Alcohol Misuse

Healthy Lives
Behavioural Risk Factors
Alcoholism
Alcohol dependence
Mental health
Alcohol

introduction Introduction

The relationship between alcohol and humanity goes way back in time, with evidence suggesting primates used alcohol even before modern humans developed. It is relatively easy to make, being the product of fermented carbohydrates, and can even occur naturally in nature. Other animal species also seek out and consume alcohol.

Alcohol is the most used psychoactive drug in the world, and this is certainly the case in the UK. Simply put, alcohol changes the way we think and feel, and it does this by altering several different brain chemicals. Some of these chemicals can give a sense of pleasure or excitement, but the main effect of alcohol, especially when consumed in larger amounts is to slow down the messaging systems in our brain and nervous system. This is why alcohol impairs our ability to do complicated things like drive, or why a person might slur their words or feel sleepy after “one too many”.  

For most people, consuming a small amount of alcohol can be a pleasurable experience and does not normally lead to harm. Alcohol can be consumed at home, with friends and can be a central part of a night out. Around a quarter of adults in the UK drink too much however, and this exposes them and others to increasing risk of harm.

Scientific investigation has now better understood that alcohol is a harmful substance, the body deals with it as a toxin, or poison. We now know that even a small amount can cause harm and the more alcohol a person consumes the more likely they are to encounter health and other problems. When alcohol is consumed in higher amounts on a regular basis, tolerance develops, and the person can experience unpleasant alcohol withdrawal symptoms, which is known medically as alcohol dependence and can sometimes also be called “alcoholism”. As well as alcohol dependence, alcohol contributes to a wide range of acute and long-term health conditions and increases the risk for needing hospital care. Alcohol is the main cause of death in people between the ages of 15 and 49 in the UK and deaths from alcohol reached their highest level on record in 2022 with 7,423 alcohol related deaths in England and Wales.

As well as having the potential to cause harm to the person who consumes it, alcohol can also cause harm for other people, including the family and friends of the person who has consumed alcohol. It can lead to an increased risk of work absenteeism; it makes significant impacts on health services and contributes to a wide range of other problems such as accidents and assaults.

why is it important to population health Why is it important to Population Health?

Alcohol is a key population health issue for several reasons. Alcohol is wholly or partly responsible for over 200 different disease conditions1,2, is the largest cause of death in working age adults in the UK, and is responsible for 16% of all working years lost3. In fact, more working years were lost due to alcohol than the ten leading causes of cancer related death combined.

The impact that alcohol makes on the NHS is significant. Alcohol is considered to cause 25% of the overall Emergency Department workload4 and can account for 70% of Emergency Department attendances at specific times, such as weekends5. Additionally, 37% of emergency ambulance time is spent on alcohol-related incidents6. In Derbyshire, alcohol is responsible for over 15,000 hospital admissions and causes almost 400 deaths each year7. Alcohol Related Liver Disease caused 119 of these deaths and is the single largest cause of alcohol-related death.

Alcohol is not just a health issue though, around half of the workload of the police is also thought to be alcohol related. Alcohol is implicated in over half of all violent incidents and 15% of deaths in road traffic accidents involved at least one driver over the drink drive limit8. 10-30% of all fires and the majority of fire related-fatalities have high blood alcohol concentrations9. For children, 61% of care applications relate to alcohol or drugs10 and parental alcohol misuse is implicated in 37% of death/serious injury of a child11.

the derbyshire population approach The Derbyshire Population Health Approach

The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.

When considering the topic of alcohol misuse within The Derbyshire Population Health Approach:

It is always preferable to avoid developing alcohol problems. Alcohol laws help to protect children and young people from purchasing alcohol and Derbyshire schools help to make sure students have quality information about alcohol’s risks and the knowledge and skills to avoid alcohol related harms.

Harmful drinking and alcohol dependence can affect anyone. Evidence shows however, that when it does occur its impact is greater for those with the lowest income and with the highest levels of social deprivation. The reasons for this are not fully understood but are thought to relate to the other issues people living with social disadvantage face.

There is a growing evidence base that people with a history of experiencing psychological traumas are more at risk of developing a problematic relationship with alcohol. Similarly, there is evidence that shows that when people are going through difficult times, drinking alcohol to excess can add to the risks they face.

There are a range of approaches that have been shown to help people avoid the harms caused by alcohol and prevention is the best way to avoid problems. Helping people, especially children and young people, to avoid experiencing trauma, and efforts to combat social deprivation can help people avoid developing alcohol problems.

There have been several population health campaigns, that help people better understand the risks of alcohol, and these seem to be having an effect, especially in younger adults, where drinking above lower risk levels is now less common.

Evidence has also led to health and social care professionals being required to talk to the people they come into contact with about their alcohol intake, and this has been shown to be effective. Simply asking someone how much they are drinking in a non-judgemental way and providing brief advice to cut down has been demonstrated to be effective.

For people that have more significant alcohol problems, such as alcohol dependence, the evidence shows that the most effective way for them to overcome this is via specialist alcohol treatment services and again all health and social care professionals are encouraged to help such people to access specialist services. Specialist alcohol services are effective in helping people to overcome even the most severe alcohol problems and employ a range of approaches to do so, from one to one and group support and counselling, to using medications to help people to detox or remain off alcohol once detoxed, to providing access to residential rehabilitation and other recovery support.

There is also a wide evidence base that relates to the different harms that alcohol can cause, such as liver disease, mental health and brain injury consequences.

Trauma and mental health difficulties are considered to often be a significant cause of severe alcohol problems and highlight why a non-judgemental approach to people with alcohol problems is essential and most effective.

On average people on lower incomes drink less alcohol than people that earn more, and complete non-drinking is much more common in more socially deprived areas. It is also a fact however that areas of social deprivation are more likely to have higher numbers of people with complex problems, and these are thought to make more severe alcohol problems more common in such areas.

For reasons not yet understood, evidence suggests that people with lower levels of income suffer greater harms from alcohol, than people who consume the same amounts but are more affluent.

Given the widespread effects that alcohol has, consistent national evidence calls for addressing alcohol problems to be “everyone’s business” and doing so is typically included in the guidelines for all health professional groups such as GPs, mental health services, Emergency Services and hospital, and other frontline care professionals.

The current National Strategy to address alcohol (and other drug) related problems, “Harm to Hope”, calls for a whole system approach to reflect this.


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Derbyshire Quilt


Prevalence Maps of Derbyshire

The maps below illustrate Lower Super Output Areas (LSOAs) and Middle Super Output Areas (MSOAs) for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.