Doctors are urging the Government to put pricing and availability restrictions in place in a bid to stem the rise of alcohol consumption. Theresa Judgereports
Public health doctors are calling on the Government to raise alcohol taxes and dramatically change its relationship with the drinks industry following new research highlighting the damage alcohol is causing to people's health.
The research found a 17 per cent increase in alcohol consumption between 1995 and 2006. The number of people discharged from hospital with alcohol-related problems or injuries increased by almost 90 per cent in the 10 years from 1995.
The report from the Health Research Board (HRB), Health-related consequences of problem alcohol use, also demonstrated how excessive drinking is placing an increasing strain on our hospitals. In 2004, people with alcohol-related illness used 117,373 bed days in hospital - more than double the 1995 figure of 55,805.
"We have a massive alcohol problem in this country - we have been calling it a national epidemic for years now and I despair about the lack of leadership on this issue from the Government. What we need is a champion at Government level saying that this is a very serious issue and our citizens are suffering really badly," says Dr Rolande Anderson of the Irish College of General Practitioners (ICGP), who is also an addiction counsellor.
Anderson argues that the drinks industry has had too much sway over Government policy. "There are too many vested interests at Government level," he says.
Prof Joe Barry of Trinity College's department of public health is equally critical of the Government's failure to face up to the drinks industry and tackle problem alcohol use.
He was a member of a Government-appointed Strategic Task Force on alcohol that issued two reports in 2002 and 2004. The first recommendation of last week's HRB report was the implementation of the task force's reports, pointing out that "international evidence supports alcohol taxation, regulating the physical availability of alcohol and drink-driving countermeasures as effective strategies for reducing alcohol consumption and related harm".
Barry says that of some 100 recommendations made by the task force in its two reports, "by and large, it's the softer ones that have been moved on a bit". He says most progress has been made on curbing drink-driving, particularly with the introduction of random breath testing. The HRB report notes that in the 12 months since it was introduced in July 2006, there have been 20 per cent fewer fatalities in road accidents than in the corresponding period in 2005/6.
However, Barry says it is disappointing that the Government has "again kicked into touch" a proposal to reduce permitted blood alcohol levels for drivers. He points out that the current permitted level of 80mg/100ml is one of the highest in Europe. "It's a pity that the Government is still 'looking at' this five years after a Government-appointed task force recommended it," he says.
Barry says the crucial issues to be addressed are price and availability. While alcohol tax levels in Ireland are relatively high, drink is still quite cheap, he says, thanks mainly to special offers at supermarkets and off-licences. Many such offers encourage people to buy in large quantities.
"Supermarkets will give these special offers to get people into their shops, and there has been a proliferation of licences since 2004 - every supermarket and petrol station is now selling drink. Availability has got laxer rather than tighter," he says.
Barry says there is a need for a minimum pricing structure on alcohol products, as applies to cigarettes, to have more regulation of the advertising and marketing of alcohol and to "break the link between music/sport and alcohol".
Lead author of the HRB report, Dr Deirdre Mongan, stresses the power of taxation to reduce alcohol consumption, pointing out that an increase in excise duty on spirits in the 2002 budget led to a 21 per cent decrease in sales of spirits the following year. Similarly an increase in excise on cider in the 2001 budget led to a 13 per cent reduction in consumption in 2002.
Barry says all the Strategic Task Force recommendations were aiming to do was to get Irish consumption down to average EU levels - from our current position of being the fourth highest of 27 countries. "That would represent an 18 per cent reduction in consumption levels, but the alcohol industry doesn't want that and the Government is really taking the side of the drinks industry," he says.
He says that comments made in the Dáil last week by Minister for Finance Brian Cowen expressing concern over alcohol consumption were meaningless unless taxes were raised.
Barry says it is "now obvious that the self-regulation of the alcohol industry doesn't work" and that the social partnership approach was ineffective. "In the last partnership agreement, Sustaining Progress, there was a commitment to tackle underage drinking, but it has done absolutely nothing - it is a complete disgrace." He says the policy of working in partnership with the alcohol industry is "inappropriate" and "a pretence of dealing with the problem but nothing is really being done".
Anderson is also totally opposed to "a partnership approach", saying the drinks industry should not be allowed any role in health promotion. Campaigns by the industry such as Meas (mature enjoyment of alcohol) and the website drinkaware.ie were "muddying the waters". He adds: "Giving the drinks industry a role is holding up progress on the measures that are needed. I feel they should just stay out of it altogether."
The HRB report is also critical of Government action or lack of it on the issue, stating: "Ireland has a number of alcohol policies, but none has been implemented consistently. The existing national alcohol policy was established as long ago as 1996 by the Department of Health, but has been largely ignored and consequently has had little success."
It goes on to point out how some policies "actually contradict each other".
Elsewhere, the report notes that "although the extent of the alcohol problem has been highlighted ad nauseam, it remains the case that no structures exist to manage this problem".
Barry points to the contrast with the drugs strategy when local and regional drugs task forces were established. No such structures were ever put in place to implement the reports of the Strategic Task Force on Alcohol.
Anderson says he hopes people do not forget the human stories behind alcohol statistics. "Every day I am hearing shocking stories of what alcohol is doing to individuals, families and communities." He points out that alcohol is often a factor in everything from road accidents, depression, suicide and relationship breakdown to sex assaults, STIs and unwanted pregnancies.