Alcohol deaths response – a whimper rather than a bang?

September 4, 2021
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When the news of Scotland’s 2020 alcohol-specific deaths – all 1190 of them – was published last month, I was fascinated to compare the reaction in the press, TV and social media to the respective reaction after the publication of the drug deaths. Our ‘other’ drug deaths, quite rightly, provoked outrage, grief and calls for change. To me the response to the alcohol deaths seemed like a whimper rather than the bang such loss deserves.

Beyond the terrible impact of those deaths is the astounding cost of alcohol harms to the Scottish economy. In 2010, the Scottish Government estimated that the cost of excessive drinking here is around £3.6 billion when social, criminal justice and health factors are considered. The fallout in families and communities is considerable.

When we were exploring access problems to residential rehabilitation in Scotland, the Residential Rehabilitation Working Group did not find any evidence that access for alcohol problems was any better than for drug problems, yet there has been little energy spent on trying to increase access for this group.

Given that there was a 17% year on year increase in fatalities and that the number of alcohol-specific deaths is a significant underestimate of deaths in which alcohol plays a part, I wondered in a tweet why there was a more muted reaction to the alcohol deaths than to the drug deaths. This touched a nerve it seems. A lot of responses were generated and I wanted to share some of the themes here.

Fred Parry, who recently made a poignant plea for more action on alcohol addiction in the Ferret makes the salient observation that there may be a degree of denial going on because alcohol is society’s ‘drug of choice’. Several commentators picked this theme up including Steven R.

The way alcohol is seen and the allowances made for it are relevant to this debate:

I am pretty much in agreement with Emma Rogan:

And do the press collude in keeping attention deflected? Bobby Smith thinks so:

There was emphasis on the contrast of the legal drug alcohol with illicit drugs, perhaps meaning we pay less attention. Perhaps too, the illicit nature of other drugs creates a glamour/mystery which causes more of a splash. My colleague, Garret McGovern picks this up, also :

The idea of underinvestment in alcohol services was challenged by Andrew McAuley:

It’s true a lot of effort has gone into policy – we have national minimum unit pricing and alcohol brief interventions, but what about treatment? Peter Rice had a different perspective:

This raised for me the unwelcome thought: what if our understandable emphasis on tackling drug deaths was having the unintended consequence of our neglecting of alcohol deaths?

Perhaps the ferocity and immediacy of other drug harms are relevant:

And does tax revenue and lobbying from the alcohol industry have a part to play in our dulled response?

Could there be a conflict of interest – revenue vs. public health?

I wonder too if part of the problem is the swing of the pendulum. We have trouble with multitasking – at points in the past, the emphasis has been on alcohol. At the moment it’s more on other drugs – perhaps it will swing back, though what we really need is a mid position where we give alcohol problems and their prevention, harm reduction and treatment the same priority as other drugs. You can see many more comments here.

For the moment though, for the sake of all those suffering and dying prematurely – and their families, I think we need not the whimper we got in response to alcohol deaths but a very loud bang instead.

Continue the discussion on Twitter @DocDavidM

Note: I’ve not sought permission to publish these tweets as they are already published in the public record, – but if anyone would like me to remove their comment, please let me know. Thanks to all who took time to comment on the Twitter thread.

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