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Fiona Ryan
Alcohol Action Ireland
www.alcoholireland.ie


             Alcohol in Ireland: An Overview
   Established in 2003/ work to
    create awareness of alcohol-
    related harm and solutions need
    to reduce that harm

   Run www.alcoholireland.ie and
    www.drinkhelp.ie

   Steering group of National
    Substance Misuse Strategy

   Campaign: minimum pricing –
    30 strong NGO coalition in
    support

   Campaign: children affected by
    parental alcohol problems
   Alcohol consumption in Ireland
    increased by 46% between 1987
    (9.8 litres) and 2001 (14.3 litres)
   Alcohol consumption in 2011-2012
    was around 11.6 litres – the
    equivalent of every person aged 15+
    drinking over 42 bottles of vodka
   One in five adults do not drink
    alcohol
   If every drinker aged 18+ drank to
    their maximum low-risk weekly
    limits, every week of the
    year, consumption levels would be
    approx 9 litres
   Over half of all Irish drinkers report
    harmful patterns of drinking; 4 out of 10
    women drinkers and 7 out of 10 men
    who drink.
    (Alcohol Use in Ireland, SLAN 2007)

   ESPAD 2011 survey (average age 15):
    One in four schoolchildren reported
    being drunk in the past month, this
    being the third highest rate of
    drunkenness of the 35 countries.
   Report from Department of Children/
    State of the Nation’s Children/ quotes
    HBSC 2010/ small decline in children
    first trying drinking but numbers getting
    drunk consistent with ESPAD
   Every seven hours, someone in Ireland dies from an alcohol-
    related illness: there are almost twice as many deaths due to
    alcohol as due to all other drugs combined
   Alcoholic liver disease deaths almost trebled (188% increase)
    between 1995 and 2009. Figures also reveal considerable increases
    of alcohol liver disease among younger age groups

     Among 15-34 years olds, the rate of ALD discharges increased by
      275%, while for the 35-49 age group, the rate increased by 227%

     These increases suggests we are starting to see the effects of the
      large increases in alcohol consumption up to 2003

   Alcohol-related admissions to acute hospitals doubled between
    1995 and 2008
The burden of most acute alcohol
related problems arises from
people who drink heavily on
occasion

   Health care costs = €1.2bn
   Criminal justice = €1.2bn
   Road collisions = €526m
   Lost output due to work
    absences = €330m

To the taxpayer = €3,318

To the shopper - cheap alcohol can
be subsidised by increasing
price of other goods
   1 in 11 children living
    with parental alcohol
    problems

   One third of domestic
    abuse cases involve
    alcohol
   Almost half of
    perpetrators of homicide
    intoxicated
   1 in 11 people said they or
    family member had been
    assaulted by person
    drinking
   1 in 11 children living
    with parental alcohol
    problems: enough
    children to fill Croke
    Park

   One in 7 kids in care due
    to parental substance
    misuse problems

   One in 9 kids witnessed
    parental conflict due to
    alcohol during childhood
   Problems for parents are problems for children

   Parental alcohol problems can and do cause serious
    harm to children

   Children often suffer the impacts of parental
    alcohol and drug problems long before their
    parent’s health suffers

   Each dependent user of alcohol will negatively
    effect the lives of two other close family members
One in eleven Irish children say parental drinking has a
  negative effect on their lives – that’s 109,684 children
  (ISPCC, 2010)
A nationally representative survey of 18-40 year olds found
   that when parents drank weekly or more often:
    14% said they often felt afraid or unsafe as a result of their
     parents’ drinking
    14% said they often witnessed conflict between their
     parents either when they were drinking or as a result of
     their drinking
    11% said they often had to take responsibility for a parent
     or a sibling
    Impact did not differ according to socio-economic class
       (Alcohol Action Ireland Keeping It In the Family Survey,
     2009)
 Isolation
 Fear and Anxiety
 Conflict in the Home
 Children take on Parental Responsibilities
 Abuse and Neglect
 Poverty


