The Nature of Alcohol Problems

Despite declines mainly in wine-producing countries, Europe remains the region of the world with the highest production and consumption of beverage alcohol, with commensurately high levels of alcohol-related harm. Any idea that to experience a significant problem with alcohol is a rare occurrence is dispelled by the available evidence. 1 North American surveys have found that over 23 per cent of men and 4.5 per cent of women experience alcohol abuse or dependence during their lifetime. Nearly 12 per cent of men and over 2 per cent of women experience abuse or dependence in any one year. North America is around the middle of the international league of alcohol consumption.

In all Member States of the European Union the harms associated with alcohol thus constitute a serious public health problem. Levels of alcohol consumption and harm are rising steeply in some of the newly independent states of Eastern Europe seeking entry to the Union.

Alcohol can be both a health and a social problem. Some of the harm associated with alcohol arises from acute intoxication, some from long-term heavy consumption. There is a range of medical, psychological and social problems associated with alcohol dependence. All types of problems exist in varying degrees of severity.

Intoxication
Long term excessive
consumption Dependence

Casualties (accidents and violence)
Physiological (acute & chronic)
Psychological problems
Impaired performance of social roles

Health Problems

Overall, alcohol products are responsible for around 9 per cent of the total disease burden in the WHO European Region, and 40 - 60 per cent of all deaths from intentional and unintentional injury are attributable to alcohol. 2

Acute and Chronic Effects of Alcohol Misuse 3.

Acute
Accidents & injury Pancreatitis
Acute alcohol poisoning Cardiac arrhythmias
Aspiration pneumonia Cerebrovascular accidents
Oesophagitis Neurapraxia
Mallory-Weiss syndrome Myopathy/rhabdomyolysis
Gastritis Hypoglycaemia

Chronic
Accidents & injury Brain damage
Oesophagitis *dementia
Gastritis *Wernicke-Korsakoff syndrome
Malabsorption *Marchiafava-Bignami syndrome
Pancreatitis *central pontine myelinolysis
Liver damage Peripheral neuropathy
*fatty change Myopathy
*hepatitis Osteoporosis
*cirrhosis Skin disorders
Hypertension Malignancies
Cardiomyopathy Infertility
Coronary heart disease Foetal damage

References
1 G. Edwards et al: Alcohol Policy and the Public Good. Oxford University Press 1994.
2 European Alcohol Action Plan. Phase 2. WHO 1999.
3 Medical Students' Handbook: Alcohol and Health The Medical Council on Alcoholism London 1998.

 

Austria
Around 400,000 alcohol dependent.
Population 8.1 million

Belgium
250,000 - 500,000 alcohol dependent requiring treatment
Population 10.2 million

Denmark
14 per cent of men and 8 per cent of women exceed recommended consumption limits
Population 5.3 million

Finland
22 per cent of men and 5 per cent of women "risky drinkers"
Population 5.1 million

France
An estimated five million drinkers are at risk of medical, psychological and social problems, and two million people are dependent on alcohol.
Population 58.3 million

Germany
2.5 million alcohol dependents and 6.5 million `excessive drinkers'
Population 82 million

Ireland
8 per cent of men and 2 per cent of women report signs of alcohol dependence.
Population 3.6 million

Italy
One third of adult hospital patients (in Naples) either have current alcohol
problems or are excessive drinkers.
Population 57.4 million

Luxembourg
9000 alcohol dependent
Population 418,300

Netherlands
Around 100,000 treated for alcohol dependence each year.
Population 15.5 million

Portugal
300,000-500,000 alcohol dependent
Population 9.2 million

Spain
1.6 million alcohol dependent
Population 39.3 million

Sweden
An estimated 300,000 people 'whose heavy drinking threatens their health and
professional status'
Population 8.9 million

UK
7.5 per cent men and 2.1 per cent women report symptoms of alcohol dependence, and around 1.7 million adults drinking at definitely harmful levels (50/35 drinks per week)
Population 59 million

Source: Overview of National Alcohol Policies in 15 Countries of European Union. Société Francaise de Santé Publique, and the European Commission 1998 and other sources.



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