Scotland Needs to get a Grip on Alcohol Deaths
Kaitlin Dryburgh
Well after the slightly more positive news that drug deaths could be on the decrease, Scotland has been hit with its alcohol death numbers. And they're not good.
We’re at a 14 year high, increasing from 1,245 in 2021 to 1,276 deaths in 2022. This is also the first time in several years that alcohol deaths are higher than drug deaths. Overall there was a two percent increase in those dying from conditions attributed to alcohol.
It will be of no shock that those living in the most deprived areas are over represented in the figures, 4.3 times more than those living in the most affluent areas. Males are the most effected by a long shot, and the health board that experienced the highest percentage of deaths was Greater Glasgow. Perhaps it’s déjà vu but these statistics look awfully similar to others I’ve seen. Drug deaths, overall health, poor education, poor housing, and poor life expectancy.
However, it seems the Government will need to investigate some more, as Drugs and Alcohol Minister Elena Whitman stated, “While we will need to better understand the reasons for this increase in deaths”. What exactly is there to better understand? Perhaps the confusion has arose from the realisation that Minimum Unit Pricing (MUP) is not the silver bullet that it is continuously pushed as.
Minimum Unit Pricing was introduced in 2018 and since then has been under varying degrees of scrutiny from all directions. From the perspective of the SNP this policy could be one of their lasting legacies, and they have invested a lot in trying to prove that it’s effective. In recent months both a study published in The Lancet and a Public Health Scotland Report have sung the praises of MUP and its numerous positive effects.
The Public Health Scotland Report left readers with no doubt that MUP was reducing deaths and hospital deaths. A result that the Government were not shy in publicising. However, a June press release concerning the report had to be redacted and altered as the first draft was seen to be wholly misleading about the policy’s true success. In a recent revelation courtesy of a Times investigation that very report conducted from an ‘independent body’ was reviewed by several civil servants and sent back with no less than 88 comments in order to make the supporting evidence appear stronger.
The report in the Lancet again states that MUP has been successful in reducing deaths and hospital admissions. Although in parts this study was hypothetical, as it looked at what could have happened if the policy wasn’t introduced.
Yet, I am still puzzled. The report states: “On average, 156 (–243 to –69) deaths wholly attributable to alcohol consumption were estimated to have been averted each year due to the implementation of MUP.”
How can that be when the past three years deaths have increased?
Both reports acknowledge that acute problems have not been affected by the policy and the report published in The Lancet stated that evidence could even point to a worsening effect for those with the most established alcohol problems. This they say, could be because the those subgroups started to prioritise purchasing alcohol over food due to the financial pressures they are prone to. The Public Health Scotland report also points to some negative effects for those who are alcohol dependant and financially vulnerable.
Hospital admissions have decreased, so that much is true. Perhaps this would indicate that the policy is effective in stopping those developing acute problems, encourages/forces a better lifestyle, and subsequently prevents long-term alcohol health issues from developing.
Yet it would be advisable that the Government begin to consider and seriously invest in other policy options to curb the deaths. And thankfully there are plenty to choose from.
One of the most significant and simple being better access to alcohol abuse services and treatments. Similarly to drug abuse services alcohol treatment services are hard to come by, and activists in the area maintain that in the past decade they have been cut up to 40%. If you know you have a problem that is teetering on the edge of problematic where can go and where can you get treatment fast? Currently there isn't enough support available.
In the same vain as MUP experts and activists alike have called for further restrictions on marketing. Although there is legislation which dictates how alcohol can be portrayed in adverts, for example it shouldn’t encourage irresponsible consumption, it’s not enough. Alcohol advertising is everywhere. On the side of buses, on the TV, billboards, magazines, it sponsors sporting events so much so often champions are named after the drink (for example The Guinness six nations), festivals, and general recreation activities often focus on alcohol. The Scottish drinking culture mixed with marketing has produced a monster. Perhaps we need to make alcohol free areas more accepted, a small step in changing the current drinking culture. When looking at this solution the strength and resources of the Scottish drink industry can’t be overlooked. They lobby hard and have a lot of influence. Yet if the Scottish government were serious about resolving the current emergency we find ourselves in, then this shouldn’t phase them.
Quite often we discuss education. We should educate the public more about the dangers of alcohol and the long-term effects drinking high volumes can cause, and to an extent that is correct. But as Dr Alastair MacGilchrist of Scottish Health Action argues that it isn't as effective as many think, and it puts a lot of onus on the consumer and not the producer.
The drink industry often tell us to “drink responsibly”, but being a rather subjective statement is that enough to make a difference? Times have changed and what once constituted for a unit several decades ago has shifted, drink is stronger and you get a lot less for your unit these days. When it comes to wasteful consumption and creating a circular economy it is the opinion of experts that producers need to take responsibility for their products waste. Similarly alcohol producers need to take more responsibility for the negative effects of their products. The onus should be on them to ensure consumers have the information to actually drink responsibly and they are actively encouraging it.
However, all of that could be in vain if Scotland doesn't address the root of the problem. If we consider the familiar statistics that those living in the most deprived areas are more likely to suffer alcohol problems, men are over-represented and the Greater Glasgow area suffers the most deaths. It isn’t a coincidence that alcohol and drug abuse follows the same pattern. A whole-system approach is desperately needed. That means better education, housing, education, tackling poverty and community outreach. Of course carry on with MUP and even increasing it inline with inflation could be beneficial. But under no uncertain terms will it be the wonder policy that many hope it will be.