Trauma and distress result when
            “caregivers not only fail to provide
  comfort at times of extreme stress, but are
  themselves the principal source of that stress”
   “They care more about drink than their
    children.”
   “When they are drunk they are in fighting
    mood.”
   “He hits me in my sleep when he drinks.”
   “It puts you off your work in school as you’re
    thinking about it.”
   “I don’t get to go anywhere or have fun the
    next day because I’m minding my brothers.”
   “It upsets me sometimes – I’m scared at times
    as well.”
11 committees, 15 reports
     1990 Working Group on Alcohol Policy
     1996 National Alcohol Policy
     1996 Oireachtas Committee on Licensing
     2000 Commission on Liquor Licensing
     2002 Strategic Task Force on Alcohol
     Oireachtas Committees on
      Health, Arts, Sports
     2005 Sustaining Progress
     2007 Government Advisory Group on
      Alcohol
     2009 Working Group on Sports
      Sponsorship by the Alcohol Industry
     2011 National Substance Misuse Strategy
     2011 Oireachtas Committee on Health
   Successive Irish governments have
    consistently pursued policies shown to be
    ineffective in reducing alcohol-related harms
    and costs
   No national alcohol policy
   Pricing
     Abolition of Groceries Order 2006
     Only three increases in excise since 1994
     Budget 201o cut excise on alcohol by 20%
     Budget 2013 restored it/ additional increase
       on wine

   Availability
     Increased opening hours
     Free movement of licences
   Establish a Clinical Directorate to develop the clinical
    and organisational governance framework to underpin
    treatment and rehabilitation services

   Develop early intervention guidelines for alcohol and
    substance use across all relevant sectors of the health
    and social care system. This will include a national
    screening and brief intervention protocol for early
    identification of problem alcohol use
   Increase the price of alcohol so that it becomes less affordable
   Introduce legislative basis for minimum pricing, along with a
    ‘social responsibility’ levy on the drinks industry
   Commence Section 9 (structural separation of alcohol from other
    products in supermarkets, etc) of the Intoxicating Liquor Act 2008
   Introduce legislation and statutory codes to provide for:
     a 9.00 p.m. watershed for alcohol advertising on television and radio
     alcohol advertising in cinemas to only be associated with films
      classified as being suitable for over-18s
     prohibition of all outdoor advertising of alcohol
     all alcohol advertising in the print media to be subject to stringent
      codes, enshrined in legislation and independently monitored
12. Develop comprehensive outcomes and evidence based approach to
addressing needs of children and families experiencing alcohol dependency
problems. This would involve a whole family approach, including the provision
of supports and services directly to children where necessary

This approach should be guided by and co-ordinated with all existing strategies
relating to parenting, children and families and in accordance with edicts from
the Office for the Minister for Children and the Child & Family Agency

13. Explore extent of parental problem substance use through the development
of a strategy similar to Hidden Harm in Northern Ireland and respond to the
needs of children by bringing together all concerned organisations and services

14. Develop family support services
   Widespread opposition in Government
    to advertising and sponsorship
    restrictions

   Minimum pricing has been progressing
    in Scotland and England – to mixed
    success

   Department of Justice deliberating on
    Section 9

   Department of Health will draft an
    action plan and this will be submitted
    Cabinet for approval

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Alcohol in Ireland: An Overview

