Alcohol use and adults

Introduction

Most adults in Britain drink alcohol, at least occasionally, and alcohol has an established place in British social life and culture.

Not everyone who drinks does so in a problematic way. Many people who drink alcohol regularly do so within the ‘low-risk guidelines‘ which are no more than 14 units a week for men and women, spread over three days or more (accessed 6 June 2016).

However, drinking more than the amount suggested by the guidelines can damage a person’s health. Yet, 83% of people who regularly drink above the guidelines don’t think their drinking is putting their long-term health at risk.

Alcohol is the leading risk factor for preventable death in 15-49 year olds and has been identified as a causal factor in more than 60 medical conditions. Nine million adults now drink at levels that increase the risk of harm, of whom 1.6 million show signs of alcohol dependence. From 2001-2012, the number of people who died due to liver disease in England rose from 7,841 to 10,948 – a 40% increase and in contrast to other major causes of disease that have been declining.

As alcohol is associated with such a wide range of harms that there will never be a simple set of solutions - different drinking behaviours also require different responses to prevention, care and management: single session binge drinking is different from alcohol dependency for example. 

Social impacts of alcohol include violent crimes, sexual assaults, domestic violence and public disorder. Therefore, alcohol misuse is not just a burden on individuals and families but also a drain on communities, hospital resources and public money with alcohol-related harm costing £21 billion.

Key inequalities and risk factors

According to Health Survey Data 2014:

  • Gender - More men than women drink above the low risk guidelines
  • Age - Younger age groups are more likely to binge drink and mid-life age groups are more likely to regularly drink too much.
    • Among men, the prevalence of drinking more than 21 units a week increased with age and was most common among men aged 65-74, 30% of whom drank at this level
    • Among women, the proportion who drank more than 14 units a week declined between the ages of 25 and 44, and was highest among women aged 55-64 (22%).   
  • Medical history and treatment - Alcohol tolerance decreases with age and combined with complications with medicines puts older people at higher risk of falls, car crashes, and other unintentional injuries
  • Mental health and emotional wellbeing - Nationally, women make up 36% of the adults in alcohol treatment. Women presenting to treatment often experience poor mental health, domestic violence and for mothers, who make up 54% of women in treatment, the challenge of being a lone parent. Alcohol dependence is also associated with increased criminal activity and domestic violence, and an increased rate of significant mental and physical disorders.
  • Ethnicity - White men and women were more likely to drink more than the low risk guidelines than men and women from Black or Asian communities
  • Income - The proportions of men who drank above 21 units and women who drank above 14 units a week was higher in higher income households

For information specifically young people and alcohol, please see the section on alcohol in the Developing Well chapter of the JSNA.

Facts, figures and trends

Alcohol consumption

The risks to health from alcohol as the leading risk factor for preventable death in 15-49 year olds are summarised in the Public Health England Evidence into Action (2014) report:

Abstinence

According to Alcohol Statistics in England (NHS Digital, 2015), more than one in five adults (21%) said that they do not drink alcohol at all – an increase of 2% since 2005.

Regular drinking

The effects of alcohol in the long-term (10 to 20 years of regularly drinking more than 14 units a week) include the development of:

The Bracknell Forest Health and Wellbeing Survey 2014 showed that proportion of males who said that they consume over the recommended levels was almost double that of females (7.9% compared to 4.1%):

Single session / binge drinking

Binge drinking usually refers to drinking lots of alcohol in a short space of time or drinking to get drunk. Researchers define binge drinking as consuming eight or more units in a single session for men and six or more for women. Risks associated with drinking too much too quickly include:

  • head injuries
  • fractures
  • facial injuries
  • scarring
  • alcohol poisoning
  • heart disease

Nationally, the proportion of adults who binged at least once in the week decreased from 18%  in 2005 to 15%  in 2013. When surveyed, the Bracknell Forest Health and Wellbeing Survey 2014  males were more likely than females to say that they consumed more than 8 units in one sitting 1-2 times per month (or more often than this):

Alcohol dependency

NICE guidance (2011) characterises alcohol dependence by craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences (for example, liver disease or depression caused by drinking).  Alcohol dependence is also associated with increased criminal activity and domestic violence, and an increased rate of significant mental and physical disorders.

Alcohol dependence affects 4% of people aged between 16 and 65 in England (6% of men and 2% of women), and over 24% of the English population (33% of men and 16% of women) consume alcohol in a way that is potentially or actually harmful to their health or well-being.  

Of the 1 million people aged between 16 and 65 who are alcohol dependent in England, only about 6% per year receive treatment. Reasons for this include the often long period between developing alcohol dependence and seeking help, and the limited availability of specialist alcohol treatment services in some parts of England. Additionally, alcohol misuse is under-identified by health and social care professionals, leading to missed opportunities to provide effective interventions.

In Bracknell Forest, the total number of individuals who received treatment at a specialist alcohol misuse service in 2014/15 was 190 (2013/14, 275).  Bracknell Forest offers effective services: no one was waiting 3 weeks or more for treatment services.  The percentage of people completing treatment (and who do not represent within 6 months) was 42.6% (2013/14, 37%).

Alcohol-related hospital admissions

Reducing the number of alcohol related hospital admissions is one of the seven public health priorities published in the Evidence into Action (2014) report.

The Alcohol Statistics in England 2015 report states that in 2013/14 there were an estimated 1,059,210 admissions related to alcohol consumption where an alcohol-related disease, injury or condition was the primary reason for hospital admission or a secondary diagnosis (broad measure).

