The UK government's long-awaited strategy to reduce the harm caused by alcohol misuse
With no major new source of funds to support the strategy, the emphasis is on improved partnership working. The Home Office and the Department of Health are jointly charged with delivering the strategy - and they will need to 'work very closely across Whitehall' to raise awareness and 'mainstream' existing activity.
The strategy notes the large number of violent incidents linked to alcohol misuse - including domestic violence - and the high rate of young male binge drinkers admitted to hospital A&E departments (up to 70% at peak times). Chronic drinkers also put stress on the health service, it says, by increasing their risk of conditions such as cancer and cirrhosis. In addition, there is a higher than average suicide rate among this group (now up to a thousand cases a year).
Training health staff to spot signs of alcohol misuse is part of the strategy. Pilot schemes are proposed to find out whether early identification and treatment can lead to longer term savings and better health.
Alcohol Concern says evidence that such schemes are effective already exists. For example, the Health Development Agency (HDA) Evidence Base shows that 'opportunistic advice' and brief interventions (extended over several visits) by primary care professionals can decrease alcohol intake, particularly among women.
The National Treatment Agency, meanwhile, is charged with drawing up a framework for treatment services. Alcohol pundits are disappointed that more resources are not being channelled into treatment immediately. 'Evidence suggests that there is more demand for treatment than is currently provided, but [the strategy] only offers an audit on service provision,' says a spokesperson for the London Drug and Alcohol Network.
Better training for bartenders and more responsible marketing are two proposals aimed at reducing under-age drinking. But schools will be largely responsible for changing the attitudes of children and young people towards alcohol.
The HDA, working in conjunction with the Department for Education and Skills and the Department for Culture, Media and Sports, will build evidence of what type of interventions work for this group. However, the strategy notes that under-age drinking cannot be limited effectively without identification schemes - and these will not be introduced until at least 2007/8.
The alcohol industry itself will play an important role in the new strategy. Drinks producers will be encouraged to sign up to a voluntary, 'social responsibility charter' to be brought in by early 2005. This will push manufacturers into producing and marketing their products responsibly, so that they do not appeal to under-18s or people vulnerable to alcohol misuse.
The industry will also contribute to a fund that pays for schemes to address alcohol misuse problems and provide information and support for young people. Other practices to be encouraged include labelling that features sensible drinking messages and the use of safer packaging - such as alternatives to glass bottles.
With an estimated 17 million working days lost each year due to the effects of alcohol, employers will be given guidance on how to handle misuse among their workforce. To achieve this, the Department of Health will set up a new website to inform employers and provide them with a directory of services for extra help.
Antisocial behaviour is another problem the government is hoping to crack down on, with greater powers given to the police - including more use of exclusion orders and fixed penalty fines.
The strategy is not prescriptive about who should take the work forward locally, but measures for tackling alcohol misuse should be 'embedded within existing strategic frameworks'. Drug action teams (DATs) are likely candidates - where they have the capacity. Similarly, local crime and disorder partnerships, where they exist, could take a lead, in partnership with PCTs.
Ultimately, it says: 'We need to ensure that communities can take the initiative in creating the right kind of environment and social norms and that their voice is heard.'
Talkback
- How can we turn around our 'binge drinking' culture - and how can schools help?
- What type of services do you think are most effective in treating alcohol misuse - do you have any examples we could cover? Mail the editor at the Health Development Agency, UK
(Your response will be used to inform future editorial debate. Some responses may be published)
Health Development Agency, UK
Guvernul britanic pe termen lung ale strategiei de aºteptate, pentru a reduce rãu de alcool cauzate de utilizarea necorespunzãtoare - The UK government's long-awaited strategy to reduce the harm caused by alcohol misuse - articole medicale engleza - startsanatate