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The Very Minimum

Kaitlin Dryburgh

Scotland’s alcohol deaths have once again increased. Official statistics from the Office of National Statistics show an increase from 1,245 deaths in 2021 to 1,276 in 2022, in comparison to the 2019 figures that equates to a 25% increase. On one hand, this means Scotland remains the country with the highest alcohol deaths in the UK, in comparison to population size. However, experts believe that this increase is due to heavier drinking patterns adopted during the Covid period, so how much we should read into this is up for debate. England also experienced an increase in alcohol deaths, yet the fact still remains that you’re more likely to die from alcohol abuse in Scotland than in England.

Although some will argue that the increase in deaths has been steeper south of the boarder this continued argument that if we’re slightly better than England then it’s okay has to end. The standard to be the best of two evils is not something we should be aspiring to. 

Deaths due to alcohol are now the highest in 14 years, noticeably female deaths had increased at a higher rate than males, and not surprising the increases were concentrated in more deprived areas, 4.3 times higher to be precise. Once again surpassing drug deaths, which in comparison receives much more attention from the media and the government.

Although the government had previously declared this a public health emergency we aren’t really seeing any action that would give the impression it was an emergency. However, it still remains that the government’s main strategic move to curb alcohol abuse is minimum unit pricing (MUP). MUP is one of the celebrated signature policies of the SNP Government, being the first of its kind in the world. First introduced in 2018 the extra cost added to every unit of alcohol sold in Scotland has on the whole helped to influence the nation into better habits. The Minister for Drugs and Alcohol Policy Christine McKelvie has reiterated the findings of the government’s research, she states the policy will have saved hundreds of lives, averted many hospital admissions and reduced health inequalities. The likes of Alcohol Focus Scotland, British liver Trust and The World Health Organisation (WHO) have come out very much in favour of the policy. WHO reported that MUP is the most effective policy in reducing harm due to the close link between abuse and the price of alcohol. And you can’t argue with the facts, alcohol sales decreased by 3.5% after the policy was introduced.  

We should be a country which actively encourages people to live a better life and place barriers and rewards for being healthier. After all the best healthcare systems in the world implement preventive healthcare, our lack of preventative healthcare is the reason we had such a high mortality rate through-out Covid. We should be healthier and have more encouragement to do so.

This February saw the announcement that MUP will be rising from 50p to 65p. This was seen as long overdue since inflation has rendered the 50p per unit price lower than when it was first introduced. In reality the increase to 65p has been sceptically accepted by some who believe the price should actually be higher. Perhaps it would be more beneficial to in act an inflation lever which would produce an accurate price for MUP so that the policy was living up to its full potential and encouraging healthy lifestyle choices

Yet Scotland’s poor relationship with alcohol abuse has been a constant and there are deep rooted reasons as to why this is.

The problem with MUP is it is not a silver bullet and the effects will not be instant, or at least instant enough to see a reduction in deaths. There also remains insufficient data to indicate when we’ll start to see a difference. There will be people now who in say 15 years or so will still be alive because of MUP, however what about the people currently in the grips of addiction?

There are arguments against the effectiveness of this policy to cut alcohol deaths among the heaviest of drinkers. Alison Douglas, chief executive of Alcohol Focus Scotland had this to say “despite the lifesaving impact of MUP the figures show that Scotland remains in the grip of an alcohol emergency”. I believe it has been a misstep of the Scottish Government to place so much emphasis on this policy.

MUP is literally the very minimum we should be doing. Yes we want to be a country that actively encourages it’s citizens to live a healthier lifestyle but since this is a current health emergency a heavily preventative policy is not enough. It cannot be implemented in isolation. Scotland is in desperate need of an increase in alcohol treatment programmes, yet as it stands over the last 10 years the numbers accessing treatment has decreased by 40%. This is not too dissimilar to Scotland’s drug addiction, we still aren’t delivering enough treatment to help the problem.

What we still can’t seem to get right is a comprehensive approach that caters to everyone, that deploys more than one method. Although research concerning MUP does confirm that it will have an overall positive effect it does have some drawbacks. For example, Public Health Scotland found some of the heaviest drinkers who are more at risk of dying have been found to skip meals in order to fund their drinking. MUP also risks deepening poverty among this group, because in reality addiction doesn’t take into account financial rational. We cannot pat ourselves on the back for MUP when we’re simultaneously cutting funding for drug and alcohol treatments, it makes little sense.

