Alcohol Help

Northern Ireland Health Minister Edwin Poots has outlined his commitment to addressing the issue of alcohol misuse at the first ever formal North/South Conference on alcohol misuse.

The Minister launched a new five-year strategy to prevent and address the harm related to alcohol and drug misuse in Northern Ireland, the New Strategic Direction for Alcohol and Drugs.

Speaking at the conference, Mr Poots said: “There is no doubt that alcohol misuse is one of the main threats to public health in Northern Ireland. Research has shown that it costs Northern Ireland up to £900 million every year, and almost £250 million of these costs are borne by the Health and Social Care sector. If we do not take significant and robust action, the costs to Northern Ireland, and the health and social care system in particular, will continue to grow.

“Therefore, I am pleased today to launch our revised strategy to prevent and address the harms related to alcohol and drug misuse in Northern Ireland, known as the “New Strategic Direction for Alcohol and Drugs – Phase 2.”

The Minister continued: “The NSD Phase 2 sets out outcomes across five main areas: prevention and early intervention; harm reduction; treatment and support; law and criminal justice; and monitoring, evaluation and research.

“I am committed to ensuring that it is implemented as fully and effectively as possible.

“Alcohol remains our favourite drug, and we face similar problems on both sides of the border. Therefore I believe today’s conference is the perfect opportunity to launch the NSD Phase 2 and for us to collaborate most effectively to reinforce the work already underway in each jurisdiction.”

The conference brought together, for the first time, the policymakers and agencies from both jurisdictions to explore some of the common issues in relation to the alcohol culture on both parts of the island, setting the scene for a collaborative approach for tackling issues relating to alcohol misuse.

At the conference, expert contributions came from Professor Sir Ian Gilmore, who chairs the UK Alcohol Health Alliance and also the European Alcohol and Health Forum Science Group; Dr Peter Anderson, an international public health consultant and expert on alcohol policy, and Dr Fiona Measham, a renowned researcher in the fields of drug and alcohol use, gender, licensed leisure and the relationship between crime and culture. John Waters also led a session on Ireland’s Alcohol Culture.

The Minister of Health in the Republic of Ireland, Dr James Reilly, jointly opened the conference with Minister Poots, stating: “This conference has set the scene for a longer term, all-island collaborative approach for tackling issues relating to alcohol abuse. The areas we would like progress on a North South basis are measures to reduce the availability of cheap alcohol and treatment and rehabilitation of those affected by alcohol misuse. Alcohol use and misuse is an area where both jurisdictions can achieve a lot together – especially in dealing with the challenges that alcohol presents for young adults.

Alcohol is associated with many aspects of Irish social and cultural life, it is part of our custom for sociability, relaxation and enjoyment. However we must recognise that alcohol is associated with 2,000 beds being occupied every night in Irish acute hospitals and annually costs the healthcare system €1.2 billion”.

Professor Sir Ian Gilmore, one of the Key note speakers at the conference said: “I welcome this cross-Ireland initiative. The health harms we are seeing in both the UK and Ireland are so great that we urgently need effective coalitions between partners such as this. These allow mutual learning and the development of shared objectives. The Westminster Government will learn much from exciting initiatives around policy areas such as minimum unit price and a lower drink driving limit.”

Northern Ireland Executive

Statistics published by the Health Research Board (HRB) today showed a rise in alcohol-related deaths in Ireland for the years 2004-2008. The findings are from the first ever national report on trends in alcohol-related deaths and deaths among people who were alcohol dependent from the National Drug-Related Deaths Index (NDRDI).

672 alcohol-related poisoning deaths were recorded during the period 2004-2008. Two thirds of those who died were men and the majority were aged less than 50 years. Annually, the number of deaths fluctuated from 111 to 170.

Alcohol is the drug most frequently implicated in poisoning deaths in Ireland, with half of all alcohol-related poisonings involved another drug, most frequently benzodiazepines (61% – a prescription medication e.g. diazepam) and opiates (56%).

3,336 non-poisoning deaths of people who were alcohol dependent were recorded, with the annual number increasing from 508 in 2004 to 799 in 2008. The vast majority (89%) of the deaths were due to medical causes; with the remainder due to traumatic causes. Alcoholic liver disease (24%), cardiac conditions (17%) and respiratory infections (11%) were the most common medical causes of death among those who were alcohol dependent in all five years.

