A selection of slides about alcohol - taken from previous "Interesting Things" slidepacks over the course of the last year.

1. Interesting things
about Alcohol in
the last year
A set of slides for Alcohol Awareness week

2. Prevalence of drinking

3. Recorded alcohol per capita consumption in the
United Kingdom, from 2000
0
2
4
6
8
10
12
14
2012201120102009200820072006200520042003200220012000
Litresofpurealcohol
All types Beer Wine Spirits Other alcoholic beverages
Source: Global Health Observatory data repository
In order to make the conversion
into litres of pure alcohol, the
alcohol content (% alcohol by
volume) is considered to be as
follows: Beer (barley beer 5%),
Wine (grape wine 12%; must of
grape 9%, vermouth 16%),
Spirits (distilled spirits 40%;
spirit-like 30%), and Other
(sorghum, millet, maize beers
5%; cider 5%; fortified wine 17%
and 18%; fermented wheat and
fermented rice 9%; other
fermented beverages 9%).

4. Share of total alcohol consumed by the 20% of
the population who drink the most
63%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Source: Health at a Glance - Alcohol (OECD)
“Alcohol consumption
is highly concentrated,
as the large majority of
alcohol is drunk by the
20% of the population
who drink the most,
with some variation
across countries.”

5. Proportions of men and women in England drinking
above the CMO low risk guideline of 14 units a week,
by age
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Male
More than 14, up to 21 units More than 21, up to 28 units
More than 28, up to 35 units More than 35, up to 50 units
More than 50 units
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Female
More than 14, up to 21 units More than 21, up to 28 units
More than 28, up to 35 units More than 35, up to 50 units
More than 50 units
Source: Health Survey for England (2014)

6. Hazardous, harmful and dependent drinking in
the past year by sex: 2000, 2007 and 2014
0%
5%
10%
15%
20%
25%
30%
35%
40%
Hazardous drinking in men Harmful/mild dependence and
probable dependence in men
Hazardous drinking in women Harmful/mild dependence and
probable dependence in women
2000 2007 2014
Source: Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2014

7. Self reported drinking behaviours of adults
invited to Health Check
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
Non-drinker Trivial <1
units/day
Light 1–2
units/day
Moderate 3–6
units/day
Heavy 7–9
units/day
Very heavy >9
units/day
NHS Health Check No NHS Health Check
Source: The NHS Health Check in England: an evaluation of the first 4 years
n = 214,295 n = 1,464,729
The NHS Health
Check is a health check-
up for adults in
England aged 40-74.
People in the age group,
who don’t have a pre-
existing condition,
receive a letter from their
GP or local authority
inviting them for a NHS
Health Check every five
years.

8. AUDIT scores for older adult (50+ years)
drinkers in UK
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Lower risk (1-7) Increasing risk (8-
15)
Higher risk +
possible
dependence (16+)
A profile of older drinkers in the UK today
▪ The vast majority (80%) of older drinkers in
the areas we surveyed are lower risk
drinkers, 17% are increasing risk drinkers,
and 3% are higher risk drinkers.
▪ Amongst higher risk drinkers, 72% drink
four or more times per week, while 58%
typically drink 10 or more units a day.
▪ People who are LGBT, are not married,
partnered, or cohabiting, live alone, and
who have a longstanding illness or
disability are more likely to be higher risk
drinkers than those who are not.
n = 10,627
Source: Drink Wise, Age Well: Alcohol Use and the Over 50s in the UK

9. Frequent drinking (at least 5 days in last week)
by income
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
Up to £9999 £10,000 up
to £14,999
£15,000 up
to £19,999
£20,000 up
to £29,999
£30,000 up
to £39,999
£40,000 or
more
Individuals with an annual income of £40,000
and over were more than twice as likely
(18%) to be frequent drinkers compared with
those with an annual income less than
£10,000 (8%).
Almost 4 out of every 5 people (78%) in the
highest income band (income of £40,000 or
more) said they had drunk alcohol in the last
week and alcohol consumption generally falls
as income falls. Almost 3 in 10 (29%) people
in the lowest income band classed
themselves as teetotal (that is, they do not
drink alcohol at all), compared with less than
1 in 10 (9%) for the highest income band.
Source: Adult Drinking Habits In Great Britain: 2014 (ONS)

