View
151
Download
0
Category
Preview:
Citation preview
Interesting things about Alcohol in the last yearA set of slides for Alcohol Awareness week
Prevalence of drinking
Recorded alcohol per capita consumption in the United Kingdom, from 2000
20122011201020092008200720062005200420032002200120000
2
4
6
8
10
12
14
All types Beer WineSpirits Other alcoholic beverages
Litre
s of
pur
e al
coho
l
Source: Global Health Observatory data repository
In order to make the conversion into litres of pure alcohol, the alcohol content (% alcohol by volume) is considered to be as follows: Beer (barley beer 5%), Wine (grape wine 12%; must of grape 9%, vermouth 16%), Spirits (distilled spirits 40%; spirit-like 30%), and Other (sorghum, millet, maize beers 5%; cider 5%; fortified wine 17% and 18%; fermented wheat and fermented rice 9%; other fermented beverages 9%).
Share of total alcohol consumed by the 20% of the population who drink the most
France
Switzerl
and
Spain
New Zea
land
German
y
UK (Eng
land)
Irelan
d
Finlan
dKore
a
Canad
aJa
pan
United
Stat
es
Hunga
ry0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
63%
Source: Health at a Glance - Alcohol (OECD)
“Alcohol consumption is highly concentrated, as the large majority of alcohol is drunk by the 20% of the population who drink the most, with some variation across countries.”
Proportions of men and women in England drinking above the CMO low risk guideline of 14 units a week, by age
16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Male
More than 14, up to 21 units More than 21, up to 28 unitsMore than 28, up to 35 units More than 35, up to 50 unitsMore than 50 units
16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Female
More than 14, up to 21 units More than 21, up to 28 unitsMore than 28, up to 35 units More than 35, up to 50 unitsMore than 50 units
Source: Health Survey for England (2014)
Hazardous, harmful and dependent drinking in the past year by sex: 2000, 2007 and 2014
Hazardous drinking in men Harmful/mild dependence and probable dependence in men
Hazardous drinking in women Harmful/mild dependence and probable dependence in
women
0%
5%
10%
15%
20%
25%
30%
35%
40% 2000 2007 2014
Source: Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2014
Self reported drinking behaviours of adults invited to Health Check
Non-drinker Trivial <1 units/day
Light 1–2 units/day
Moderate 3–6 units/day
Heavy 7–9 units/day
Very heavy >9 units/day
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
NHS Health Check No NHS Health Check
Source: The NHS Health Check in England: an evaluation of the first 4 years
n = 214,295 n = 1,464,729The NHS Health Check is a health check-up for adults in England aged 40-74. People in the age group, who don’t have a pre-existing condition, receive a letter from their GP or local authority inviting them for a NHS Health Check every five years.
AUDIT scores for older adult (50+ years) drinkers in UK
Lower
risk (
1-7)
Increa
sing r
isk (8
-15)
Higher
risk +
poss
ible d
epen
denc
e (16
+)0%
10%20%30%40%50%60%70%80%90% A profile of older drinkers in the UK today
▪ The vast majority (80%) of older drinkers in the areas we surveyed are lower risk drinkers, 17% are increasing risk drinkers, and 3% are higher risk drinkers.
▪ Amongst higher risk drinkers, 72% drink four or more times per week, while 58% typically drink 10 or more units a day.
▪ People who are LGBT, are not married, partnered, or cohabiting, live alone, and who have a longstanding illness or disability are more likely to be higher risk drinkers than those who are not.
n = 10,627
Source: Drink Wise, Age Well: Alcohol Use and the Over 50s in the UK
Frequent drinking (at least 5 days in last week) by income
Up to £9999
£10,000 up to £14,999
£15,000 up to £19,999
£20,000 up to £29,999
£30,000 up to £39,999
£40,000 or more
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20% Individuals with an annual income of £40,000 and over were more than twice as likely (18%) to be frequent drinkers compared with those with an annual income less than £10,000 (8%).