Two out of every three (65%) of those who died from medical causes were aged 64 years or younger with more than one third (37%) of the deaths in the 25–34-year age group the result of alcoholic liver disease.

Overall, the most common traumatic causes of death were as a result of a fall (40%) and hanging (19%). Those who died from traumatic causes were generally younger than those who died from medical causes, with half aged 49 years or younger at the time of their death.

Dr Suzi Lyons, senior researcher at the HRB noted that “The type of deaths among those who were alcohol dependent recorded in the NDRDI correlate very closely with the international research on alcohol-attributable mortality, for example alcoholic liver disease, cardiovascular disease and cancer; and traumatic causes such as falls and drowning. But what we cannot do in this paper though is estimate the social cost of premature mortality of these individuals, the detrimental effect on the family and burden on society.”.

Dr Lyons also said that the increase in the number of deaths recorded may be explained by a true increase in deaths or by improved recording practices
“Given that the per capita consumption of alcohol in Ireland is among the highest in Europe, that the majority (56%) of Irish people drink in a harmful manner, and that the NDRDI is a relatively new system, a combination of these factors is the most likely explanation” she concluded.

The World Health Organisation has identified a number of evidence-based strategies that have been shown to have an effect on reducing alcohol-related harm. These include: increasing taxes on alcohol, restrictions on days and hours of sale and a low legal blood alcohol concentration for drivers.

The Health Research Board (HRB)

Approximately 20% of lawyers have an alcohol disorder. Many of them limit drinking during the work week so they can function and then binge over the weekend. These binge drinking lawyers may not realize it, but they are doubling their risk of a heart attack by their drinking behavior.

A study published in the November 24, 2010 issue of the British Medical Journal compared the health effects of different drinking cultures in middle aged men in Ireland and France. From 1991-2001 the researchers tracked the drinking habits and health status of 9,758 men who were free of heart disease and aged 50-59 at the start of the study. Information was acquired at health centers in Belfast, Ireland and in three French cities (Lille, Strasbourg and Toulouse).

While the French men drank mostly wine spread evenly through the week, the Irish men drank mostly beer or spirits over the weekend. The average amount of alcohol the Irish men consumed over the weekend was 2-3 times higher than in France.

The researchers classified the men into categories of never drinkers, occasional drinkers, moderate regular drinkers and binge drinkers. A binge drinker was defined as someone who drank over 4-5 drinks over the course of one day (with a drink equaling a glass of wine or a half pint of beer). The rate of binge drinking in Ireland was 20 times higher than in France.

The researchers looked at the which men had heart attacks and tried to isolate the effect of patterns of alcohol consumption by taking account of other possible contributors to heart attacks such as age, smoking, blood pressure, level of physical activity, and waist circumference.

After adjusting for the other risk factors, the researchers concluded that men who binge drink had nearly twice the risk of heart attack or death from heart disease compared to regular drinkers over the 10 years of follow up.

Currently anti-binge drinking messages focus on the risk of alcohol poisoning, injuries, assaults, and regretful risky sexual encounters. In a press release the researchers said that anyone who binge drinks should be alerted to the doubling of the risk of heart attack from this behavior.

Lawyers Wellbeing Blog

A new study has revealed that the pattern of drinking affects the relation of alcohol intake to coronary heart disease.

The study found that French drink more than the Northern Irish each week, as they drink daily, rather than more on less occasions, the French suffered from considerably less coronary heart disease than the Northern Irish.

Ruidavets and colleagues compared groups of middle-aged men in France and Northern Ireland, who have very different drinking cultures and rates of heart disease.

The authors found that men who ‘binge’ drink had nearly twice the risk of myocardial infarction or death from coronary disease compared with regular drinkers over 10 years of follow-up.

Results showed that, after multivariate adjustment, the hazard ratio for hard CHD events compared with regular drinkers was 1.97, for binge drinkers, 2.03, for never drinkers, and 1.57, for former drinkers.

The authors concluded that regular and moderate alcohol intake throughout the week, the typical pattern in middle-aged men in France, is associated with a low risk of ischemic heart disease, whereas the binge-drinking pattern more prevalent in Belfast confers a higher risk.

