Griffiths, MD

English

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20 21April/May 2014 Intervene 149I drink, therefore I am:  the UK’s alcohol dependenceWant to fi nd statistics on alcohol in the UK? And to put them in context? Professor Mark Griﬃ  ths BSc, PhD, CPsychol, PGDipHE, FBPsS, FRSA does the work and brings you his fi ndings.“According to a 2013 report by Alcoholics Anonymous, alcoholism kills more people in the UK than any other drug apart from nicotine. Based on government statistics, it claims that one adult in every 13 is alcohol-dependent”participants might – consciously and/or unconsciously – underestimate alcohol consumption (for instance, alcohol use in the home could be based on the number of  glasses of  wine drunk with the amount poured into the glass being much greater than a standard unit of  alcohol). IN THE MOST RECENT 2013 REPORT, based on ONS data collected in 2011, participants were asked two questions about their alcohol consumption. These were (i) maximum amount of  alcohol drunk on any one day in the previous seven days, and (ii) average weekly alcohol consumption. The survey also obtained three measures of  maximum daily alcohol consumption:    exceeding the recommended daily alcohol limit; this measure assessed the proportion of  men and women exceeding the recommended units of  alcohol on their heaviest drinking day – ie, four units for men, three units for women     engaging      in binge drinking - ie, intoxication; this measure assessed the proportion of  men and women whothat: “The Department of  Health estimates that the harmful use of  alcohol costs the National Health Service about £2.7billion a year and 7% of  all hospital admissions are alcohol related. Drinking can lead to over 40 medical conditions, including cancer, stroke, hypertension, liver disease and heart disease. Reducing the harm caused by alcohol is therefore a priority for the government and the devolved administrations. Excessive consumption of  alcohol is a major preventable cause of  premature mortality with alcohol-related deaths accounting for almost 1.5% of  all deaths in England and Wales in 2011”.The ONS notes that obtaining reliable data on drinking behaviour is diﬃ  cult. Compared to national alcohol sales, surveys carried out by social scientists consistently record lower levels of  how much alcohol they consume because ALCOHOL DEPENDENCE is often viewed as a cluster of  behavioural, cognitive and physiological phenomena that in most aﬀ ected people includes a strong desire to consume alcohol, and diﬃ  culties in controlling their drinking. According to a 2013 report by Alcoholics Anonymous, alcoholism kills more people in the UK than any other drug apart from nicotine. Based on government statistics, it claims that one adult in every 13 is alcohol-dependent. The General Household Survey and the General Lifestyle Survey have been measuring drinking behaviour for over 30 years, and measure this lower – see later in this article. In relation to alcohol use, the 2013 Oﬃ  ce for National Statistics report notes Photography MagannSTATISTICSexceeded the number of  daily units considered as intoxicating – that is, eight units for men and six units for women  engaging in heavy drinking; this assessed the proportion of  men and women who drank over three times the recommended daily units of  alcohol – ie, over 12 units for men and over nine units for women.The results indicated the following.  59% of  all adults reported that they had consumed alcohol in the week prior to the survey.  66% of  men and 54% of  women had an alcoholic drink in the week before the survey.  More men (16%) drank on at least fi ve out of  seven days than women (9%) in that week.  9% of  men drank alcohol every day in the week prior to the survey compared to only 5% of  women.  34% of  men and 28% of  women exceeded the daily recommended units of  alcohol.  18% of  men and 12% of  women were binge alcohol drinkers.  More men (9%) were heavy drinkers than women were (6%)  Heavy drinking was most prevalent in people aged 16-44 years old.  Drinking alcohol was also associated with smoking nicotine, with smokers being more likely to be binge drinkers and heavy drinkers.ANOTHER MAJOR REPORT on alcohol use in England was recently published by the Lifestyle Statistics, Health and Social Care Information Centre (in 2013). Its analyses were obtained mainly from the Health and Social Care Information Centre’s Hospital Episodes Statistics, and prescribing data. The statistics that it reported are below.  