Doctors say lack of response on alcohol deaths could spell disaster for Scotland

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Doctors say lack of response on alcohol deaths could spell disaster for Scotland

Scottish Government not doing enough to address alcohol deaths
36 charities and medical bodies call for strong leadership to tackle highest level of deaths since 2008
Investment in services and recovery support - alongside renewed efforts to tackle price, availability and marketing of alcohol - urgently needed to turn the tide of harm

A campaign group of medical professionals, public health practitioners and charities are calling for new First Minister, Humza Yousaf, to show strong leadership and priority setting to address the highest level of alcohol deaths in Scotland since 2008.

More than 30 organisations are calling for increased and sustained investment in alcohol services and recovery support, in combination with a renewed commitment to preventative policies like minimum price and alcohol marketing restrictions. They say this is essential to protecting and promoting people’s right to health.

They are calling on the Scottish Government to:

Provide a range of recovery-oriented alcohol services, including: specialist services, counselling, residential and community-based rehabilitation provision and peer-led and mutual aid options
Improve identification and testing of patients at risk of liver disease, in primary care
Establish Alcohol Care Teams in hospitals to identify people with underlying alcohol problems earlier.
Introduce an Alcohol Harm Prevention Levy on alcohol retailers to help fund local prevention, treatment, and care services.
Increase the minimum unit price for alcohol to at least 65p per unit to save more lives.
Deliver restrictions that will reduce children and young people’s exposure to alcohol marketing.

Despite the positive effect of minimum unit pricing, which was recently found to have saved 268 lives each year since it was introduced, Scotland has still seen a dramatic increase in alcohol deaths over the past few years. This significant rise in loss of life was likely caused by changing drinking habits during the pandemic, in particular among heavy drinkers, alongside reduced access to services.

Even if drinking patterns return to pre-pandemic levels it is likely these worrying trends will continue to be felt into the future.[1]

While death is the most tragic outcome of alcohol harm, the adverse impact on society is much wider, affecting not only those suffering alcohol problems, but also family, friends and colleagues. The total societal costs of alcohol in Scotland have been estimated at between £5-10 billion a year, including a £1.2 billion cost to the economy.[2]

Despite this, the group say there has been little political attention on the increase in deaths and a lack of a proportionate response from Scottish Government.

Medical professionals are worried that if we don’t act now, we could be turning back the clock 30 years to when Scotland saw deaths rates soar, reaching record levels.

Alison Douglas, chief executive of Alcohol Focus Scotland, said “Alcohol is Scotland’s drug of choice. It is addictive and carcinogenic. Yet because it is promoted as an everyday product, essential to having fun and relaxing, we are blinkered to the reality of the high levels of damage it causes. Before the pandemic almost 1 in 15 of all deaths in Scotland were caused by alcohol. Unless urgent action is taken now then we could be sleep-walking our way back to the record levels of deaths we saw in the early 2000s.

“It’s 16 months since the Scottish Government rightly recognised there is a ‘public health emergency’ on alcohol, but there has been no plan to address it. This is unacceptable. When bold action is taken it saves lives, as we have seen with minimum unit price. The First Minister and his new team must act urgently to improve access to treatment and support and deliver on prevention, including by uprating the minimum unit price and by introducing meaningful marketing restrictions that protect people from being bombarded by alcohol ads.”

Dr Alastair MacGilchrist, Chair of expert alcohol medical group, Scottish Health Action on Alcohol Problems, said: “Our new First Minister and new Minister for Drugs and Alcohol Policy must now step up to the plate. Instead of warm words recognising the public health emergency with alcohol harms in Scotland, we now need to see action. Clinicians see the impact of alcohol on patients day-in, day-out and rightly are calling the Scottish Government out on this and are demanding urgent action.”

