Alcohol Misuse

Healthy Lives
Behavioural Risk Factors
Alcoholism
Alcohol dependence
Mental health

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.

latest derbyshire data Latest Derbyshire Data

Trend Data

No trend data currently available

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.

In the top right of the map, you’ll find the ‘Layer Control’ icon. This is an easy way to customise what you see on the map visualisation. Click the ‘Layer Control’ to choose which information is displayed on the map. Pick the indicator that interests you the most, and the map will transform accordingly.

Slope Index

This chart illustrates the differences in health and lifestyle factors across areas in Derbyshire, from the most deprived (decile 1, red) to the least deprived (decile 10, green). As you move from left to right on the chart (from more deprived to less deprived areas), the line shows whether these factors are becoming more or less common. Essentially, it’s a way to see how living in wealthier or poorer areas affects the prevalence of these factors.

further analysis and assessments Further Analysis & Assessments

Derbyshire Joint Strategic Needs Assessment (JSNA) involves a thorough examination of a specific health problem, exploring its causes, consequences, and underlying factors. It combines various data sources, collaboration with stakeholders, and rigorous analysis to generate insights for evidence-informed interventions and policy changes.

Coming soon…

more information and resources More Information & Resources

In Derbyshire there are a range of specialist alcohol services for children, young people, and for adults. These services seek to help not only the person with the alcohol problem, but also the people affected by another person’s drinking.

Derbyshire also has specialist alcohol professionals based in acute hospitals that can provide help and support to people at this important time and ensure they are connected into community specialist services.

Derbyshire also supports people to go to residential rehabilitation when this is needed and adults can access this through specialist community alcohol services.

Alcohol Support

If you think that you, or someone you know, might have an alcohol related problem, help is available. Making the decision to pick up the phone or speak to someone might seem difficult right now, but there is lots of support and confidential services waiting to help you.

Derbyshire treatment and recovery services supported over 4,000 people last year, so you are not alone.

Lower My Drinking

Our drinking levels can sometimes creep up, so it’s a good idea to review this from time to time. If you do and find that you are drinking more than the recommended lower risk level of no more than 14 units per week you should make a plan for cutting back. Sometimes this can feel difficult to do alone, but help is available, Lower My Drinking App is a free online resource that provides expert advice and scientifically proven tools to help you reduce your drinking to the recommended lower risk limit of 14 units a week or less. We have commissioned this to be free to Derbyshire residents.

Lower My Drinking will guide you to set your drinking goal. Then it will help you achieve this by guiding you to:

  • Track your progress towards your drinking goal
  • Recognise all the gains you will make by cutting down
  • Focus on what is really motivating you to reduce your drinking
  • See how your drinking compares to the rest of the population

As well as this, Lower My Drinking will show you the issues that could potentially cause you to drink more than is healthy for you and give you a set of proven skills you can use to address these.

You can download Lower My Drinking for Apple and Android.

Treatment and support services

Drug and alcohol services for adults in Derbyshire are integrated. This means the service provides help to people with alcohol problems and to people with drug problems.

These are provided by Derbyshire Recovery Partnership which is a partnership between 4 organisations - Derbyshire Healthcare Foundation Trust, Phoenix Futures, Derbyshire Addiction Advice Service, and Intuitive Thinking Skills.

Derbyshire Recovery Partnership works with all levels of alcohol problem and offers a mix of high and low intensity levels of support together with a specialist prescribing programme.

You can refer yourself into the service tel: 01246 206514 or 0845 308 40 10. Appointments are available across the county.

You can find out more about Derbyshire Recovery Partnership here: drug and alcohol treatment services at Safer Derbyshire.

Family and carer support

Derbyshire Recovery Partnership can also offer support to people affected by another person’s alcohol use such as family, friends, and carers.

Space 4 U | Action for Children is a service specifically supporting children who are significantly affected by someone else’s substance misuse.

Alcoholics Anonymous

Alcoholics Anonymous (AA) is a group of people who share their experiences with each other in order to support and help others to recover from alcoholism.

The only requirement for membership is a desire to stop drinking. There are no fees for AA membership.

You do not need to be referred to AA, you can get in contact with them yourself and take part in a local meeting.

Find your nearest AA group or tel: 0845 769 7555.

Young people’s substance misuse

We make sure that services are available to help young people who may have an alcohol or substance misuse problem.

We work with Derbyshire CGL, a targeted and specialist substance misuse service for young people up to and including 18-years-old who are using drugs or alcohol who feel they have a problem and want some support. This can be done through one-to-one sessions or group work.

Derbyshire CGL also offers targeted and specialist help to reduce the risks and harm associated with alcohol or drug misuse, as well as to help young people wanting to reduce or stop their substance use or avoid relapsing.

The service works with children, young people and their families or carers. It provides support and helps them to build resilience to enable sustainable recovery and prevent further use and harm.

email: derbyshire@cgl.org.uk

Tel: 01773 303646.

Residential treatment

For people with severe alcohol and substance misuse problems who need extra help in tackling addictions we have 2 different residential treatment options.

In patient detox

This is a period in hospital or other residential setting where people take part in a medically managed programme enabling them to come off drugs or alcohol. This usually lasts between one and 2 weeks.

Residential rehabilitation

This often follows on from an inpatient detox programme and involves a 3 to 6 month stay.

These are referral-only services accessed through community treatment services. Contact the Derbyshire Recovery Partnership for more details on how to access residential treatment services, tel: 0845 308 4010 or 01246 206514.

Other Recovery Supports

Overcoming an alcohol problem can sometimes need more than traditional treatment services. There are several charities and organisations in Derbyshire offering support for people who are in recovery from alcohol problems.

More information about the excellent recovery projects in Derbyshire can be here recovery projects and organisations in Derbyshire

Contributors

David Henstock, Public Health Lead (Clinical) Alcohol & Drugs