10. Alcohol and the NHS

11. Those with the most problems with alcohol are
more likely to use the NHS
0%
5%
10%
15%
20%
25%
30%
35%
40%
Inpatient stay in the past quarter Outpatient visit in the past
quarter
Spoken with GP in the past 2
weeks
Spoken with GP in the past year
Non-drinker/low risk (0-7)
Hazardous drinking (8-15)
Harmful/ mild dependence (16-19)
Probable dependence (20+)
Source: Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2014

12. Number of attendances at A&E in England recorded
as having social problems (including chronic
alcoholism and homelessness)
39,507
40,867
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
2013-14 2014-15
Please note:
During the period
covered (2013-14
and 2014-15) not
all NHS trusts have
provided data
submissions to
A&E HES and data
quality can be poor
for some fields.
Source: Accident and Emergency Attendances in England - 2014-15

13. Number of prescription items for the treatment of
alcohol dependence dispensed in the community in
England
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
200,000
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Prescribed in primary care Prescribed in NHS hospitals
Source: Statistics on Alcohol, England 2016 (HSCIC)

14. The cost and number of prescriptions of Disulfiram
(to treat alcohol disorders) in England
-
1,000
2,000
3,000
4,000
5,000
6,000
£-
£20,000.00
£40,000.00
£60,000.00
£80,000.00
£100,000.00
£120,000.00
£140,000.00
£160,000.00
£180,000.00
Cost Items
Source: OpenPrescribing.net - https://openprescribing.net/chemical/0410010B0

15. Drink driving

16. Casualties in reported drink drive accidents: GB
1979 to 2014
0
5,000
10,000
15,000
20,000
25,000 1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Slight
Serious
Fatal
Source: Reported road casualties in Great Britain, estimates involving illegal alcohol levels: 2015
The number of killed or seriously
injured (KSI) casualties [where
at least one driver was over the
drink drive limit], which is 1,310
for 2014, is the lowest KSI total
for reported drink drive accidents
on record.
However the reduction in KSI
casualties from the 2013 levels
is not statistically significant.
Nevertheless, there is an
ongoing downward trend, with
falls in every year since 2002,
barring 2011.

17. Positive response to question of whether you
know anyone who does this…
6%
12%
19%
38%
38%
0% 5% 10% 15% 20% 25% 30% 35% 40%
Drive after taking Class A drugs
Drive after smoking cannabis
Drive when over the legal alcohol limit
Drive when unsure if over legal alcohol limit
Drive after drinking two pints
Source: THINK! Road Safety Biennial Survey
Drink Driving
While the vast majority of
people agree that it is
dangerous and unacceptable
to drive when over the legal
alcohol limit or when unsure,
the level of agreement has
fallen in 2015.

18. Disqualified from driving after being convicted
of a drink or drug driving offence
60,890
58,652
53,819
50,523
36,438
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
2011 2012 2013 2014 2015
Source: FOI release: Number of individuals who have been disqualified from driving after a drink driving offence

19. Age profile of those disqualified from driving
following a drink or drug driving offence 2011 to 2015
0
2,000
4,000
6,000
8,000
10,000
12,000
15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71 73 75 77 79 81 83 85 87 89 91 93 95
Female
Male
Source: FOI release: Number of individuals who have been disqualified from driving after a drink driving offence

20. Change in the number of breath tests carried out by
police in England and Wales & the proportion that are
positive
0%
5%
10%
15%
20%
25%
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
Proportionofpositivetests
Numberofbreathtests
Number of tests Positive/refused (%)
Source: Police powers and procedures England and Wales year ending 31 March 2015
Police carried out
607,000 breath
tests in 2014, a fall
of 10% compared
with the 676,000
breath tests carried
out in 2013.
Eleven per cent of
breath tests carried
out in 2014 were
positive or refused,
up one percentage
point on 2013.