Dr David McCartney, addictions consultant said “As a country our response to our shameful alcohol deaths feels more like a whimper than a bang. In terms of urgency and resources, we really need to see a similar reaction to that around our country’s drug deaths. At the moment, things are getting worse. We’re seeing people presenting at services in in poorer physical and mental health and with more complex needs. We need to see action to improve treatment access and to reduce harms; this will improve people’s lives and reduce pressure on our NHS.”

Dr Catriona Morton, GP and representative of the Royal College of GPs said “Alcohol related harms are at crisis level in Scotland. Each week 700 people are hospitalised and 24 die as a result of alcohol, and the numbers of people whose lives are dominated by alcohol-related suffering is even greater. The everyday experience of many GPs is that patients are often unaware of the breadth or severity of the impact alcohol has upon their health. The normalisation of drinking, including widespread advertising, presents a significant barrier to reducing consumption on either an individual or societal basis. Much of the impact is borne by the most socio-economically deprived individuals and communities, contributing significantly to Scotland’s extremely poor record on health inequalities. Action is desperately needed to address the cause and effects of adverse alcohol consumption in Scotland.”

Professor Ewan Forrest, Consultant Hepatologist at Glasgow Royal Infirmary said: “Whilst the benefits of public health measures such as minimum unit price for alcohol are welcomed, there are still large numbers of people in hospital with alcohol-related illness. Liver disease in particular is often only recognised when the damage is very severe. As a result the outcomes are very poor and alcohol-related liver disease accounts for the majority of alcohol specific deaths. We need to identify people at risk early and then ensure that they have access to effective alcohol treatment services. This requires resources and commitment. Such action will not only help individuals but will also benefit the NHS.”

Dr Seonaid Anderson, Consultant Addictions Psychiatrist said: “In specialist addictions services, the number of referrals for people seeking support for an alcohol problem far outweighs the number of people with drug issues. However, it seems that the political focus remains on reducing drug-related deaths without the same attention being given to people with alcohol problems. In the last few years, people with alcohol problems have tended to present later and their needs are increasingly complex as a result. There has been a significant reduction in the support available for these people and it is essential that investment in specialist services is prioritised to meet this unmet need for individuals and their loved ones. At a population level, the success of such measures as MUP should be built upon so that people no longer reach the point of requiring specialist services.”

Read the briefing paper

Supported by: Alcohol Focus Scotland, Scottish Alcohol Counselling Consortium, Scottish Families Affected by Alcohol and Drugs, Scottish Health Action on Alcohol Problems (SHAAP), Scottish Recovery Consortium, Aberdeenshire Alcohol and Drug Partnership, Alcohol Health Alliance, Argyll and Bute Alcohol and Drug Partnership, ASH Scotland, BMA Scotland, Borders Alcohol and Drug Partnership, British Heart Foundation Scotland, British Liver Trust, Children in Scotland, Directors of Public Health Scotland, East Ayrshire Alcohol and Drug Partnership, East Renfrewshire Alcohol and Drug Partnership, Edinburgh Alcohol and Drug Partnership, Falkirk Alcohol and Drug Partnership, Glasgow Alcohol and Drug Partnership, Highland Alcohol and Drug Partnership, Inverclyde Alcohol and Drug Partnership, NCD Alliance Scotland, North Lanarkshire Alcohol and Drug Partnership, Queen's Nursing Institute for Scotland, Royal College of General Practitioners Scotland, Royal College of Physicians and Surgeons of Glasgow, Royal College of Physicians of Edinburgh, Scottish Cancer Foundation, Shetland Alcohol and Drug Partnership, South Lanarkshire Alcohol and Drug Partnership, SPECTRUM, Stroke Association, We are with you.

[1] Angus, C., Henney, M., & Pryce, R. (2022). Modelling the impact of changes in alcohol consumption during the COVID-19 pandemic on future alcohol-related harm in England. The University of Sheffield.

[2] Bhattacharya, A (2023). Getting in the spirit: Alcohol and the Scottish Economy. Social Market Foundation.