New alcohol policy measures could reduce ambulance callouts, study suggests

Researchers called on policy makers to learn lessons from the pandemic and find ways to reduce harm from alcohol and protect the health service while also supporting business recovery.

New alcohol policy measures should be considered to cut drink-related ambulance callouts and avoid a return to pre-pandemic levels, a study suggests.

University of Stirling researchers found that Scottish Ambulance Service callouts related to drinking in licensed premises fell significantly during the first lockdown in 2020, but were replaced relatively quickly by alcohol-related callouts to homes.

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Meanwhile, some paramedics interviewed for the study spoke of their relief at not having to deal with scenes of “mass intoxication” and a “battlefield environment” on city streets when premises were closed during lockdown.They suggest measures including increasing the minimum unit price of shop-bought alcohol to reduce consumption within homes without affecting prices in bars, and also propose restrictions on online sales.

Professor Niamh Fitzgerald, Director of the Institute for Social Marketing and Health at Stirling, who led the study, said: “During the pandemic, both in the UK and abroad, licensed premises – including bars, restaurants and nightclubs – faced significant restrictions, including closures and curfews, which helped to reduce spread of the virus.

“However, we know that these restrictions also led to many people drinking more alcohol at home.

“By looking at data from the frontline of the NHS – the Scottish Ambulance Service – and adjusting for the fact that ambulance callouts fell during this period for other reasons, our study shows that there were disproportionately large short-term reductions in alcohol-related callouts in April and May 2020, when licensed premises were closed, compared to the previous year.

“This was a situation that paramedics described as a welcome break from the hostile, alcohol-fuelled scenes experienced in towns and cities on weekend nights pre-pandemic.

New alcohol policy measures could reduce ambulance callouts, study suggests. (Picture credit: Lisa Ferguson)

“However, we also identified public health risks caused by increased home drinking during this period – with those night-time callouts quickly replaced by alcohol-related ambulance callouts on all days of the week, likely to be linked to home drinking.”

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She added: “Our findings suggest that policymakers here in Scotland, and also around the UK and abroad, need to consider how to build upon the lessons learned during the pandemic.

“As the night-time economy recovers, how can we avoid a return to pre-pandemic levels of alcohol-related callouts arising from the night-time economy, but also reduce callouts and harm from home drinking?”

Researchers found that overall ambulance callouts for all causes between March and June 2020 – when lockdown was in place – decreased in comparison to the previous year.

However, alcohol-related callouts fell much more sharply – with a 23.9% reduction in April 2020 compared to the same period in 2019.

The drop was even more stark at weekends – down 31.8% – and at weekend night-times, down 48.9%.

After April, despite licensed premises remaining closed, the proportion of alcohol-related callouts gradually started to return to pre-lockdown levels.

Alcohol Focus Scotland said more needs to be done to change Scotland’s unhealthy relationship with alcohol and urged the Scottish Government to increase the minimum unit price of alcohol to 65p per unit, limit how available alcohol is in communities and bring in restrictions on alcohol marketing.

The charity’s chief executive, Alison Douglas, said: “Whether it’s weekend nights out or weekdays at home, these findings show the impact of alcohol on the Scottish Ambulance Service is unacceptable and unsustainable.

“Paramedics should not have to dread working a Friday or a Saturday night shift.”

Dr Alastair MacGilchrist, chairman of Scottish Health Action on Alcohol Problems (SHAAP), echoed calls to increase the minimum unit price of alcohol and restrict alcohol marketing and suggested banning alcohol sponsorship of sports.

The new paper, Lockdown and Licensed Premises: Covid-19 Lessons for Alcohol Policy, is published in Drug and Alcohol Review.

The Scottish Government has been asked for comment.

Dr Jim Ward, medical director at the Scottish Ambulance Service, said: “We will always respond to people in need regardless of cause, location, or time.

“However, heavy drinking both at home and when on nights out, as well as through chronic alcohol problems, not only increases the risk of accidents but can also lead to a rise in assaults, including those against ambulance staff.

“By drinking in a way that avoids harm, the public can support our hard working staff and avoid putting unnecessary pressure on our service and A&E departments at an extremely busy time.”

Public Health Minister Maree Todd said the Scottish Government is continuing to seek ways to cut alcohol consumption.

“I am determined to build on the progress we’ve already made and we will consult next year on potential restrictions to alcohol advertising and promotion,” she said.

“We remain absolutely committed to ensuring the level of minimum unit price (MUP) remains effective in reducing harm.”

Ms Todd said the Scottish Government is gathering evidence to analyse the impact MUP has had since its introduction, with a final report from Public Health Scotland due in 2023.

“It is important this work is carried out thoroughly as we must ensure any change to the level has a robust evidence base,” she said.

“When we announced we would review the level after two years, we did not know we would also need to factor in the impact of a pandemic and a changed legal landscape post-Brexit.

“Our ambulance service is currently experiencing unprecedented demand, largely because of Covid-19, but also due to a combination of increasingly complex cases, and exceptionally busy emergency departments.

“We are doing everything possible to help and improve the service, and would urge everyone to use the service responsibly and appropriately.”

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