61% of  men and 72% of  women had either drunk no alcohol in the last week, or had drunk within the recommended levels on the day they drank the most alcohol.  64% of  men drank no more than 21 units weekly, and 63% of  women drank no more than 14 units weekly.  12% of  school pupils had drunk alcohol in the last week; this continues a decline from 26% in 2001, and is at a similar level to 2010, when 13% of  pupils reported drinking in the last week.  In 2011/12, there were 200,900 admissions to English hospitals where the primary diagnosis was attributable to alcohol consumption, up 1% on the previous year.  In 2011/12, there were an estimated 1,220,300 admissions to English hospitals related to alcohol consumption where an alcohol-related disease, injury or condition was the primary reason for hospital admission or a secondary diagnosis – a rise of  4% on the previous year.  In 2012, there were 178,247 prescription items for the treatment of  alcohol dependence in primary care settings or NHS hospitals and dispensed in the community, up of  6% on the previous year.ARGUABLY THE MOST ROBUST data on alcohol dependence in the UK comes from the 2009 Adult Psychiatric Morbidity Survey carried out by the National Centre for Social Research and University of  Leicester. Alcohol problems, including alcohol dependence, were measured using the Audit (Alcohol Use Disorders Identifi cation Test) and the SADQ-C (Severity of  Alcohol Dependence Questionnaire, community version). An Audit score of  eight or more indicated hazardous drinking, and 16 or more indicated harmful drinking. SADQ-C scores of  4-19 indicated mild dependence; 20-34 = moderate dependence; 35 or more = severe dependence.Using the Audit, the prevalence of  hazardous drinking was 24.2% (33.2% males, 15.7% females). A total of  3.8% of  adults (5.8% males, 1.9% females) drank alcohol at harmful levels – that is about one in 25 adults. Among males, the highest prevalence of  both hazardous and harmful drinking was in 25-34 year olds, whereas in females it was in 16 -24 year olds. Using the SADQ-C, the prevalence of  alcohol dependence was 5.9% (8.7% males, 3.3% females) – that is about one 1 in 16 adults. For males, the highest levels of  dependence were identifi ed in those between the ages of  25-34 years (16.8%), whereas for females it was between the ages of  16-24 years (9.8%). Most of  the recorded dependence levels were mild (5.4%), with relatively few adults showing symptoms of  moderate or severe dependence (0.4% and 0.1% respectively). Compared to the previous APMS survey in 2000, the prevalence of  alcohol dependence was lower for males in 2007, whereas it remained at a similar level for females.FOR MORE INFORMATIONLifestyle Statistics, Health and Social Care Information Centre (2013). Statistics on Alcohol: England 2013 - to be found at https://catalogue.ic.nhs.uk/publications/public-health/alcohol/alco-eng-2013/alc-eng-2013-rep.pdf.National Centre for Social Research/University of Leicester 2009. Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. NHS Information Centre.“Drinking can lead to over 40 medical conditions, including cancer, stroke, hypertension, liver disease and heart disease. Reducing the harm caused by alcohol is therefore a priority for the government and the devolved administrations”22 23“ According to a 2013 report by Alcoholics Anonymous, alcoholism kills more people in the UK than any other drug apart from nicotine.”However you add up the statistics, these are part and parcel of a UK population of 60million adults – so even a low conservative ﬁ gure of 3.8% of adults drinking at harmful levels means there are 2.28million people who need to have their alcohol problems tackled. Even the lowest statistic of 1.9% means that 1.14million women are drinking at levels which could give their unborn children foetel alcohol syndrome and all its consequences, that 1.14million women are drinking at levels which triple their risk of breast cancer. And, depending on the research you look at, each of these 2.28million can aff ect 4-7 people around them.STATISTICS

I drink, therefore I am: the UK’s alcohol dependence

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