Alcohol and The Irish
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Alcohol and The Irish

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Dr Philip McGarry's presentation on alchool’s impact on mental health in Northern Ireland. Dr McGarry is a Consultant Psychiatrist at the Mater Hospital in Belfast and was Chair of the Royal ...

Dr Philip McGarry's presentation on alchool’s impact on mental health in Northern Ireland. Dr McGarry is a Consultant Psychiatrist at the Mater Hospital in Belfast and was Chair of the Royal College of Psychiatrists in Norther Ireland from 2009 to 2013.

This presentation was given at Alcohol Action Ireland's conference, Facing 'The Fear': Alcohol and Mental Health in Ireland, on November 20, 2013.

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Alcohol and The Irish Alcohol and The Irish Presentation Transcript

  • I wish I was in sweet Dungloe, And seated on the ground, And in my arm a bottle of wine, And on my knee a bride, I’d call for liquor of the best, And pay before I was done, And hold my Mary in my arms, In the town of sweet Dungloe.
  •  Only Country to celebrate its national addiction ‘Arthur’s Day’  Mythology of ‘uisce beatha’ or as Joyce calls it ‘wine of the country’ is interwoven in Irish stories, songs and folklore
  •  “ There is a crisis with problem alcohol consumption in Ireland . Increasing death rates from liver cirrhosis and increasing rates of hospital admission in young women tell a story of a bitterly unhappy relationship between the Irish and cheap alcohol.” Professor Frank Murray, Chair of RCPI ‘s Alcohol Policy Group. Medical Independent, 2013.
  • Behan  Kavanagh  Best  Alex Higgins  Waste of genius!
  • Binge Drinking per 100 drinking occasions: Europe Ireland UK Sweden Finland Italy Germany France Female 30 21 16 16 12 7 5 Male 59 40 31 29 13 13 9 Strategic Task Force on Alcohol, Sept . 2004
  • Age at Onset of Drinking by Gender: Ireland Age Onset Drinking  Under 14 years  15-16 years  17 years or older  Females Males 17.3% * 21.4% 48.6% * 46.9% 34.0% * 31.7% Total 18.9% 48.0% 33.1% The Health of Irish Students, Health Promotions Unit,  Dept of Health & Children , 2005
  • IRELAND  UK  NEW ZEALAND  AUSTRALIA 80%  66% 53% 38% BJOG 2013
  •  At 15 weeks 33% Irish women report two or more binges* (New Zealand 4%)  20% report moderate* to heavy drinking *Binge 6 or more units *Moderate 7-14 units per week; heavy≥ 14 BJOG 2013
  • Home  Societal  General Practice  Emergency Department  General Psychiatry  Addictions Services 
  • Violence – Unpredictable Behaviour  Children – Direct and Indirect  Financial Problems  Unplanned Pregnancy  Relationship Breakdown 
  • Late night atmosphere on streets  Violence – e.g. alcohol in over 50% of rapes  Road Traffic Accidents  Other Accidents  Days Lost at Work 
  • Alcohol affects almost every organ  GI system – gastric pain to liver failure  Psychiatry – depression, anxiety to suicide  Neurological – neuropathy to dementia  Cancer – increases many cancers  Sex life affected, both short term and long term 
  • •Prenatal alcohol exposure can exert its negative effects on the developing fetus directly by acting on fetal tissues or indirectly by interfering with the maternal support of the growing fetus. •Indirect Mechanisms include altering the placenta’s ability to provide necessary nutrients to the fetus, impairing the mother’s physiology through malnutrition or may be combined with other drugs of abuse. Dr Nneka Orankwve
  • At weekend nights alcohol an overwhelming factor in presentations  ED can be an unpleasant environment  Alcohol the major precipitant of self harm   In Northern Ireland (2011- 2012) – 7,767 admissions due to alcohol related diagnoses (DHSSPSNI)
  •  Always ask!  Background factor in other conditions (‘Dual Diagnosis’)  Often the reason for admission to hospital  In mental illness alcohol increases morbidity and mortality
  •  In Northern Ireland 70% of under 25’s known to psychiatric services who later killed themselves had had problem drinking (National Confidential Inquiry 2011 ).  This was significantly greater than England and greater than Scotland
  •  Public Policy  Enhanced Services  Always ask how much – and why
  •  Drug users usually more honest!  Embarrassment, or not thinking it a problem  Middle classes forget can put cork back in!  Alcohol is a depressant; stops AD’s working
  •  Addiction Services often under resourced  Dual Diagnosis Services  Specialist Support to General Psychiatry  ?Most female alcoholics sexually abused
  •  Minimum Pricing 1  Targets young people and the alcohol dependent  More effective than increasing duty  Cost free, but improves health significantly  Supported by publicans
  •  Law approved by Scottish Parliament 2012  Scottish courts rejected appeal by Industry May 2013  Ministers White and Reilly keen to follow Scotland  NI Executive likely to follow
  •  Tobacco advertising is greatly restricted  Will alcohol advertising be limited?  Sports sponsorship a disgrace!  Strong (well funded) lobby against restrictions
  •  Enjoy alcohol wisely  Drunkenness is an embarrassment, not a matter for banter  Careful about language ... ‘great time’, ‘can’t remember’ ... ‘legless’ ... ‘hammered’  Think how others would see us!
  • ◦ illness o mortality o suicide o cancer o road traffic accidents o domestic violence o marital breakdown o sexual abuse, accidents o abortion rates They can easily – and for no cost – do this BUT WILL THEY?