21. Drinking and crime

22. Number of offences committed pre and post
treatment for alcohol use disorders
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
General Driver Violent Acquisitive Total
Pre-treatment Post-treatment
“We observed a reduction in
offending during a two-year
follow-up after treatment for
AUD (crude pre-treatment
and post-treatment offending
rate per 1000 falling from
221.5 to 169.4). Less
offending was independently
associated with completion
of treatment (and long
retention) and inpatient
withdrawal management
and/or pharmacological
therapy.”
Source: Is treatment for alcohol use disorder associated with reductions in criminal offending? A national data linkage cohort study in England

23. Finds of alcohol in prisons in England and
Wales, 2005 to 2014
0
200
400
600
800
1000
1200
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Number of Incidents
Source: http://www.parliament.uk/business/publications/written-questions-answers-statements/written-question/Commons/2016-01-06/21315/

24. Problem drinking among women in England by
violence and abuse typology and whether in poverty
0%
5%
10%
15%
20%
25%
30%
Little or no violence and abuse Physical violence from a
partner
Sexual violence Extensive violence and abuse
Women in poverty Women not in poverty
Source: Joining the dots: The combined burden of violence, abuse and poverty in the lives of women (Agenda)

25. Prevalence of partner abuse victimisation in the last
year, by sex and the frequency of drunkenness
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
Never Less than once
every couple of
months
Once every
couple of
months
Once a month Two or three
times a month
Once a week
or more
Men Women
Source: Crime Statistics, Focus on Violent Crime and Sexual Offences, year ending March 2015
NB: Caution should be taken
when making inferences
about the relationship
between alcohol consumption
and partner abuse
victimisation. The victims’
alcohol consumption may
affect or be affected by their
experience of partner abuse.

26. Two in five Scottish prisoners were drunk (41%)
at the time of their offence
0%
10%
20%
30%
40%
50%
60%
2008 2009 2011 2013 2015
I was drunk at the time of my offence I am worried that alcohol will be a problem for me when I get out
Source: Scottish Prison Service Prisoners Survey 2015

27. Alcohol and death

28. Rate per 100,000 of alcohol related deaths in the
UK
0
5
10
15
20
25
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Male Female
Source: Alcohol-related deaths in the UK, 2014

29. Number of deaths from alcohol related diseases in
England and Wales in 2014 by sex and age group
0
100
200
300
400
500
600
700
800
05-09 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74
Male Female
Source: Avoidable mortality in England and Wales: 2014 ONS

30. Causes of death in alcohol related deaths
registered in England in 2014
0 500 1000 1500 2000 2500 3000
Chronic hepatitis, not elsewhere classified
Intentional self-poisoning by and exposure to alcohol
Alcoholic gastritis
Alcohol induced chronic pancreatitis
Degeneration of nervous system due to alcohol
Alcoholic cardiomyopathy
Accidental poisoning by and exposure to alcohol
Mental & behavioural disorders due to alcohol use
Fibrosis and cirrhosis of liver
Alcoholic liver disease
Number of deaths
Females Males
Source: Alcohol-related deaths in the UK, 2014

31. Alcohol and money

32. Public attitudes to a minimum unit price for
alcohol
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Strongly against
Somewhat
against
Neither in favour
nor against
Somewhat in
favour
Strongly in
favour
0% 50% 100%
Unfair to those on low
incomes
Effective at reducing
heavy drinking
Effective at reducing
young people's drinking
Unfair to sensible drinkers
Agree strongly Agree
Neither agree nor disagree Disagree
Disagree strongly
Source: Attitudes to alcohol (NatCen)