Depravation, however, remains the untreated cancer in this saga. Despite the Government’s fairly feeble attempts at reducing poverty Scotland still claims 21% of its population living in relative poverty. As previously stated we have a long and troubled relationship with alcohol and it’s been ingrained into our culture to a certain extent, it feeds off of depravation and is caught up in a cycle of abuse. We do have the ability to turn this around, but we need more than MUP. Legislating alone wont get us out of this hole, we need investment and a cultural change to turn the tide on this health emergency.

4 thoughts on “The Very Minimum”

  1. Deal with the causes?

    Nah much too hard, let’s just tinker with the symptoms.

    And it’s all so hypocritical – the MSP’s weekend bottle of Lagavulin? Completely unaffected.

    No it’s all heaped onto the likes of a ten pack of Tennents fleecing another fiver from the poorest to make the middle class arseholes feel smug.

  2. Alasdair Macdonald

    Ms Dryburgh, like so many of your articles, you have a good case to make but you weaken its impact because you always begin by emphasising the negative. Out come the usual depressing phrases like “the worst in the UK” etc. And then you stamp on positives like the rate of increase being less than that in England being “nothing to be proud of”.

    And this establishes the reader in the kind of defeatist mindset, such as that in the preceding post by J Galt.

    The meat of the article is about Minimum Unit Pricing for alcohol and the benefits that brings. Start with that and emphasise the positive, give praise to the legislators and others who have implemented this and won against the financial might of the alcohol and INhospitality (sic) industries and our baleful media. Identify other positives such as the decrease in numbers of boys taking up smoking, etc.

    This puts people in a positive frame of mind and when the negatives come the reader can place them in context and get a sense of proportion. I tried to do this in my opening sentence in this post!

    In his article, Mr McAlpine points out that he is not often mistaken for a ray of sunshine – and I agree with that! – but it is clear that he is poking fun at himself and this brings a smile to the reader’s face and feels more positive towards the article.

    Commonweal over the years has produced a huge number of constructive proposals. Present them positively and engender a sense of hope!

  3. The relationship between alcohol misuse and poverty needs to be explored more deeply than just a superficial ‘poverty is the root cause of alcohol misuse’ narrative that commonly appears. The truth is that someone whose life goes down the path of alcohol misuse is very likely to be in poverty by the time their condition is dominating their life so causation is by no means always in the direction of ‘poverty leads to alcohol misuse’.
    Sadly, I have personal experience of a close friend whose son died due to alcoholism at the age of 19 (yes, no typo, just 19.) He was born into a loving, stable family, with an above average standard of living. I visited and held him in my arms days after his birth, watched him grow, and saw his life begin to change at around age 13 when he started to socialise with some young people who were heavily involved in antisocial behaviour and underage drinking. By 15 he was an alcoholic but could not get any treatment, despite parental efforts, due to treatment for alcoholism not being available for under 18s. (I don’t know if that has now changed.) Poverty was not a cause of his alcoholism but, by the time he died, he was living in poverty.

  4. The Scottish government has spent years having consultation on the alcohol issue, I know because I have contributed to most of them, including a year long series of monthly meetings in Edinburgh. In the end we produced our report with some really radical proposals, an hour before we launched our report to the media, the Scottish government launched their own report report, completely ignoring the voices of around 2,000 citizens they consulted with. That was about twelve years ago, nothing has changed.

    To me there are two things they could do that would make a serious difference. Address the out of control selling of alcohol as if it was not a very powerful drug, my local Morrisons has 151 metres of alcohol on sale but both Aldi and Lidl have under 40 metres of alcohol on sale.interestingly neither of these popular supermarkets sell tobacco or any vapes. We should like Denmark only sell alcohol in government owned alcohol shops where promotions do not exist, and the public have to make a deliberate effort to buy alcohol.

    The second thing they need to do to have very much better public about the nature of the depressant drug alcohol. That public education should make it clear that the basic nature of alcohol is that it disinhibits us. Alcohol picks up your personality traits and your moods and can then effect you positively or negatively. If you are a very hurt, angry person, alcohol will allow you to express your suppressed angry feelings often Ian violet ways affecting others. If you are already depressed then that mood too will be multiplied up which is why alcohol is associated with most suicide. On the positive if you are a shy and find socialising with others difficult alcohol will often disinhibit you enough to grab the karaoke Mike and entertain us all.
    Good alcohol education is a preventative approach that does work when well done. Max Cruickshank

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