  • 1. Fiona Ryan Alcohol Action Ireland www.alcoholireland.ie Alcohol in Ireland: An Overview
  • 2. Established in 2003/ work to create awareness of alcohol- related harm and solutions need to reduce that harm  Run www.alcoholireland.ie and www.drinkhelp.ie  Steering group of National Substance Misuse Strategy  Campaign: minimum pricing – 30 strong NGO coalition in support  Campaign: children affected by parental alcohol problems
  • 3. Alcohol consumption in Ireland increased by 46% between 1987 (9.8 litres) and 2001 (14.3 litres)  Alcohol consumption in 2011-2012 was around 11.6 litres – the equivalent of every person aged 15+ drinking over 42 bottles of vodka  One in five adults do not drink alcohol  If every drinker aged 18+ drank to their maximum low-risk weekly limits, every week of the year, consumption levels would be approx 9 litres
  • 4. Over half of all Irish drinkers report harmful patterns of drinking; 4 out of 10 women drinkers and 7 out of 10 men who drink. (Alcohol Use in Ireland, SLAN 2007)  ESPAD 2011 survey (average age 15): One in four schoolchildren reported being drunk in the past month, this being the third highest rate of drunkenness of the 35 countries.  Report from Department of Children/ State of the Nation’s Children/ quotes HBSC 2010/ small decline in children first trying drinking but numbers getting drunk consistent with ESPAD
  • 5. Every seven hours, someone in Ireland dies from an alcohol- related illness: there are almost twice as many deaths due to alcohol as due to all other drugs combined  Alcoholic liver disease deaths almost trebled (188% increase) between 1995 and 2009. Figures also reveal considerable increases of alcohol liver disease among younger age groups  Among 15-34 years olds, the rate of ALD discharges increased by 275%, while for the 35-49 age group, the rate increased by 227%  These increases suggests we are starting to see the effects of the large increases in alcohol consumption up to 2003  Alcohol-related admissions to acute hospitals doubled between 1995 and 2008
  • 6. The burden of most acute alcohol related problems arises from people who drink heavily on occasion  Health care costs = €1.2bn  Criminal justice = €1.2bn  Road collisions = €526m  Lost output due to work absences = €330m To the taxpayer = €3,318 To the shopper - cheap alcohol can be subsidised by increasing price of other goods
  • 7. 1 in 11 children living with parental alcohol problems  One third of domestic abuse cases involve alcohol  Almost half of perpetrators of homicide intoxicated  1 in 11 people said they or family member had been assaulted by person drinking
  • 8. 1 in 11 children living with parental alcohol problems: enough children to fill Croke Park  One in 7 kids in care due to parental substance misuse problems  One in 9 kids witnessed parental conflict due to alcohol during childhood
  • 9. Problems for parents are problems for children  Parental alcohol problems can and do cause serious harm to children  Children often suffer the impacts of parental alcohol and drug problems long before their parent’s health suffers  Each dependent user of alcohol will negatively effect the lives of two other close family members
  • 10. One in eleven Irish children say parental drinking has a negative effect on their lives – that’s 109,684 children (ISPCC, 2010) A nationally representative survey of 18-40 year olds found that when parents drank weekly or more often:  14% said they often felt afraid or unsafe as a result of their parents’ drinking  14% said they often witnessed conflict between their parents either when they were drinking or as a result of their drinking  11% said they often had to take responsibility for a parent or a sibling  Impact did not differ according to socio-economic class (Alcohol Action Ireland Keeping It In the Family Survey, 2009)
  • 11.  Isolation  Fear and Anxiety  Conflict in the Home  Children take on Parental Responsibilities  Abuse and Neglect  Poverty Trauma and distress result when “caregivers not only fail to provide comfort at times of extreme stress, but are themselves the principal source of that stress”
  • 12. “They care more about drink than their children.”  “When they are drunk they are in fighting mood.”  “He hits me in my sleep when he drinks.”  “It puts you off your work in school as you’re thinking about it.”  “I don’t get to go anywhere or have fun the next day because I’m minding my brothers.”  “It upsets me sometimes – I’m scared at times as well.”
  • 13. 11 committees, 15 reports  1990 Working Group on Alcohol Policy  1996 National Alcohol Policy  1996 Oireachtas Committee on Licensing  2000 Commission on Liquor Licensing  2002 Strategic Task Force on Alcohol  Oireachtas Committees on Health, Arts, Sports  2005 Sustaining Progress  2007 Government Advisory Group on Alcohol  2009 Working Group on Sports Sponsorship by the Alcohol Industry  2011 National Substance Misuse Strategy  2011 Oireachtas Committee on Health
  • 14. Successive Irish governments have consistently pursued policies shown to be ineffective in reducing alcohol-related harms and costs  No national alcohol policy  Pricing  Abolition of Groceries Order 2006  Only three increases in excise since 1994  Budget 201o cut excise on alcohol by 20%  Budget 2013 restored it/ additional increase on wine  Availability  Increased opening hours  Free movement of licences
  • 15. Establish a Clinical Directorate to develop the clinical and organisational governance framework to underpin treatment and rehabilitation services  Develop early intervention guidelines for alcohol and substance use across all relevant sectors of the health and social care system. This will include a national screening and brief intervention protocol for early identification of problem alcohol use
  • 16. Increase the price of alcohol so that it becomes less affordable  Introduce legislative basis for minimum pricing, along with a ‘social responsibility’ levy on the drinks industry  Commence Section 9 (structural separation of alcohol from other products in supermarkets, etc) of the Intoxicating Liquor Act 2008  Introduce legislation and statutory codes to provide for:  a 9.00 p.m. watershed for alcohol advertising on television and radio  alcohol advertising in cinemas to only be associated with films classified as being suitable for over-18s  prohibition of all outdoor advertising of alcohol  all alcohol advertising in the print media to be subject to stringent codes, enshrined in legislation and independently monitored
  • 17. 12. Develop comprehensive outcomes and evidence based approach to addressing needs of children and families experiencing alcohol dependency problems. This would involve a whole family approach, including the provision of supports and services directly to children where necessary This approach should be guided by and co-ordinated with all existing strategies relating to parenting, children and families and in accordance with edicts from the Office for the Minister for Children and the Child & Family Agency 13. Explore extent of parental problem substance use through the development of a strategy similar to Hidden Harm in Northern Ireland and respond to the needs of children by bringing together all concerned organisations and services 14. Develop family support services
  • 18. Widespread opposition in Government to advertising and sponsorship restrictions  Minimum pricing has been progressing in Scotland and England – to mixed success  Department of Justice deliberating on Section 9  Department of Health will draft an action plan and this will be submitted Cabinet for approval

