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Time running out for Scottish Government to show leadership and tackle alcohol deaths

 

Near record alcohol deaths see experts from over 70 organisations demand the Scottish Government take urgent action 

Ahead of the publication of the 2025 Programme for Government a group of more than 70 organisations are demanding that the Scottish Government use the year before the election to prioritise increasing early detection and treatment of liver disease alongside other targeted measures, to address the highest number of unnecessary deaths from alcohol since 2008.

The First Minister has been clear that the Government is focused on eradicating child poverty, boosting the Scottish economy and improving public services.  Taking steps to improve the health of the nation and prevent further deaths is essential to fulfil these ambitions. 

Alcohol acts as a drag on the Scottish economy, costing an estimated £10 billion per year, including an annual £700million bill for our NHS, £1.2billion in lost productivity costs and a further £1billion through alcohol related crime.

However, these costs are not evenly spread through Scottish society. The heaviest burden of harm and costs fall on our most deprived communities, further entrenching economic and health inequalities – increasing the pressure on public services and harming the life chances of our most vulnerable children.

Four years on from declaring a public health emergency, deaths from alcohol have reached a 15-year high, while government commitments to tackle the crisis have been delayed or paused. 

As the Government sets out its plans for the coming year, a collective of over 70 organisations including Alcohol and Drug Partnerships, charities, recovery groups and Medical Royal Colleges are asking the Scottish Government to expand tests to detect liver disease at an early stage in at-risk individuals in the community.

Existing projects have demonstrated that this is a highly effective and cost-effective way to allow people at risk be identified sooner and provided with care and support to address their liver problem and their alcohol use rather than waiting until they become ill by which time the disease is usually irreversible. When detected early, liver disease can be reversed, preventing the need for long term treatment and hospital care. Not only would this save lives but also reduce cost pressures on our NHS.

The collective also say further urgent action is required, including the need to:

• Establish nurse-led Alcohol Care Teams (ACTs) in hospitals to ensure patients with severe alcohol problems or dependence are identified and provided with safe, specialised support to address their alcohol problem and access community-based support after they leave hospital.
• Improve access to alcohol detoxification services by introducing a range of detox support options including within hospitals, residential rehabilitation services and in the community.
• Increase funding for recovery, treatment and support services, generated through re-introducing a levy on alcohol retailers.

As well as specific measures to help those already affected by alcohol, the group are advocating for a new comprehensive alcohol strategy to prevent deaths continuing to rise. This strategy must deliver clear leadership and include plans for population-level prevention as well as recovery treatment and care services.

Laura Mahon, Acting Chief Executive of Alcohol Focus Scotland said, “For too long we have seen deaths from alcohol continue to rise. We need concrete measures to prevent this. Time is running out for this Government to demonstrate genuine results, so together with partners, we’ve provided a roadmap for delivery. Now we need to see clear leadership and investment.

“Earlier detection of liver damage is essential because of its life-saving potential.   A number of these initiatives are already happening at a local level and could be scaled up and enable people with serious or potentially life-threatening alcohol problems to be identified sooner and supported more effectively, reducing their risk of experiencing further harm.

“It is also crucial that we consider the bigger picture. People don’t just become unwell overnight. We are continually being fed the message that alcohol has an essential role in our lives, normalising drinking and influencing our consumption habits. We need to challenge this with well evidenced and cost-effective prevention measures adopted as part of a robust strategy for now and into the future.”

Dr Alastair MacGilchrist, Chair of SHAAP said, “The Scottish Government declared alcohol harms to be a public health emergency in 2021, but we have not seen an emergency response. Deaths and illness from alcohol continue to rise but this is not inevitable. If politicians take bold action now we can prevent future harm. 

“Alcohol is linked to over 100 illnesses including cancer, heart disease and liver disease. Investment in treatment saves lives - for every £1 spent on treatment there is a £3 return. Alcohol Care Teams, for example, can lower the number of acute hospital admissions, readmissions, and deaths along with improving the quality of care for people with alcohol-related health problems. However, inconsistencies in approach mean not everyone has access to these life-saving services.

“We need an overall alcohol strategy which sets out what steps the government will take in terms of prevention – including action on the price, availability and marketing of alcohol – but also how it will improve treatment services so that everyone can access help when and where they need it.”

Louise Stewart, Director of Operations at WithYou in Scotland, says: “WithYou is proud to stand alongside Alcohol Focus Scotland and other organisations in calling for the Scottish Government to renew its commitment to preventing alcohol-related deaths. 

“We know that community-based recovery, treatment and support services can play a vital role in helping people to change their relationship with alcohol. Yet 80% of people experiencing alcohol dependency are not accessing treatment. 

“As well as increasing the availability and long-term funding of services, we need to challenge the way alcohol is enmeshed with our culture, overcome harmful stereotypes, and let people know that change is possible.”

Dr Ewan Forrest, a Consultant Hepatologist in Glasgow said:

“In recent years in North East Glasgow those attending the community alcohol services have been scanned for liver damage. This has identified a large number of people with liver disease about which they were unaware. Early recognition of liver disease offers the opportunity to prevent liver failure and to reduce alcohol-related deaths. Liver damage through alcohol can be ‘silent’ for many years and so we need to actively look for it if we want to make difference.

“The liver assessment service in Glasgow has been received well by those attending the community alcohol team and can provide further motivation to address alcohol problems.”

Pamela Healy OBE, Chief Executive, British Liver Trust commented:

“Too many people are diagnosed with liver disease when it’s too late for effective treatment, yet we know that alcohol related liver disease can be reversed if it’s identified early enough. Research has shown that with the correct support, many patients are able to stop drinking.  If we can find those people who are most at-risk of alcohol related liver disease, before it’s too late for them, and ensure that they receive the right intervention and support at the right time, this will not only save countless lives, it will also reduce growing pressures on an already stretched NHS.

“We also need to see the urgent introduction of much bolder measures to restrict the availability, advertising and accessibility of alcohol. Scotland led the way in 2018 by becoming the first country in the world to introduce minimum unit pricing for alcohol, but that was only this is the first step. As the latest figures show, much more action is needed now to reduce the damaging effects of alcohol and to cut the numbers of premature deaths from liver disease.

“This is a health crisis that needs urgent attention. Scotland has led the way with alcohol restrictions before, and Scotland needs to lead the way again.”