India4u News

Trinity College Dublin, in partnership with the HSE recently published research into alcohol use and drinking patterns among amateur Irish sportsmen in what is believed to be the largest study ever undertaken on alcohol use among adult sportspeople in Ireland.

The research, which was conducted by Professor Shane Allwright (TCD) and Dr Anne O’Farrell (HSE/TCD) of the Department of Public Health and Primary Care, Trinity College Dublin, together with Susan Kenny, Nazih Eldin and Gerry Roddy of HSE Health Promotion Department in Dublin North East, found that alcohol consumption amongst GAA players was higher than those found in a nationally representative sample of males of a similar age, and that over half of the members surveyed engaged in binge drinking.

The research published in BioMed Central Research Notes, an online medical journal, forms part of an extensive evaluation, undertaken by TCD and funded by the Health Research Board (HRB) and HSE, into an innovative HSE health promotion programme focused on reducing alcohol use and related harms within the Gaelic Athletic Association (GAA) club setting.

Sporting organisations and clubs are key settings for promoting health and well-being, and participation in sport has numerous proven health benefits. However, international research has shown that those involved in sport may be more likely to engage in regular binge drinking than the rest of the population.

In 2004, the GAA established a task force to consider how the organisation could promote positive health behaviours and reduce alcohol related harms within both the organisation itself and the wider community. In response to the GAA task force recommendations and other national recommendations, TCD and the HSE Health Promotion Department in Dublin North East established a collaborative partnership with the specific aim of implementing and evaluating an alcohol health promotion programme for the GAA.

A survey was undertaken to assess current alcohol use and associated health behaviours within participating GAA clubs. The research among 960 playing members of the GAA is believed to be the largest study ever undertaken on alcohol use among adult sportspeople in Ireland. The findings show that:

* over 90% of players were current drinkers;
* almost one third (31%) reported drinking over the recommended limit of 21 standard drinks per week;
* just over half of the current drinkers (54.3%) reported drinking 6 or more standard drinks in a row at least once a week (regular binge drinking);
* almost all (87.6%) of the 864 drinkers reported experiencing at least one harm due to their drinking within the last 12 months;
* regular binge drinking was more common among players who said they were under 18 when they had their first drink;
* regular binge drinking was significantly associated with increased likelihood of reporting alcohol-related harms e.g. players who regularly binge drink were twice as likely to report being in a fight or that alcohol harmed their work or studies.

Although problem alcohol use outcomes were higher than those found in a nationally representative sample of males of a similar age, the study confirmed that smoking rates among GAA players at 8% is significantly lower than the national average for young men of the same age.

Speaking about the results of the survey, Professor Shane Allwright of TCD said: “The GAA were to be commended for their pro-active approach to the issue of alcohol misuse. Having recognised that there might be a problem, rather than sweeping it under the carpet, they are willing to use the study to evaluate the size of the problem and are already trying to address the issues raised.”

Dr Nazih Eldin, Head of Health Promotion, HSE Dublin North East said: “Working with the GAA in order to meet the recommendations of the GAA Taskforce on Alcohol helps us reach the players, coaches and followers of the game, and TCD’s research informed the HSE’s intervention programme in an insightful way. This collaborative approach gives us the best possible basis to address alcohol issues in a targeted way.”

As an initial step in the development of the programme, Dr Anne O’Farrell pointed out that while these figures may look bad, players of other team sports such as rugby, soccer or hockey, may be similar or worse but we do not yet have this information for other sports.

Following the initial survey, a comprehensive health promotion programme was put in place by the Health Promotion Department of HSE Dublin North East. This comprised alcohol and nutrition health education sessions for GAA players and mentors and a social marketing campaign in local sports media. The key health promotion messages for the programme focused on the benefits to participants’ health and sports performance of drinking less alcohol and making healthy lifestyle choices. The programme encouraged clubs to adopt substance use prevention policies that would support players and mentors to choose healthier choices. Information was provided to participants of local HSE addiction services should they require additional help or support. The programme incorporated resources and key messages from the GAA’s own Alcohol and Substance Use Prevention Programme (ASAP) to allow for ongoing sustainability of the programme.

Trinity College Dublin