Editor's Notes

  1. Ireland is one of 35 countries from across Europe taking part in the survey which is conducted every four years. Over 2000 school-children from across Ireland were interviewed with a mean age of 15.8 years. 50% of the children reported drinking alcohol in the month before interview.Of these, just over half had bought alcohol for their own consumption in an off-license or supermarket, with girls opting for spirits and boys going for beer. This should not come as a surprise as last April, a Garda operation demonstrated that 8 of 12 off-licenses in Louth served a 16 year old boy.Almost four in every five of the young female drinkers consumed alcohol in a bar or nightclub setting, highlighting the hugely ineffective efforts of Gardai to police this issue.One in four of the Irish School-children reported being drunk in the past month, this being the third highest rate of drunkenness of the 35 countries. More girls get drunk than boys and the only girls in Europe to get drunk more regularly than the Irish were the Danes.Given the very lax guidelines on alcohol advertising in Ireland and the fact that the alcohol industry sponsors the sports with the highest youth participation in the country it is not surprising that these Irish children have the second highest levels of positive expectations of drinking, linking it with having fun and being friendly. Worryingly, over half of these children see alcohol as something which is likely to help them to forget their problems.15% of the children said that their drinking had resulted in an accident or injury in the past year. Accidents are one of the major causes of death in adolescents and alcohol has a well established role in such deaths.The ESPAD survey was last conducted in 2007, towards the end of the Celtic tiger and near the peak of adult alcohol consumption in Ireland. While measures of drinking by Irish children remain very high by European standards, there are some positive changes over the last four years. As more parents get the message that drinking by teenagers is a bad idea, the proportion of these 4th year student who have never had a drink has risen from 14% in 2007 to 19% in 2011. The proportion drinking in the past month has fallen slightly from 56% in 2007 to 50% in 2011, mirroring the slight fall in alcohol consumption by adults in these more difficult financial times.In terms of drinking preferences my Irish children, not too much has changed in the past four years. While the dominant drink for Irish girls remains spirits, a growing proportion are opting for beer and cider. While beer remains the dominant drink for boys, 60% of male drinkers also consume spirits, but they have moved away from alcopops in recent years. 
  2. Many cancers, including cancer of the mouth, larynx, oesophagus, liver, colorectum and female breast, have a causal relationship to alcohol consumptionFor example, drinking one standard drink a day is associated with a 9% increase in the risk of developing breast cancer. Drinking 3-6 standard drinks increases the risk by 41% - three standard drinks is less than half a bottle of wine. Ireland has the second highest cancer rate in the worldRisk of most conditions increases even at low levels of consumption15% of the children said that their drinking had resulted in an accident or injury in the past year. Accidents are one of the major causes of death in adolescents and alcohol has a well established role in such deaths. (ESPAD 2011)Heavy drinking increases impulsivity, risk-taking, loss of inhibitions and poor co-ordination, which in turn is related to falls, injuries, assault as well as suicide. The one in four people who end up in A&E for alcohol-related reasons (falls, assaults, road collisions) didn’t factor a visit to A&E as part of their night out. In fact, the burden of most acute alcohol-related problems arises from people who drink heavily on occasion rather than the heaviest drinkers – the reason for this is the harms caused by the high numbers of occasional heavy drinkers in the population outweigh those caused by the smaller numbers of chronic drinkers. Alcohol is a factor in one in four traumatic brain injuries