Almost 4 out of every 5 people (78%) in the highest income band (income of £40,000 or more) said they had drunk alcohol in the last week and alcohol consumption generally falls as income falls. Almost 3 in 10 (29%) people in the lowest income band classed themselves as teetotal (that is, they do not drink alcohol at all), compared with less than 1 in 10 (9%) for the highest income band.
Source: Adult Drinking Habits In Great Britain: 2014 (ONS)
Alcohol and the NHS
Those with the most problems with alcohol are more likely to use the NHS
Inpatient stay in the past quar-ter
Outpatient visit in the past quarter
Spoken with GP in the past 2 weeks
Spoken with GP in the past year
0%
5%
10%
15%
20%
25%
30%
35%
40%Non-drinker/low risk (0-7)Hazardous drinking (8-15)Harmful/ mild dependence (16-19)Probable dependence (20+)
Source: Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2014
Number of attendances at A&E in England recorded as having social problems (including chronic alcoholism and homelessness)
2013-14 2014-150
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
39,50740,867 Please note:
During the period covered (2013-14 and 2014-15) not all NHS trusts have provided data submissions to A&E HES and data quality can be poor for some fields.
Source: Accident and Emergency Attendances in England - 2014-15
Number of prescription items for the treatment of alcohol dependence dispensed in the community in England
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 20150
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
200,000
Prescribed in primary care Prescribed in NHS hospitals
Source: Statistics on Alcohol, England 2016 (HSCIC)
The cost and number of prescriptions of Disulfiram (to treat alcohol disorders) in England
Nov-11
Jan-1
2
Mar-12
May-12
Jul-1
2
Sep-12
Nov-12
Jan-1
3
Mar-13
May-13
Jul-1
3
Sep-13
Nov-13
Jan-1
4
Mar-14
May-14
Jul-1
4
Sep-14
Nov-14
Jan-1
5
Mar-15
May-15
Jul-1
5
Sep-15
Nov-15
£-
£20,000.00
£40,000.00
£60,000.00
£80,000.00
£100,000.00
£120,000.00
£140,000.00
£160,000.00
£180,000.00
-
1,000
2,000
3,000
4,000
5,000
6,000
Cost Items
Source: OpenPrescribing.net - https://openprescribing.net/chemical/0410010B0
Drink driving
Casualties in reported drink drive accidents: GB 1979 to 2014
1979
1981
1983
1985
1987
1989
1991
1993
1995
1997
1999
2001
2003
2005
2007
2009
2011
2013
0
5,000
10,000
15,000
20,000
25,000
SlightSeriousFatal
Source: Reported road casualties in Great Britain, estimates involving illegal alcohol levels: 2015
The number of killed or seriously injured (KSI) casualties [where at least one driver was over the drink drive limit], which is 1,310 for 2014, is the lowest KSI total for reported drink drive accidents on record.
However the reduction in KSI casualties from the 2013 levels is not statistically significant.
Nevertheless, there is an ongoing downward trend, with falls in every year since 2002, barring 2011.
Positive response to question of whether you know anyone who does this…
Drive after taking Class A drugs
Drive after smoking cannabis
Drive when over the legal alcohol limit
Drive when unsure if over legal alcohol limit
Drive after drinking two pints
0% 5% 10% 15% 20% 25% 30% 35% 40%
6%
12%
19%
38%
38%
Source: THINK! Road Safety Biennial Survey
Drink DrivingWhile the vast majority of people agree that it is dangerous and unacceptable to drive when over the legal alcohol limit or when unsure, the level of agreement has fallen in 2015.