This is 50,360 (5% ) more admissions than 2012/13 (1,008,850) and 565,450 (115% ) more estimated admissions than 2003/04 (493,760). CVD accounted for the highest number of admissions with 66%  more admissions than 2003/04 (174,160).

In 2013/14, there were an estimated 333,010 admissions where the primary diagnosis or alcohol-related external causes recorded in secondary diagnosis fields were attributable to the consumption of alcohol (the narrow measure). This is 7,150 (2% ) more estimated admissions than 2012/13 (325,870) and 96,240 (29% ) more estimated admissions than 2003/04 (236,770).

Admission episodes show that hospital admissions are higher for people aged 40 and over for both men and women although the rate per 100,000 is higher for men than women:

Alcohol related illness and injury

The Local alcohol consumption profiles for England (2015) reports Bracknell Forest data on alcohol related illness and injury including: cardiovascular disease, mental health and behavioural issues, liver disease, cancer, unintentional poisoning and physical injuries.

Mortality

The Alcohol Statistics in England 2015 records 6,592 alcohol-related deaths in 2013. This is a 1% increase from 2012 (6,495) and a 10% increase from 2003 (5,984).

The number of estimated deaths in Bracknell Forest related to alcohol has fallen since 2011 at a faster rate than the south east and England averages:

The number of estimated deaths related to alcohol is consistently higher for men than women:

Alcohol-related crime

Data on alcohol and crime was last recorded in 2012/13. The rate of alcohol-related recorded crime in Bracknell Forest in 2012/13 was 3.94 per 1000 population. This was lower than the national average of 5.74 per 1000.

The rate of alcohol-related violent crime in Bracknell Forest in 2012/13 was 2.97 per 1000 population. This was also lower than the national average of 3.93 per 1000.

Costs

A number of measures assess the individual and societal costs of alcohol.  Recognising alcohol dependency leads to significant harms and places a financial burden on communities, key data for planning effective alcohol harm prevention, treatment and recovery in 2016-17 makes the case for investment in prevention, treatment and recovery interventions reduces this burden on individuals, their families, communities and health and care services.

Hospital admissions

Alcohol consumption as a whole is a contributing factor to hospital admissions and deaths from a diverse range of conditions. Alcohol misuse is estimated to cost the NHS about £3.5 billion per year and society as a whole £21 billion annually.

Alcohol related prescriptions

Nationally, 194,706 items were prescribed (in a primary care setting or NHS hospital) in 2014. The majority of these 185,251 (95%) were prescribed in a primary care setting (e.g. GP surgery, pharmacist or clinic). The Net Ingredient Cost (NIC) of these prescription items in 2014 was £3.43 million, which is an increase of £0.30 million since 2013 and more than double the NIC in 2004 of £1.52 million.

Benefits

In Bracknell Forest, on 31st May 2015, there were 40 claimants of Incapacity Benefit/Severe Disablement Allowance or Employment and Support Allowance with alcohol misuse as the main disabling condition. This was a rate of 52.8 per 100,000 working age population (16-64) and was a significantly better figure than the England average of 136.8 per 100,000.

Traffic accidents

Alcohol consumption is responsible for around one in every seven deaths in reported road traffic accidents in Great Britain. Final estimates for 2013 show that between 220 and 260 people were killed in accidents where at least one driver was over the drink drive limit, around 1,100 were seriously injured and the total number of casualties of all severities was 8,270.

Between 2012-14, there were 22 alcohol-related road traffic accidents in Bracknell Forest. Equivalent to 35.8 accidents per 1,000 accidents, this was statistically similar to the national 26.1 average rate.

Want to know more?

The Government’s Alcohol Strategy (2012) – outlines national commitments and approaches to change drinking behaviours (e.g. binge drinking and “pre-loading”) and local licensing powers to address negative impact on individuals’ health and wellbeing and society.  The government is currently reviewing its alcohol related policies and service commissioners should consider these in service commissioning.

Alcohol harm prevention, treatment and recovery for adults: JSNA support pack (Public Health England) - Key data for planning effective alcohol harm prevention, treatment and recovery in 2016-17 and Good practice prompts for planning comprehensive interventions in 2016-17.

Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (NICE, 2011).

Alcohol-use disorders: diagnosis and management of physical complications (NICE, 2010) – guidelines covering the care of people (aged 10 years and older) who have physical health problems completely or partly caused by alcohol use, including acute alcohol withdrawal, liver disease and inflammation of the liver.

Adults Drug and Alcohol Health Needs Assessment (Berkshire Public Health Team, 2015) - identified treatment demand and service provision for substance misuse which draws upon comparisons between local authorities (LAs) across Berkshire to support service commissioning.

Alcohol IBA Commissioning Toolkit (Public Health England, 2016) - evidenced based resources, as well as guidance and case studies to help commissioners to commission effectively in hospitals, social care, criminal justice system and community settings.

Alcohol-use disorders: prevention (NICE, 2010) – population as well as individual level guidance on the prevention and early identification of alcohol-use disorders among adults and adolescents.

Drink Aware – alcohol related advice, information and support for people and professionals.

Local alcohol consumption profiles for England (2015) - provide information for local government, health organisations, commissioners and other agencies to monitor the impact of alcohol on local communities, and to monitor the services and initiatives that have been put in place to prevent and reduce the harmful impact of alcohol.

 

This page was created on 27  February 2014 and updated on 22 June 2016.  Next review date May 2017.

Cite this page:

Bracknell Forest Council. (2016). JSNA – Alcohol. Available at: jsna.bracknell-forest.gov.uk/living-working-well/healthy-lifestyles/alcohol (Accessed: dd Mmmm yyyy)

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