  3. That’s 12% of our total healthcare budgetIn Ireland, if we look at the outcomes due both entirely to alcohol, such as alcoholic liver disease, and the outcomes partially due to alcohol, such as road traffic accidents and cancers, alcohol is responsible for approximately 100 deaths per month, 2000 beds occupied every night in hospitals around the country, 3 out of every 10 emergency department attendances and 7% of GP consultations. These health effects are avoidable and preventable.If we look at young people in particular one in four deaths in young men (15-34) is due to alcohol compared with 1 in 12 deaths due to cancers and one in 25 deaths due to circulatory disease. We no longer accept that people have to die from cancer and heart disease, so how can we ignore the fact that so many more of our young people are dying from alcohol than anything else?There are more than 4 times as many deaths due to alcohol as due to all other drugs combined.We all pay for someone else’s drinking – even if we don’t drink ourselveswe pay as taxpayers, an estimated €3,318 each, as consumers when the price of essentials such as bread and milk costs more, so the supermarket can subsidise the cheap vodka and beer sold in the next aisle.
  4. DV alcohol neither an excuse nor an explanation
  5. DV alcohol neither an excuse nor an explanation
  6. DV alcohol neither an excuse nor an explanation
  7. DV alcohol neither an excuse nor an explanation
  8. DV alcohol neither an excuse nor an explanation
  9. DV alcohol neither an excuse nor an explanation
  10. 2003 which led to a 6% reduction in total alcohol consumption, the first drop in alcohol consumption in 16 yearsCut in excise led to an increase in alcohol sales Alcohol 50% more affordable than it was in 1996Increase in off-licences (2,879 in 2003 to 4,557 in 2008)Governments have choices – have chosen not to implement policies shown to reduce levels of alcohol-related harms and costs. Instead have chosen policies that have increased the availability and affordability of alcohol, policies which have weaved alcohol into our day-to-day lives, normalised drink as part of our family shop, as an essential element of every celebration, including children’s birthday parties and first communions.
  11. What is the Hidden Harm Strategy (2003)We estimate there are between 250,000 and 350,000 children of problem drug users in the UK – about one for every problemdrug user.• Parental problem drug use can and does cause serious harm to children at every age from conception to adulthood.• Reducing the harm to children from parental problem drug use should become a main objective of policy and practice.• Effective treatment of the parent can have major benefits for the child.• By working together, services can take many practical steps to protect and improve the health and well-being of affected children.• The number of affected children is only likely to decrease when the number of problem drug users decreases.The Hidden Harm Action Plan (Northern Ireland)The plan takes account of the views of stakeholders across Northern Ireland including children affected by Hidden Harm, their parents and carers, front line workers, managers and commissioners in the HSC and key individuals from other statutory, voluntary and community organisations whose work can contribute to this agenda. It sets out to draw together what has been learned from wide consultation. It describes those actions that must be taken to ensure that children and young people who experience compromised parenting due to alcohol and/or drug abuse can receive the support they need to reduce harm today and assure their health and well-being in the future.To effectively address Hidden Harm it is essential that it be viewed firstly as a children and young people’s issue. Therefore the action plan places emphasis on the role of services supporting children and families, including those outside Health and Social Care, notably in Education and Community & Voluntary Sectors.Family Support Services to include: access to information about addiction and the recovery process for family members peer-led family support groups to help families cope with problematic drinking evidence-based family and parenting skills programmesReconciliation of problem drinkers with estranged family members where possible Development of short-stay respite programme for families of problem drinkers