33. Total Alcohol Duty Receipts per quarter
(current and previous ten financial years)
0
500
1,000
1,500
2,000
2,500
3,000
3,500 2005Q2
2006Q2
2007Q2
2008Q2
2009Q2
2010Q2
2011Q2
2012Q2
2013Q2
2014Q2
2015Q2
£million
▪ Total alcohol receipts followed a consistent pattern from 2005 to
2007, of around £2,000m per quarter, but with a peak during the
final quarter of each calendar year (usually to around £2,200m,
related to the Christmas period) followed by a dip in receipts in the
first quarter of each calendar year (to approximately £1,600-
£1,700m per quarter).
▪ From 2008 total receipts became slightly more volatile. The overall
pattern remained the same however, with the lowest receipts being
received by HMRC in the first calendar quarter of the year and
highest receipts received in the final quarter. This may be
attributable to there being two increases in duty rates in 2008 (one
in March and one in December). Receipts have since trended
upwards slightly, reaching their highest level recorded in Q4 2015,
at close to £3,168m.
▪ In more recent years receipts from alcohol have been noticeably
higher due to sustained periods of good weather, or major
outdoor/sporting events, which typically increase alcohol receipts.
Source: Monthly statistics on clearances of alcohol products and duty receipts

34. Working more than 48 hours per week is associated
with an increased risk of binge drinking
0.7
0.8
0.9
1
1.1
1.2
1.3
< 35 hours 35 - 40
hours
41- 48
hours
49 - 54
hours
> 55 hours
“This systematic review and meta-analysis of 63 studies provides
comprehensive evidence of an association between long working
hours and alcohol use. Long working hours were associated with
1.11-fold likelihood of higher levels of alcohol use in the cross
sectional analysis of 333 693 participants from 14 countries. A
similar association (odds ratio 1.12) for new onset risky alcohol
use was observed in a prospective analysis of 20 studies
including 100 602 participants from nine countries. The
associations were not dependent on participants’ sex, age,
socioeconomic status, geographical region, type of study
sample, prevalence of risky alcohol use in the cohort, or
participation rate at follow-up. Eighteen prospective studies with
individual participant data allowed us to perform a more refined
comparison between work hour categories. Compared with the
standard (35-40) weekly working hours, working 49-54 hours
was associated with an odds ratio of 1.13 and working ≥55 hours
a week was associated with an odds ratio of 1.12 for new onset
risky alcohol use.”
Source: Virtanen, Marianna, et al. "Long working hours and alcohol use: systematic review and meta-analysis of published studies and
unpublished individual participant data." BMJ 350 (2015)

35. Price per unit of alcohol in Scotland and
England & Wales, by trade sector, 2000-2015
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40
1.60
1.80
2.00
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Priceperunit(£)
E&W - On-trade Scotland - On-trade E&W - Combined
Scotland - Combined E&W - Off-trade Scotland - Off-trade
Source: MESAS alcohol sales and price update May 2016

36. More than one third (36%) of the volume of alcohol
sold in the off-trade (excluding discount retailers) in
England & Wales in 2015 was at below 45 pence a
unit of alcohol.
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
Under 30
p
30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80 - 84 85up
Source: MESAS alcohol sales and price update May 2016
Off licences in England and
Wales sold 265.8 million litres of
pure alcohol in 2015

37. Over half (54%) of strong ciders sold in the off-trade
(excluding discount retailers) in England and Wales
in 2015 were sold at below 20 pence a unit
0%
10%
20%
30%
40%
50%
60%
Under 20p 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64
There were 3.6 million litres of pure
alcohol classified as strong ciders sold
in the off-trade (excluding discount
retailers) in England and Wales in 2015
Source: MESAS alcohol sales and price update May 2016

