Today with Sean O'Rourke - RTÉ Radio 1, Wednesday 3rd of January 2018 Professor Jim Lucey MD PhD FRCPI FRCPsych Medical Director of St Patricks University Hospital
There is a great deal at stake in the campaign to pass the Public Health (Alcohol) Bill. The legislation which is currently at Committee Stage in the Oireachtas is about nothing less than the health and safety of our nation. The unbridled market for below cost ultra-cheap alcohol is a great risk to our population’s health, a recurring source of injury to our general health and safety, and a toxic influence on our mental wellbeing.
The harm caused by alcohol consumption is directly proportional to the volume of alcohol consumed within society: the more alcohol consumed the more harm. Limiting the availability of below cost ultra-cheap alcohol is the most effective way of reducing the volume consumed, reducing alcohol abuse and limiting the damage caused to public health and safety. The evidence for this relationship between price and the level of alcohol abuse is very substantial. Below cost ultra-cheap alcohol sales increase the volumes consumed and this harms everyone. The Public Health (Alcohol) Bill is not attack on the poor (as has been said by some critics). Alcohol abuse effects every social class but its economic cost is harshest on the poor. Alcohol abuse creates poverty. We might all think of better responses to poverty, providing more social housing, more employment and better education. Providing cheap alcohol is not a helpful response to poverty.
Obviously the alcohol industry and its allies will make every argument to oppose even this modest legislative reform. The alcohol industry has nothing to gain from limits placed on its behaviour. Their interests are in maintaining market share and growing sales volumes both increasingly obtained through below cost ultra-cheap off-sales in shops and super-markets. The industry’s interest is in greater volume sales making even greater returns to their shareholders. Meanwhile alcohol abuse causes substantial damage to the quality of life in our country. The availability of below cost ultra-cheap alcohol contributes to this alcohol abuse and so creates many more problems for living.
That is why we need to be more enlightened and more health aware. Public health is the public’s concern. This Public Health (Alcohol) Bill is not about an individual choice to drink alcohol. It is about our collective health and safety. We all stand to gain from a society with better wellbeing. The measures in this Public Health (Alcohol) Bill would improve our population’s health by limiting exposure to ultra-cheap alcohol and by placing limits on the alcohol industry’s ability to expose their alcohol products to more young people.
The Department of Public Health and Primary Care at Trinity College in Dublin has provided evidence of the societal damage done by the current industry led alcohol policy. Every night in Ireland at least 1500 acute hospital beds are occupied as a result of alcohol misuse. One in ten Breast Cancers is directly attributable to alcohol and at least six other common cancers are also known to be alcohol-related. There has been a steady rise in liver failure in parallel with the rise in our alcohol consumption.
Alcohol abuse is a significant contributory factor in many cases of child neglect. Parental drinking has been identified as a key factor in very many child welfare issues. Alcohol is a factor in two fifths of fatal collisions on our roads and in many assaults, including sexual assaults, rape and domestic violence, and manslaughter. Alcohol is the common factor in the vast majority of public order offences. These are the facts and they affect us all.
But what about alcohol use and our mental health? The mental health case for reform of alcohol legislation is also compelling. Successive government ministers with specific responsibility for mental health have spoken in support of alcohol policy reform. Former Minister Helen McEntee highlighted the links between alcohol use in young people and the tragedy of youth suicide. “Alcohol is a contributory factor in half of all suicides and the risk of suicide when a person is abusing alcohol is eight times greater than if they were not abusing alcohol, according to the World Health Organisation (WHO). Suicide is the leading cause of death among young Irish men aged 15 to 24. Approximately 48% of sixth year students at second level and over 60% of young adults’ report drinking behaviour outside of the normal range. Alcohol also has a significant impact on the number of young people who self-harm. The 2014 annual report of the National Self-Harm Registry found that alcohol was involved in 35% of all cases of self-harm.”
Every mental health problem is increased by alcohol abuse. Problems such as Anxiety Disorder, Depression and Psychoses all deteriorate in the context of alcohol use and abuse. Modern mental health care recognises these as ‘Dual Diagnostic’ challenges in an effort to coordinate more effective routes to recovery; but the problems of alcohol abuse need to be addressed further up-stream, at a societal and legislative level, at the level of marketing supply and promotion. The current unbalanced situation leaves all the weapons of alcohol promotion in the hands of the industry and all the responsibility for its consequences in the hands of the individual. If we took the same attitude to other public health and safety issues we would have no regulation anywhere. Where would the smoking ban be now? Ireland led the world in the right direction regarding smoking. We should not delay following the example shown by Scotland regarding below cost ultra-cheap alcohol sales.
Passing the Public Health (Alcohol) Bill would be a significant step towards redressing the current imbalance in the industry-led marketplace for alcohol. That is why this reform bill is supported by such a broad coalition of stakeholders across our communities. Its passing is a key objective in the programme for government. It would result in both a significant saving to the state and a positive uplift in our nation’s health. It would save many lives.
In short, the bill would improve our nation’s health and safety by limiting the availability of below cost ultra-cheap alcohol that is doing such harm to our physical and mental well-being. The arguments in favour of the Bill represent a collective commitment to our physical and mental wellbeing. If we really want to improve the quality of life, safety and mental health of all our people we have a clear step to take.
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Public Health Alcohol Bill
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Prof Jim Lucey
Prof. Jim Lucey was Medical Director of St Patrick’s Mental Health Services, Dublin, from 2008 to 2019. He is Clinical Professor of Psychiatry at Trinity College Dublin. He has been working for more than 30 years with patients suffering from mental health problems. In addition to medical management, he maintains his clinical practice at St Patrick`s, where he specialises in the assessment, diagnosis and management of Obsessive Compulsive Disorder (OCD) and other anxiety disorders. He gives public lectures and is a regular broadcaster on mental health matters on RTÉ radio, featuring on ‘Today with Sean O’Rourke’.
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