Disqualified from driving after being convicted of a drink or drug driving offence
2011 2012 2013 2014 20150
10,000
20,000
30,000
40,000
50,000
60,000
70,000
60,89058,652
53,81950,523
36,438
Source: FOI release: Number of individuals who have been disqualified from driving after a drink driving offence
Age profile of those disqualified from driving following a drink or drug driving offence 2011 to 2015
15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 66 69 72 75 78 81 84 87 90 930
2,000
4,000
6,000
8,000
10,000
12,000FemaleMale
Source: FOI release: Number of individuals who have been disqualified from driving after a drink driving offence
Change in the number of breath tests carried out by police in England and Wales & the proportion that are positive
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 201252013 20140
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
0%
5%
10%
15%
20%
25%Number of tests Positive/refused (%)
Num
ber o
f bre
ath
test
s
Pro
porti
on o
f pos
itive
test
s
Source: Police powers and procedures England and Wales year ending 31 March 2015
Police carried out 607,000 breath tests in 2014, a fall of 10% compared with the 676,000 breath tests carried out in 2013.
Eleven per cent of breath tests carried out in 2014 were positive or refused, up one percentage point on 2013.
Drinking and crime
Number of offences committed pre and post treatment for alcohol use disorders
General Driver Violent Acquisitive Total0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
Pre-treatment Post-treatment “We observed a reduction in offending during a two-year follow-up after treatment for AUD (crude pre-treatment and post-treatment offending rate per 1000 falling from 221.5 to 169.4). Less offending was independently associated with completion of treatment (and long retention) and inpatient withdrawal management and/or pharmacological therapy.”
Source: Is treatment for alcohol use disorder associated with reductions in criminal offending? A national data linkage cohort study in England
Finds of alcohol in prisons in England and Wales, 2005 to 2014
2005 2006 2007 2008 2009 2010 2011 2012 2013 20140
200
400
600
800
1000
1200Number of Incidents
Source: http://www.parliament.uk/business/publications/written-questions-answers-statements/written-question/Commons/2016-01-06/21315 /
Problem drinking among women in England by violence and abuse typology and whether in poverty
Little or no violence and abuse
Physical violence from a partner
Sexual violence Extensive violence and abuse
0%
5%
10%
15%
20%
25%
30%Women in poverty Women not in poverty
Source: Joining the dots: The combined burden of violence, abuse and poverty in the lives of women (Agenda)
Prevalence of partner abuse victimisation in the last year, by sex and the frequency of drunkenness
Never Less than once every couple of months
Once every couple of months
Once a month Two or three times a month
Once a week or more
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0 Men Women
Source: Crime Statistics, Focus on Violent Crime and Sexual Offences, year ending March 2015
NB: Caution should be taken when making inferences about the relationship between alcohol consumption and partner abuse victimisation. The victims’ alcohol consumption may affect or be affected by their experience of partner abuse.
Two in five Scottish prisoners were drunk (41%) at the time of their offence
2008 2009 2011 2013 20150%
10%
20%
30%
40%
50%
60% I was drunk at the time of my offence I am worried that alcohol will be a problem for me when I get out
Source: Scottish Prison Service Prisoners Survey 2015
Alcohol and death
Rate per 100,000 of alcohol related deaths in the UK
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 20140
5
10
15
20
25 Male Female
Source: Alcohol-related deaths in the UK, 2014
Number of deaths from alcohol related diseases in England and Wales in 2014 by sex and age group
05-09 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-740
100
200
300
400
500
600
700
800
Male Female
Source: Avoidable mortality in England and Wales: 2014 ONS
Causes of death in alcohol related deaths registered in England in 2014
Chronic hepatitis, not elsewhere classified
Intentional self-poisoning by and exposure to alcohol
Alcoholic gastritis
Alcohol induced chronic pancreatitis
Degeneration of nervous system due to alcohol
Alcoholic cardiomyopathy
Accidental poisoning by and exposure to alcohol
Mental & behavioural disorders due to alcohol use
Fibrosis and cirrhosis of liver
Alcoholic liver disease
0 500 1000 1500 2000 2500 3000
Females Males
Number of deaths
Source: Alcohol-related deaths in the UK, 2014
Alcohol and money
Public attitudes to a minimum unit price for alcohol
0%10%20%30%40%50%60%70%80%90%
100%
Strongly againstSomewhat againstNeither in favour nor againstSomewhat in favourStrongly in favour Unfair to those on low
incomes
Effective at reducing heavy drinking
Effective at reducing young people's drinking
Unfair to sensible drinkers
Agree strongly Agree Neither agree nor disagree
Disagree Disagree strongly
Source: Attitudes to alcohol (NatCen)
Total Alcohol Duty Receipts per quarter(current and previous ten financial years)
2005
Q2
2006
Q1
2006
Q4
2007
Q3
2008
Q2
2009
Q1
2009
Q4
2010
Q3
2011
Q2
2012
Q1
2012
Q4
2013
Q3
2014
Q2
2015
Q1
2015
Q4
0
500
1,000
1,500
2,000
2,500
3,000
3,500
£ m
illio
n
▪ Total alcohol receipts followed a consistent pattern from 2005 to 2007, of around £2,000m per quarter, but with a peak during the final quarter of each calendar year (usually to around £2,200m, related to the Christmas period) followed by a dip in receipts in the first quarter of each calendar year (to approximately £1,600-£1,700m per quarter).
