Tackling alcohol misuse - What works best?

The UK Health Development Agency today publishes its report on the prevention of alcohol misuse. The updated edition of
the briefing document 'Prevention and reduction of alcohol misuse' highlights what works in tackling alcohol misuse, any gaps
in the evidence and puts forward recommendations for policy and research commissioners.


The report examines interventions to combat the damaging effects of alcohol and the burden placed by alcohol on the NHS.
Statistics show that in 2002, 27% of men and 17% of women aged 16 and over drank on average more than the recommended weekly
safe amounts of 21 and 14 units respectively. 40% of all A&E admissions are alcohol related, and as many as 150,000 hospital
admissions each year are related to alcohol misuse.


The recommendations include specific interventions such as behavioural counselling in healthcare settings to reduce risky and
harmful alcohol consumption. There is evidence to support that brief advice sessions given in this setting could reduce
weekly drinking by up to 34%, which could result in an average of nearly 9 fewer drinks per week. On the roads, evidence
supports the effectiveness of breath-test ignition systems (interlocks) and introducing a lower legal maximum blood alcohol
concentration to reduce alcohol-impaired crash deaths, particularly among younger drivers.


Professor Mike Kelly, HDA director of Evidence and Guidance, said:


"The need for effective interventions to reduce the negative impact of alcohol is clear - up to 22,000 deaths each year are
associated with alcohol misuse, up to 17 million working days are lost annually due to alcohol related absence, and overall,
it is estimated that the costs of alcohol misuse are around ?20billion a year.


This evidence briefing highlights the most effective ways of tackling alcohol misuse, showing that advice from healthcare
professionals can help reduce levels of drinking, and providing the evidence on the best methods of reducing alcohol-impaired
driving."


The briefing identifies a number of inequalities and vulnerable groups, but finds a lack of review-level evidence for the
effectiveness of interventions in reducing alcohol misuse in these sections of the community. The briefing recommends that
research is needed on which approaches work best among minority ethnic groups, and identifies an urgent need to fill the
evidence gap to reduce alcohol misuse in young people.


The policy context is also summarised, reiterating that combating alcohol-related crime and disorder is a key requirement to
address the problems of town and city centres that are affected by alcohol misuse at weekends. This includes greater
adoption of policies such as exclusion orders to ban those causing trouble from pubs, clubs or entire town centres and
greater enforcement of existing rules on under age drinking, and serving those who are drunk - evidence shows that bartender
training is effective in reducing intoxication levels in customers. It also stresses the importance of working with the
alcohol industry to build on the good practice of some existing initiatives such as Citysafe schemes.


1. 'Prevention and reduction of alcohol misuse, 2nd edition' is available at hda.nhs/Documents/alcoholEB2ndedition.pdf


2. The Health Development Agency hda.nhs is the national
authority on what works to improve people's health and to reduce health inequalities. It works in partnership across sectors
to gather evidence of what works, advise on standards and to develop the skills of all those working to improve people's
health.


3. From 1 April 2005, the functions of the Health Development Agency will transfer to the National Institute for Clinical
Excellence. The new organisation will be the National Institute for Health and Clinical Excellence (to be known as NICE). It
will be the independent organisation responsible for providing national guidance on the promotion of good health and the
prevention and treatment of ill health.


Health Development Agency

Tel: 020 7061 3117

hda.nhs


Please note that from 1 April 2005 the functions of the Health Development Agency will transfer to the
National Institute for Clinical Excellence to become the new National Institute for Health and Clinical Excellence
(to be known as NICE). The web address for the new organisation will be nice.