The high cost of drinking culture revealed
With a month crammed full of public meetings before the summer break, alcohol consumption has featured repeatedly in council, NHS and Shetland Charitable Trust papers as part a bid to reduce the harm caused by excessive drinking.
Shetland’s four-year local outcome improvement plan (LOIP) estimates the economic cost to the public purse of alcohol is between £6.8 to £10.8 million per year.
The cost to the health service is up to £1.9 million, social care up to £2.9 million and crime around £2.1 million.
Meanwhile “productive capacity” – which covers costs to the economy from drinking including things like poor performance at work, absenteeism, unemployment and premature death – is estimated to make up to a £3.9 million dent on local finances.
Most up to date figures from Alcohol Focus Scotland estimate that the cost of alcohol-related hospital admissions in Shetland was £350,500 in 2010/11.
According to the LOIP report “there is a distinct overlap between mental health and substance use/misuse; ongoing audits of suicide and sudden deaths in Shetland show that alcohol is almost always a factor – either a significant quantity has been used prior to death, or there has been a history of unhealthy drinking patterns.”
Health improvement manager Elizabeth Robinson said the team has been working to change people’s attitude to drinking through its Drink Better campaign.
Ms Robinson said the scheme was about “drinking for pleasure” rather than drinking to get drunk, and more about “quality than quantity”.
Lucy Ward health improvement officer, said: “I think people get the health message that drinking too much is bad for them, I think people understand that.
“But maybe they don’t know what is too much and don’t appreciate they are drinking outwith the guidelines.
“I think people’s interpretation of what is considered too much alcohol is higher than what is considered dangerous for your health.”
Government alcohol guidelines for men and women state they should not regularly drink more than 14 units a week – about six glasses of wine, or six pints of four per cent lager or ale.
National figures from 2014 provided by Ms Ward state nearly one in four men and one in six women in Scotland drink at harmful or hazardous levels – more than 21 units a week for men and more than 14 for women.
“In Shetland a lot of people drink in the house and at home, rather than in pubs,” said Ms Robinson.
“So with your home pouring measures, if you got somebody to pour out a measure of whisky it’s normally a triple to what the measure is.”
Drink Better was not about stopping people drinking, she added it was about people enjoying alcohol but for the right reasons.
She explained more work was due, focus groups and targeted campaigns as well as including work-based training “on how to deal with alcohol in the workplace”.
Ms Robinson hoped to build the campaign’s momentum, with Macmillan’s Sober October around the corner – asking people give up alcohol for a month to raise money for charity.
When asked about the drinking culture in Shetland, Miss Ward said: “It seems to be that it’s common for social things to revolve around a bar or availability of alcohol – I suppose if you think of festivals and the Tall Ships and even the Island Games and things.”
Anecdotally the pair had heard that Mareel and the Fjara cafe in Lerwick had been welcomed as “being more non-drinker friendly” on Friday and Saturday nights.
More formal data has also been gathered on younger drinkers.
Last year an S3 health check was carried out in Shetland with 113 pupils answering a question on how often they drank alcohol.
About 70 per cent of students said they only drank alcohol on special occasions, with around ten per cent saying they drank on a monthly or fortnightly basis.
“Underage drinking did go up for a bit but now it’s on its way down,” Ms Robinson said.
“It just seems to be one of these patterns that fluctuates, again it’s small numbers that are self-reported, but what we do know with underage drinking it’s very difficult to buy alcohol when you’re underage [with Challenge 25], so somebody is supplying the alcohol, you would assume; friends and family.”
Ms Ward explained parents’ drinking habits – how often and how much they drink – can influence their children, and Ms Robinson said parents were one of the target groups of the Drink Better campaign.
Work is also being done with GPs and practice nurses to ask people about their drinking.
“Anyone coming in to see the GP who has had a sore tummy or feeling down and lethargic, or irritated or suffering from stress. There’s a whole list of prompts where alcohol might be a cause or might be a consequence,” Ms Robinson said.
“We’re trying to get beyond GPs and practice nurses so it’s in other settings [outside of hospital],” added Ms Ward. That includes raising issues through social workers, criminal justice, youth workers and even physios.