▪ From 2008 total receipts became slightly more volatile. The overall pattern remained the same however, with the lowest receipts being received by HMRC in the first calendar quarter of the year and highest receipts received in the final quarter. This may be attributable to there being two increases in duty rates in 2008 (one in March and one in December). Receipts have since trended upwards slightly, reaching their highest level recorded in Q4 2015, at close to £3,168m.
▪ In more recent years receipts from alcohol have been noticeably higher due to sustained periods of good weather, or major outdoor/sporting events, which typically increase alcohol receipts.
Source: Monthly statistics on clearances of alcohol products and duty receipts
Working more than 48 hours per week is associated with an increased risk of binge drinking
< 35 hours 35 - 40 hours
41- 48 hours
49 - 54 hours
> 55 hours0.7
0.8
0.9
1
1.1
1.2
1.3 “This systematic review and meta-analysis of 63 studies provides comprehensive evidence of an association between long working hours and alcohol use. Long working hours were associated with 1.11-fold likelihood of higher levels of alcohol use in the cross sectional analysis of 333 693 participants from 14 countries. A similar association (odds ratio 1.12) for new onset risky alcohol use was observed in a prospective analysis of 20 studies including 100 602 participants from nine countries. The associations were not dependent on participants’ sex, age, socioeconomic status, geographical region, type of study sample, prevalence of risky alcohol use in the cohort, or participation rate at follow-up. Eighteen prospective studies with individual participant data allowed us to perform a more refined comparison between work hour categories. Compared with the standard (35-40) weekly working hours, working 49-54 hours was associated with an odds ratio of 1.13 and working ≥55 hours a week was associated with an odds ratio of 1.12 for new onset risky alcohol use.”
Source: Virtanen, Marianna, et al. "Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data." BMJ 350 (2015)
Price per unit of alcohol in Scotland and England & Wales, by trade sector, 2000-2015
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 20150.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40
1.60
1.80
2.00E&W - On-trade Scotland - On-trade E&W - CombinedScotland - Combined E&W - Off-trade Scotland - Off-trade
Pric
e pe
r uni
t (£)
Source: MESAS alcohol sales and price update May 2016
More than one third (36%) of the volume of alcohol sold in the off-trade (excluding discount retailers) in England & Wales in 2015 was at below 45 pence a unit of alcohol.
