It's time for tough decisions to halt the alcohol epidemic

THE British Medical Association has just launched a report on tackling alcohol misuse in the UK. Drinking is very much part of British culture – we are not trying to overturn this, but we do want to change the way many people behave. Sensible drinking is enjoyable, social and can even be good for you.

Our key message is enjoy alcohol in moderation –getting "plastered", "bladdered" or "trollied" every Friday and Saturday night could you cost you health and perhaps your life.

As a GP, I have witnessed the consequences of alcohol abuse not just to the individual but also to their family. The tragedy is that alcohol misuse can cause family breakdowns, it is a major factor in domestic violence, unwanted pregnancy, it ruins job prospects and is often related to crime and disorderly behaviour and it kills.

How many people have been afraid to walk down a city or town centre late at night because they are frightened about being faced with a group of drunken louts? How many road traffic accidents are caused by drink-driving or even a drunken pedestrian walking in front of car?

It is staggering how many health problems are related to alcohol misuse – over consumption of alcohol is related to more than 60 medical conditions including heart and liver disease, diabetes, strokes and mental health problems.

As a doctor, one of my difficulties is first convincing a patient that they have a problem and then having to explain to them that there is chronic shortage of specialised services to help with their treatment.

They can wait weeks, if not months, for specialist help and in this time their problems can spiral out of control. We need much more funding for the treatment of alcohol misuse.

Alcohol costs the country many millions of pounds. Not only does the NHS spend millions on treating and dealing with alcohol problems, but the criminal justice system also spends similarly large amounts dealing with alcohol-related and drink-driving offences.

But, of course, as with so many things, prevention is better than cure. When I read the BMA report I was struck by the bigger picture of alcohol abuse. How ironic that when the NHS is struggling to cope with patient demand it is spending so much money on trying to manage the consequences of a preventable diseases. Speak to any nurse or doctor about working in A&E at the weekend, or worse still, Christmas or New Year's Eve. They have to cope with drunken and violent abuse; they patch up wounds and stabbings following drunken brawls and they often have to admit patients suffering with alcohol poisoning. Then there are the longer-term problems of liver, heart and many other diseases and I would not be surprised if these health professionals asked themselves: "Has all my training been for this?"

The BMA is particularly worried about alcohol consumption among young people, particularly young girls. It is shocking that the UK's teenagers are most likely to be heavy drinkers in Europe. The problem is that when you are young and healthy, you cannot imagine not being that way. Perhaps if teenagers saw how
liver disease ravages health they might think differently about
how they spend their Saturday nights.

I am not blaming individuals, but alcohol misuse is getting out of control. If the Government is serious about tackling alcohol misuse, it should start with tough decisions like focussing on cost and availability, the promotion of alcohol to the young and bad practices such as two-for-one offers and happy hours.

Since 1997, taxes on wine and beer in the UK have only increased in line with inflation while taxes on spirits have not increased at all.

There is strong and consistent evidence that price increases result in reduced consumption and that increased
opening hours are associated with increased alcohol consumption and alcohol-related problems. The Government needs to act on this evidence.

The Licensing Act 2003 now permits 24-hour opening in England and Wales and the BMA is dismayed that public health was not considered as one of the licensing objectives in the Act. We are not saying that we should return to the situation before this legislation.

Rather than liberalising licensing laws, we should be looking to restrict the availability of alcohol. An important
message, however, is that there is not only one solution to this complex problem. We've put forward a package of proposals and these need to be implemented together.

Awareness campaigns in themselves will not work, nor will simply hoping that the alcohol industry will put its own house in order. It's time for leadership and I hope the Government is ready to show it.

Yorkshire Post