Reducing harm caused by alcohol


How can we prevent alcohol deaths?

National Records of Scotland have published the latest statistics on alcohol deaths in Scotland. Here we look at what AFS is doing to help prevent deaths in the future.

First we have to be clear which cases we are talking about. These figures, like most of AFS’s work on alcohol deaths prevention, cover alcohol-specific deaths. These are ones which are wholly caused by alcohol, usually from conditions like liver disease or addictions.

There are around 1,100 alcohol-specific deaths per year in Scotland, a huge number. While all deaths are tragic, the scale of alcohol’s role is shocking – Scotland sees around 150 road deaths per year, and we haven’t had a year with more than 100 homicides in 15 years, but alcohol deaths receive far less attention.

Better information, better decisions

Lack of information around alcohol deaths is the first thing AFS has been working to change. Without learning which services people were in contact with, we cannot know how to improve services to better reach and support people in the future.

Everyone in Scotland has a local Alcohol Drug Partnership, and NHS Public Health team. These local groups work to set up effective supports for people who have problems with alcohol, and those at risk of dying.

In September, AFS published the first guidance for ADPs and Public Health teams on how they can undertake alcohol death reviews. These will help local areas learn lessons from previous cases, and plan for better support in the future. With better information and a dedicated setting to discuss alcohol deaths, we can make sure people at risk of dying are identified and can get help.

Helping people in hospitals

We know that most people with alcohol problems in Scotland are not in treatment. But even before someone is ready to acknowledge they have an alcohol issue and embark on recovery their alcohol use may result in a hospital attendance, for example, they may require emergency treatment for an injury sustained while intoxicated.

AFS is working with local teams to find out how hospitals can help identify people who might have problems with alcohol and connect them to support or, if the person isn’t ready to consider support, to set the stage for recovery in the future.

Hospital liaison services can be a big part of this, providing specialist alcohol support and signposting to other hospital or community services.

We are also looking at support for people who frequently attend hospital settings. Sometimes these people are painted as a drain on resources, but the healthcare system is there to help people and we have to look at the person, not the problem.

We have to make sure people attending hospital have constructive experiences which encourage recovery and link seamlessly to community recovery networks. We can learn from innovative approaches such as that of Navigator project which operates in a number of emergency departments in Scotland pairing patients with chaotic lifestyles with people who can help make sure they are heard in healthcare settings and linking to community support as well.

Early Intervention

One of the tragic things about alcohol deaths is that people sometimes only find out how significantly their drinking has damaged their health when it becomes very serious. People can drink, even at very high levels, for a long time without being aware of the physical impact.

We need to find approaches for people who suspect they may have a problem with alcohol, or that their drinking might be doing them physical damage, to get help sooner.

There are new ways of finding out how people’s livers have been damaged which are quick, painless and accurate. A ten minute ultrasound can give an indication of liver damage, enabling people to be put in touch with addictions supports to address their drinking and, if necessary, liver specialists who can start treatment before serious damage is done.

AFS plans to work with local teams already using this fibro-scanning technology to find out how we can make sure it is used in the best way. Training for staff in how to engage with addiction issues, and issues around funding and administration of these programmes, can help make sure people around the country can benefit from new technologies.

Changing cultures

We need to make sure that care systems in our communities are identifying people at risk of dying, and adapting to meet their needs. Many people who die of alcohol-specific causes are known to be isolated, socially and from support networks for a long time before they die.

Reaching out to people and remembering that recovery is possible is really important. People at risk of dying are typically drinking at very high levels, and have been for a long time. That can make it difficult to cut down without medical support, but also to access help as it often needs people to be able to reflect on their drinking with a clear head.

Part of our planned work on alcohol deaths prevention involves working with local teams to find places where this work is already done well, including internationally. We can then recommend changes to local systems and work with professionals and service providers to make sure they are taken up.


27 November 2020.