Under 30 p
30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80 - 84 85up0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
Source: MESAS alcohol sales and price update May 2016
Off licences in England and Wales sold 265.8 million litres of pure alcohol in 2015
Over half (54%) of strong ciders sold in the off-trade (excluding discount retailers) in England and Wales in 2015 were sold at below 20 pence a unit
Under 20p 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 640%
10%
20%
30%
40%
50%
60%There were 3.6 million litres of pure alcohol classified as strong ciders sold in the off-trade (excluding discount retailers) in England and Wales in 2015
Source: MESAS alcohol sales and price update May 2016
Alcohol and young people
Drinking behaviours of young people in Scotland, Wales and England15-year-olds who report first drunkenness at age 13 or younger
Scotland Wales England0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
12%
10% 10%
12%
10%9%
Girls Boys
Proportion of 15-year-olds that drink at least once a week
Scotland Wales England0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
11%12%
10%
16%
14%
12%
Girls Boys
Source: Health Behaviour In School-aged Children (HBSC)
Nearly 1 in 5 assessments of children in need in England in 2014/15 identified alcohol (17.8%) as issues in the family
North E
ast
North W
est
Yorksh
ire an
d The
Hum
ber
East M
idlan
ds
Wes
t Midl
ands
East o
f Eng
land
Lond
on
South
East
South
Wes
t0%
5%
10%
15%
20%
25%
Source: Characteristics of children in need: 2014 to 2015 (DfE)
Excessive alcohol use findings from “Suicide by children and young people in England” report
Male Female Under 18 18-19 years0%
5%
10%
15%
20%
25%
30%
35%
Alcohol use seen as excessive Family substance misuse “Most of the antecedents of suicide identified in this study—exam pressures, abuse, bullying, bereavement, physical health conditions, and self-harm—were more common in females. Males were less likely to be known to services.
“There were also differences in antecedents in those under 18 or 18-19 years old. Abuse, academic pressures and bullying were more common in those under 18, while excessive alcohol use, illicit drug use and serious self-harm were more common in 18-19 year olds.”
Source: Suicide by children and young people in England. National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH). Manchester: University of Manchester, 2016.
n = 145
Alcohol and mental health
Monitoring of alcohol consumption in primary care among adults with bipolar disorder
Apr 2000 - March 2002
Apr 2002 - March 2004
Apr 2004 - March 2006
Apr 2007 - March 2009
Apr 2009 - March 20011
Apr 2011 - March 2013
0
100
200
300
400
500
600
700
800
900
88.6
168.3
244.7307.5
388
837.4
People with bipolar disorder People without servere mental illness
Rat
e of
alc
ohol
reco
rdin
g pe
r 100
0 pe
rson
-yea
rs
The current high alcohol recording rates in people with bipolar disorder is very encouraging, especially given evidence that assessment of alcohol use alone (without subsequent intervention) can lead to reductions in hazardous drinking. Nevertheless screening is just a first step in the management of AUDs in people with bipolar disorder. To fully address the high prevalence of AUDs in this population, appropriate effective interventions need to be delivered, where indicated by the screening. Further research is needed to determine the extent to which alcohol interventions are implemented in people with bipolar disorder.
SMI QOF in effect
Alcohol screening added in SMI QOF
Source: Monitoring of alcohol consumption in primary care among adults with bipolar disorder: A cross-sectional and retrospective cohort study, Hardoon, Sarah L. et al. Journal of Affective Disorders , Volume 198 , 83 - 87
Number of patients in touch with mental health service in the last 12 months who died by suicide with a history of alcohol and/or drug use dependence in England
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 20140
100
200
300
400
500
600
700
Alcohol
Drug
Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness
There were 6,151 suicides in patients with a history of alcohol misuse, 45% of the total sample, an average of 559 deaths per year. 4,435 had a history of drug misuse, 33% of the total sample, an average of 403 deaths per year. 7,391 had a history of either alcohol or drug misuse or both, 54% of patient suicides, an average of 672 deaths per year.
The number of suicides in patients with a history of alcohol or drug misuse has increased. Between 2012-2014, 240 (7%) patients were under drug services, 247 (7%) were under alcohol services, and 392 (11%) were under either drug or alcohol services.
And finally…
Would you stop drinking if your long term romantic partner asked you to?
45%
40%
15%Yes No
Not sure
Source: https://d25d2506sfb94s.cloudfront.net/cumulus_uploads/document/9ab2u5x5oi/Relationships_29-Jul-2016_Website.pdf
Recommended