38. Alcohol and young
people

39. Drinking behaviours of young people in
Scotland, Wales and England
15-year-olds who report first
drunkenness at age 13 or younger
12%
10% 10%
12%
10%
9%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
Scotland Wales England
Girls Boys
Proportion of 15-year-olds that drink at
least once a week
11%
12%
10%
16%
14%
12%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
Scotland Wales England
Girls Boys
Source: Health Behaviour In School-aged Children (HBSC)

40. Nearly 1 in 5 assessments of children in need in
England in 2014/15 identified alcohol (17.8%) as
issues in the family
0%
5%
10%
15%
20%
25%
North East North West Yorkshire and
The Humber
East Midlands West
Midlands
East of
England
London South East South West
Source: Characteristics of children in need: 2014 to 2015 (DfE)

41. Excessive alcohol use findings from “Suicide by
children and young people in England” report
0%
5%
10%
15%
20%
25%
30%
35%
Male Female Under 18 18-19 years
Alcohol use seen as excessive Family substance misuse “Most of the antecedents of suicide
identified in this study—exam
pressures, abuse, bullying,
bereavement, physical health
conditions, and self-harm—were more
common in females. Males were less
likely to be known to services.
“There were also differences in
antecedents in those under 18 or 18-
19 years old. Abuse, academic
pressures and bullying were more
common in those under 18, while
excessive alcohol use, illicit drug use
and serious self-harm were more
common in 18-19 year olds.”
Source: Suicide by children and young people in England. National Confidential Inquiry into Suicide and Homicide by People with Mental
Illness (NCISH). Manchester: University of Manchester, 2016.
n = 145

42. Alcohol and mental
health

43. Monitoring of alcohol consumption in primary
care among adults with bipolar disorder
88.6
168.3
244.7
307.5
388
837.4
0
100
200
300
400
500
600
700
800
900
Apr 2000 -
March 2002
Apr 2002 -
March 2004
Apr 2004 -
March 2006
Apr 2007 -
March 2009
Apr 2009 -
March 20011
Apr 2011 -
March 2013
Rateofalcoholrecordingper1000
person-years
People with bipolar disorder People without servere mental illness
The current high alcohol recording
rates in people with bipolar disorder is
very encouraging, especially given
evidence that assessment of alcohol
use alone (without subsequent
intervention) can lead to reductions in
hazardous drinking. Nevertheless
screening is just a first step in the
management of AUDs in people with
bipolar disorder. To fully address the
high prevalence of AUDs in this
population, appropriate effective
interventions need to be delivered,
where indicated by the screening.
Further research is needed to
determine the extent to which alcohol
interventions are implemented in
people with bipolar disorder.
SMI QOF
in effect
Alcohol
screening
added in
SMI QOF
Source: Monitoring of alcohol consumption in primary care among adults with bipolar disorder: A cross-sectional and retrospective cohort study, Hardoon, Sarah L.
et al. Journal of Affective Disorders , Volume 198 , 83 - 87

44. Number of patients in touch with mental health service
in the last 12 months who died by suicide with a history
of alcohol and/or drug use dependence in England
0
100
200
300
400
500
600
700
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Alcohol
Drug
Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness
There were 6,151 suicides in patients with
a history of alcohol misuse, 45% of the
total sample, an average of 559 deaths
per year. 4,435 had a history of drug
misuse, 33% of the total sample, an
average of 403 deaths per year. 7,391
had a history of either alcohol or drug
misuse or both, 54% of patient suicides,
an average of 672 deaths per year.
The number of suicides in patients with a
history of alcohol or drug misuse has
increased. Between 2012-2014, 240 (7%)
patients were under drug services, 247
(7%) were under alcohol services, and
392 (11%) were under either drug or
alcohol services.

45. And finally…

46. Would you stop drinking if your long term
romantic partner asked you to?
45%
40%
15%
Yes
No
Not sure
Source: https://d25d2506sfb94s.cloudfront.net/cumulus_uploads/document/9ab2u5x5oi/Relationships_29-Jul-2016_Website.pdf