Alcohol and Open Water: a risky cocktail...Alcohol and drowning •Alcohol has been a factor in 103...
Transcript of Alcohol and Open Water: a risky cocktail...Alcohol and drowning •Alcohol has been a factor in 103...
Alcohol and Open Water:
a risky cocktail
Kirsty Wilkinson
Alcohol Harm Reduction Coordinator,
Public Health
A quick test
• How many units?
• 125ml glass
• 12% ABV
• Rose wine
1.5 UNITS
• How many units?
• 250ml glass
• 12% ABV
• Red wine
3 UNITS
• How many units?
• 1 pint
• 3.6% ABV
• Lager
2 UNITS
• How many units?
• 330 ml
• 5% ABV
• Bottle
lager/beer/cider
1.7 UNITS
• How many units?
• 25 ml
• 40% ABV
• Vodka/Gin/Rum/
Whisky/Tequila/
Sambuca
1 UNIT
The maths:
Strength (ABV) x Volume (ml) ÷ 1,000 = units
12% x 125ml ÷ 1,000 = 1.5 units
• What do you get on the AUDIT-C?
• Score of 5+ indicates increasing risk
drinking
Alcohol – The Stats
• Top 5 risk factor for disease, disability and death
(WHO, 2014)
• Harmful use of alcohol is the leading risk factor for
death in males aged 15–59 years
• Causal factor in over 200 disease and injury
conditions (WHO, 2014)
• Not only volume but pattern of drinking affects risk
• The more you drink and the more often you drink the
more your ‘risk’ of harm increases
• Fuels inequalities – people who live in deprived areas
have poorer outcomes
Alcohol and drowning • Alcohol has been a factor in 103 fatal
coastal incidents from 2010-2013
• In adults of working age alcohol is a
factor in about 1 in every 3 drownings
• Drowning is a leading risk factor in
males dying prematurely (age 15-59)
(WHO, 2014)
• Males – drink more frequently and in
larger volumes (WHO, 2012)
• Avoidable deaths (WHO, 2014)
Alcohol and drowning
• Impairs judgement – distorts perception
of risk
• Increases risk taking behaviour –
removes inhibition
• Reduces coordination – numbs senses,
unsteadiness – ability to swim is
reduced
• Impairs reaction time
Alcohol and drowning
• Physical changes
• Inner ear – balance – sudden changes of
temperature can cause disorientation
• Hypothermia – draws blood away from
limbs to vital organs – more difficult to
swim
Alcohol and drowning
• Pattern of drinking (i.e. binge or heavy
episodic drinking (HED)) linked to
intentional and unintentional injury
(MacDonald et al 2013)
Have patterns of drinking
changed? • Home –v- Pub/Club
• Drink to get drunk
• Bigger/uncontrolled measures – drink
as much as you want!
• Pre-loading – drink before going out
for the night
• Long drinks –v- shots
• Energy drinks into the toxic mix
Individual responsibility or societal
issue?
OTHER MODEL
Problem – few bad
people who can’t
control themselves
Solution –
partnership, self
regulation, education
PUBLIC HEALTH MODEL
Problem – addictive
drug irresponsibly
produced, priced,
promoted, sold
Solution - regulation
The Evidence: REDUCE AFFORDABILITY
• Alcohol 61% more affordable than
1980
• NICE: “Making alcohol less
affordable is the most effective way
of reducing alcohol related harm”
• MUP (50p): • Targets children and heavy drinker
• Doesn’t penalise moderate drinkers or poor –80%+
lives saved from less affluent
• Would help community pubs
• Deaths down 960; crimes down 50,700; hospital
admissions down 35,100
The Evidence: REDUCE AVAILABILITY
• Places selling alcohol doubled since 1950s
• NICE: “…making it less easy to buy alcohol …
is another effective way of reducing alcohol related harm”
LICENSING ACT
• Presumption to approve
• Move to off sales, pubs closing
• More inappropriate locations – soft play,
multiplex cinemas
The Evidence: REDUCE ADVERTISING
NICE: “…children and young people should be protected
as much as is possible by strengthening the current
[marketing] regulations”
LATEST
• 1 in 4 cinema ads for alcohol
• Children see more TV alcohol ads than adults
• Football on TV – 111 visual references to alcohol an
hour
• UK has some of laxest regulation in Europe
The Evidence:
SCREENING and BRIEF ADVICE
• NICE: “NHS professionals should routinely carry out
alcohol screening as an integral part of service
provision …non-NHS professionals should focus on
groups that may be at an increased risk of harm
SPECIALIST TREATMENT
• Treatment effective and cost effective – 1:5 ROI
• NICE, DH, Alcohol Concern all recommend c15%
dependent drinkers should be in treatment
Questions?