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Still waiting for that ‘aha!’ moment

30 Jun 2016

Alcohol is bleeding the health system, as the latest report shows again, Lloyd Mudiwa writes

Trying to persuade some alcohol addicts to desist from their destructive habits, before they are ready, can be extremely difficult, with some of them persisting with drinking even though they may be aware of the associated dangers, even if they are up to and including death.

This really does seem to be the case in Ireland’s ‘love’ affair with alcohol, which continues even as the health costs from the drug continue to increase with significant socioeconomic impacts.

Irish drinkers consumed an average of 11 litres of pure alcohol — equal to 29 litres of vodka, 116 bottles of wine or 445 pints of beer — in 2014 alone, compared to the Department of Health’s target to reduce consumption to nine litres per head, placing Ireland fourth in the OECD, behind Estonia, France and Lithuania, a fresh report shows.

The Health Research Board (HRB)’s ‘Alcohol in Ireland: consumption, harm, cost and policy response’, shows what, basically, is a chronic problem nationwide, depicting the damage, often enough fatal, that alcohol visits not only upon individuals but on our society as a whole. Three people die from drinking alcohol in Ireland every day.

One of the most striking findings for me, as a medical journalist, was alcohol’s impact on people’s health and our already struggling health system.

The report estimates the cost of the problem to hospitals at €1.5 billion, equivalent to €1 out of every €10 spent on public health in 2012, and this is without considering the cost of emergency cases, GP visits and alcohol treatment services.

Some 10 per cent of hospital-related admissions are down to alcohol, and one-in-four people on trolleys are there because of drink-related issues.

Hospital discharges solely attributable to alcohol have doubled just in the past 20 years, and alcoholic liver disease has risen three-fold, according to the study.

There were more than 17,000 drink-related discharges from Irish hospitals in 2013 and this uses up 10 per cent of the entire public health budget.

The average length of stay in hospital for alcohol-related conditions has grown steadily, from six days in 1995 to 10 days in 2013, as the illnesses involved become more complex.

Alcohol is also a factor in one-in-10 cases of breast cancer and one-in-three presentations for self-harm.

Alcohol-related issues everyday accounted for almost 1,500 of all beds in our crowded hospitals (4 per cent of all hospital beds days in 2013), more than double the level recorded in 1995.

Especially worrying is that alcoholic liver disease rose fastest among 15-34 year-olds, which is a real public health concern, as the disease usually develops after a number of years of harmful drinking, and so was normally seen in older people.

The issue though is not really about the extent of the problem, but the apparent lack of political will and committed pressure from society on the leadership. This is despite the work of tireless campaigners over the years such as public health specialist Prof Joe Barry, the RCPI’s President Prof Frank Murray, Alcohol Action Ireland and the Alcohol Health Alliance Ireland — Ireland’s first coalition of healthcare organisations, charities and alcohol health campaigners to come together to highlight harms caused by alcohol and to support the Public Health (Alcohol) Bill.

One just can’t help but wonder when we as a country are going to eventually have our ‘aha moment’ when we finally come to not only the realisation of the harm alcohol is doing to us and our society and what we need to do to tackle this scourge, but also that we actually need to act.

Indeed, as the HRB report states: “Given the ambivalence towards alcohol and drunkenness in Ireland, it is not surprising that the overall findings of this Overview illustrate the prolonged negative impact of alcohol in Ireland on individuals and the people around them.”

The drinks industry influences our elected representatives, funds our sporting bodies and defends its ‘poison’ with legal devices such as Drinkaware.ie but pushes the benign image through ‘cool’ advertisements aired during media broadcasts of popular events, such as Ireland’s last-16 Euros football match versus France.

As the many campaigners have often lobbied, let us start seriously considering a ban on advertising, particularly drinks sponsorship of sports events, like they have in France and most other countries.

If it somehow does not seem to be the right time for Irish society to be reshaping its lifestyle, we cannot continue to hide behind rationalisations such as, ‘we are just not ready to change’. Irish society (and dare I say the medical profession) has an obligation, nonetheless, to research, understand and address this phenomenon of resistance.

Resistant behaviours and attitudes can also be assisted and encouraged to change through education. We could start by educating our young ones about the dangers of alcohol and most importantly, at an individual level, set an example for our own children that every event is not a reason to take out the alcohol.

It might be a long time coming, but it’s never too late for an ‘aha!’

Lloyd Mudiwa

Click here to view the full article which appeared in Irish Medical Times: Opinion