Economics Of Alcohol

11.5.06

National burden
• 1 in 20 adults addicted to alcohol.
• 1 in 3 Northern men drink at harmful levels.
• 16-24-year-olds are most likely to be drinking at harmful levels.
• 41% of men and 22% of women in this age group drink above sensible levels.

Local burden
• 1952 patients.
-12.4% attendances to Accident and Emergency.
-9% under age of 18 years.
• Most common reasons for attendance:
-Falls/intoxication.
-Head injury.
-Assault/fight.

Cost to the Trust
• ITU reported to cost 20% of hospital annual operating cost.
• 20% medical admissions related to alcohol.
• Consistent framework for costing yet to be developed.

OTHER COSTS: CASE STUDIES
Case 1: 12-year-old female
• Brought to Accident and Emergency by known prostitute.
• Reported drinking 1 bottle whiskey per day.
• Mother teacher, father accountant, attends good school.
• Resulting harm:
-Medical emergency (choking).
-Child Protection Register.
-STD.

Case 2: 21-year-old female
• 1 bottle whiskey per day since aged 9.
• Sexual abuse by father aged 7.
• Date rape 4 months ago.
• Resulting harm:
-Medical emergency (alcohol withdrawal symptoms).
-Rape.
-STD.
-Homeless.
-?HIV.
-Deliberate self-harm.

Case 3: 76-year-old gentleman
• Drinking 2 bottles sherry per day for many years.
• Evicted from sheltered housing.
• Accused of many petty crimes.
• Resulting harm:
-Chronic unmonitored ill-health.
-Public health risk.
-Probation services.
-Local police.
-Voluntary agencies.

CHALLENGES - Do we have a capsule of despair?

The need to change attitudes
• Whose?
-Society's, as a whole.
• But where do we start?
-Perhaps with our own attitudes and those of our colleagues.

The Alcohol Continuum
Teetotal↔Social↔Hazardous↔Problem↔Dependency

Types of drinker
• Heavy drinker.
• Dependent drinker.
• Problem drinker.

How many units?

Alcohol specialist nurse theory
• Screening for alcohol-related problems.
• Education of doctors/nurses.
• Increase confidence.
• Improve detection rates.

Alcohol specialist nurse practice
• Give support and advice to patients with alcohol-related problems.
• Give support, advice and training to staff caring for patients with alcohol-related problems.
• Advice on medical management of alcohol withdrawal.

Screening and detection of alcohol-related problems
• Prevent consequences of long-term heavy consumption.
• Optimise medical management.

Brief intervention - what are they?
• Limited assessment.
• Advice on changing.
• Materials for self-monitoring and education.
• Setting of goals.
• Motivational interviews for those who are not ready to change.