The hidden harms of drink

The long-term effects of alcohol will be key to discussions at a major international conference in Edinburgh, learns Sarah Devine

Scotland needs to learn from its past in order to tackle alcohol-related hidden health harms, says a leading health campaigner.

According to a leading figure at the Scottish Health Action on Alcohol Problems (SHAAP), the public has a strong understanding of alcohol’s short-term effects including violence, but needs to be better informed of the long-term health implications.

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Health harms, including the so-called “quiet” health harms, is among the topics of discussion by health professionals, ministers, officials and academics at the 8th European Alcohol Policy Conference at the Royal College of Physicians of Edinburgh (RCPE) in November.

The conference organised by SHAAP and Eurocare is supported by the Scottish Government and aims to stimulate debate about alcohol-related issues.

SHAAP’s chair Dr Peter Rice says: “There is a very considerable range of health harms. Alcohol is different from other drugs in that its range of effects is so wide and varied.

“There are effects on mental health, mood, anxiety, memory and sleep.”

Liver disease, digestive problems and peripheral nerve damage are also among the significant alcohol-linked problems, alongside cancers of the throat, mouth, oesophagus, liver, colon and breast.

To reduce risk of these harms, the UK’s Chief Medical Officers advise drinking no more than 14 units of alcohol per week, which is around a bottle and half of wine or six pints of beer.

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They also advise not drinking to intoxication and avoiding alcohol during pregnancy because of the potential for harm to the baby.

Rice points to National Health Service (NHS) figures which show that during the 1990s there was a substantial increase in the number of hospitalisations and deaths linked to alcohol.

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Since the mid-2000s there have been falls in deaths and hospitalisations.

Rice welcomes these trends which he attributes to policy, treatment developments and changing economic conditions.

He says that it was notable that the increase in harms were experienced mainly by people on low incomes and it is this group whose health has improved in the more recent positive trends.

There is concern, however that these improvements have stalled over the last two to three years, reinforcing the argument that alcohol health harm needs close and continuing monitoring.

Rice, a former addiction psychiatrist at NHS Tayside, says: “The things that were really changing in Scotland during the 1990s that worried us were the quiet, chronic illnesses that are not publicly obvious to people in the community but affect people at a relatively young age and have a major impact on families.”

At that time, the nation moved from being a pub-drinking nation to a home-drinking one as a result of economic factors including the cheapness of alcohol in supermarkets.

It also began to have a serious impact on society.

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Rice says: “We know that children growing up in families who are heavy drinkers are considerably affected by that, because of the secondary effect of the heavy drinker and the atmosphere within the family.

“More generally, communities accept alcohol harm as the norm, for instance avoiding city centres on weekend nights because of the impact of alcohol.”

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In addition, alcohol harms cost the health service £267 million each year and Scotland £3.6 billion annually in health, social care, crime and productive capacity, according to NHS figures.

SHAAP hopes that the recently introduced minimum unit pricing (MUP) will reduce the overall figures.

Rice says: “We think there are good grounds to think that MUP will particularly benefit the health of people on low incomes, their families and the people close to them.”

In a further attempt to reduce the long-term health harms and social problems from alcohol, he believes that public expectations need to change.

He adds: “People feel this is just how [the nation’s relationship with alcohol] is and it is never going to change.

“Yet, it has not always been like this and we are keen to promote ideas that will lead to things changing for the better.”

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Rice will be joined at the conference by Dr Catherine Calderwood, chief medical officer for Scotland and Aileen Campbell, Scotland’s public health minister.

The 8th European Alcohol Policy Conference will take place at the Royal College of Physicians in Edinburgh on 20 and 21 November. To book a place, visit

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