In a recent study in the Health Services Executive, North Eastern Area, alcohol was detected in more than half of a sample of consecutive suicide deaths in three counties in the area, which occurred in 2001 and 2002. Recent findings from the National Parasuicide Registry indicate that nearly half (47.4%) of the male episodes and 39.1% of the female episodes of deliberate self-harm involved alcohol (NSRF, 2004). There is evidence of alcohol consumption in 41% of all episodes of deliberate self-harm in 2005.

The increase in per capita consumption of alcohol in Irish society is mirrored in one key indicator, alcoholic liver disease. The chart below portrays the severity of the increase in per capita consumption of alcohol in Ireland over a 7 year period.

 

Liver disease was historically associated with older generations of drinkers in Ireland but in recent years increased numbers of younger people are presenting with liver disease as a result of excessive drinking.

The most visible effect of alcohol related harm is on our healthcare system, particularly hospitals. In a 2002 study on the impact of alcohol and injuries in the emergency department it was found that three quarters of those who attended A&E with alcohol related injuries were moderately to severely intoxicated with 60% having consumed 12 or more drinks in the 6 hours prior to the injury. Furthermore, two thirds of those with alcohol related injuries reported that if they had not been drinking that the injury would not have happened.

• Alcohol dependency or abuse is identified as a factor for 30% of male and 8% of female total admissions to hospital
• 1 in 8 of all accident and emergency admissions are due to an alcohol related injury
• The number of patients being admitted into hospital when drunk has grown by 80% in the 5 years from 1997 – 2002

The policy context
The table and statistics above are enough to convince most people that Ireland does not have a healthy association with alcohol. 

Legislation impacting the sale and consumption of alcohol in Ireland has become increasingly relaxed in recent years. Since the enactment of The Intoxicating Liquor Act 2000,

• opening hours have been significantly extended.
• The number of pub licenses has increased from 7,466 in 2000 to 9,555 in 2006, and
• licenses are now more easily acquired and transferred.

While there have been amendments to this Act and a new 2003 Act has provided for penalties for offences of disorderly conduct, it is apparent that a free market approach for increased competition prevails.

A Sale of Alcohol Bill, is expected to be published in 2007, which is intended “to modernise and streamline licensing law in order to make it more understandable and user friendly for the licensed trade, the courts and members of the public”. This is an opportunity for the government to introduce a restricted licensing code and control measures, which would impact on the level of alcohol related harm in Irish society. However, it is likely that there will be extended debate and controversy upon the publication of this Bill.

Re Price:
The Economic and Social Research Institute report - Conniffe and McCoy, 1993 - pointed out, that Irish alcohol consumption is relatively price inelastic but income elastic; these two economists correctly predicted that if the economy continued to grow, this would lead to disproportionate increases in alcohol consumption here: this is what happened in the Celtic Tiger era.

Cost of harm: 2.653 billion euros
The highest cost of alcohol related problems identified above is borne by business through reduced work productivity and absenteeism. Interestingly the business sector could be considered as a potentially significant lobby to reduce alcohol related harm in society (although such a lobby does not currently exist).

Alcohol Industry:
However, the alcohol industry lobby itself is very strong and has committed €20m over the next 4 years in Corporate Social Responsibility campaigning through its own ‘social responsibility’ organisation MEAS which is strongly supported by IBEC(Employers Union) and the unions that represent workers in the Drinks Industry.

Foetal Alcohol Spectrum Disorders:
Publication  of the report entitled 'The Coombe Women's Hospital Study  of  Alcohol,  Smoking and Illicit Drug Use, 1988-2005' in March this year,  Mary  Harney  TD,  Minister  for Health and Children asked the Chief Medical  Officer (CMO) in the Department of Health and Children to consider the  data  presented  in the Study particularly with respect to the finding that  most pregnant women drink alcohol. The Study found that 1 in 10 women reported  drinking  more  than 6 units of alcohol per week in pregnancy and that  this  pattern  was  more  pronounced  in  younger women. The Chief Medical Officer concluded that:-

• Alcohol consumption by pregnant women in Ireland poses a risk to unborn babies
• There is no known safe level of alcohol consumption during pregnancy
• Alcohol offers no benefits to pregnancy outcomes
• It is in the child's best interest for a pregnant woman not to drink alcohol during pregnancy

The Chief Medical Officer is now providing unambiguous advice in relation to alcohol consumption and pregnancy:

'Given the harmful drinking patterns in Ireland and the propensity to 'binge drink', there is a substantial risk of neurological damage to the foetus resulting in Foetal Alcohol Spectrum Disorders (FASD).  Alcohol offers no benefits to pregnancy outcomes. Therefore, it is in the child's best interest for a pregnant woman not to drink alcohol during pregnancy.'

Announced on Monday of this week:
Commission to look at alcohol in society

The Minister for Justice, Brian Lenihan, has said he is to bring a proposal to Government to reduce the effect of alcohol on society.

Speaking in Dublin, Minister Lenihan said he was currently compiling a proposal on the make up of the commission to review the matter.

However the minister added that in a country were there is full independence at 18 years of age it would be difficult to place restrictions on the consumption of alcohol.

Meanwhile, a new €4m campaign aimed at informing people about the impact excessive drinking can have on others is due to be officially launched tomorrow.

The Had Enough campaign looks at the impact irresponsible drinking behaviour can have on third parties, through the eyes of those it has impacted.

The campaign has been developed as part of the drinkaware.ie initiative by Mature Enjoyment of Alcohol in Society.

Advertisements will run until December on television, radio, the internet as well as in bars, nightclubs and cinemas.

The television advert shows how a woman alone on a street, an A&E nurse, a taxi driver, a shopkeeper and a neighbour all view anti-social drinking behaviour.

Those behind the campaign say it is the result of extensive research that revealed what young adults feel about excessive drinking and public drunkenness.

It identified that Ireland is now ready for a change of attitude to alcohol abuse.

Alcohol Action Ireland carried out a comprehensive analysis of the alcohol problem in Ireland between April-September 2007 and has set out a plan of action for the next 3-5 years. We estimate that to enable the organisation to develop to it’s full potential,we require 4 full time staff to carry out 2 specific goals:

Strategic Goal # 1

AAI fills the credibility gap and becomes a nationally recognised and respected voice of the public health perspective on alcohol

AAI has identified 3 clear credible voice objectives:  To be perceived as a leading independent and objective commentator on alcohol To be recognised by government as a critical contributor to alcohol related dialogue and policy development To be seen as the national authoritative voice on alcohol and young people

Strategic Goal # 2

AAI to drive sequenced and prioritised change across three areas of focus:

• Specific regulatory, policy and legal changes
• Government structural reform around alcohol
• Raising awareness and knowledge around alcohol (to change behaviours)

Alcohol Action Ireland is currently seeking funding to enable us to commence this journey. This is our most challenging task.

Email: marion@alcoholactionireland.ie