Alcohol deaths in Scotland: Here's what should be done to stem this tide of grief and suffering – Elinor Jayne

This week we found out just how heavy a price people in Scotland paid for having an alcohol problem in 2020, the year we’re all so desperate to forget: 1,190 people died directly from alcohol.

Drinking alcohol is a part of ordinary life for many people in Scotland. But for some it can become a life-threatening (Picture: Jeff J Mitchell/Getty Images) (Picture: Peter Summers/Getty Images)

Not only did those 1,190 people have to struggle with their addiction and with all the harms both caused by and contributing to their addiction, the people they left behind – colleagues, friends, family, partners – have struggled to support the person they loved or cared for and now have the burden of their grief to struggle with.

Perhaps it is not surprising that some people turned to alcohol in the year that lockdowns and the global pandemic hit.

The pubs shut and it turns out wine, beer, cider and spirits are all much cheaper when bought in a shop or online. Indeed early data shows that the heaviest drinkers tended to drink more during this period (while others cut back).

But what is depressing is by how much the number of people dying from alcohol went up. And, continuing past trends, it is men who are disproportionately more likely to die from alcohol, and as ever, it is people living in the most deprived areas of Scotland who are more likely to die from alcohol.

Why is this? For men, it’s partly because drinking is wrapped up more in male identity and because men are much less likely to seek support for any mental health problems they are having – whether these are contributing to their alcohol problem or are caused by it.

And for people who live in Scotland’s poorest communities, the arguments around health inequalities are well-rehearsed yet often go unaddressed. There are straightforward measures that can be taken, for instance, reducing the number of places to buy alcohol in our poorest communities so there are no longer 40 per cent more places to choose from than in our wealthiest communities.

So what else can be done, not only to stem this tide of deaths from alcohol, but also to reframe Scotland’s relationship with drink?

Scotland led the way internationally when minimum unit pricing for alcohol was introduced in 2018. This was an important milestone and immediately had an effect: sales went down, volumes consumed went down and, as we’d all hoped, deaths then went down, and even alcoholic liver disease cases went down.

There is no denying that price (and taxation) is one of the most important levers that policymakers have at their disposal to reduce alcohol consumption and harm. However, inflation very rarely rests, so now we must see a renewed focus on price and for the minimum unit price to go up from 50p to 65p, so that its effectiveness is not eroded.

Alongside this, and on the back of devastating figures on alcohol deaths in England too, the Treasury must now move forward with its long-awaited proposals to reform alcohol duty. The current system makes no sense: we must have an alcohol duty structure that is proportionate, scaled, consistent across different types of alcoholic drinks and uprated to keep pace with inflation. The current approach is simply an anomaly.

Price is not the only policy lever available. Limiting availability of alcohol must now be considered. Why are alcoholic drinks considered a necessary part of the weekly shop? Let’s look at models in countries such as Sweden and Canada where alcohol is sold in designated alcohol stores rather than in supermarkets and convenience stores.

Given the shift of alcohol consumption from more highly regulated pubs and other licensed premises to the home environment – given an enormous boost when pubs and restaurants closed for much of 2020 – regulation of off-sales premises should now be the Scottish government’s priority.

And then there is advertising, sponsorship and marketing. Children should simply not be exposed to alcohol marketing and advertising but there is no escape.

Just waiting at a bus stop or watching football are two ways in which children – and adults – are regularly exposed. Sports sponsorship and advertising are surely the next key areas of focus for government here: there is nothing more incongruous than a healthy activity being so heavily associated with an alcoholic drink, yet we all take it for granted.

The UK government is currently steering legislation on labelling of unhealthy food and drink through Westminster yet has specifically excluded alcohol – not known for its health benefits – from this.

With others we’re asking for this to be reconsidered so at the very least the UK Chief Medical Officers’ guidelines on low-risk alcohol consumption are added to labels on alcoholic drinks.

But as well as our policymakers looking upstream to do what they can to prevent alcohol harm and deaths, looking downstream at what can be done to support those with alcohol problems – and the people in their lives – is now incredibly urgent.

Accessing treatment and support when you have an alcohol problem is undeniably difficult and can make people feel incredibly isolated and stigmatised. This was made all the more difficult in 2020 as services were halted or changed.

Alongside all the investment promised for services for people who use drugs, we must see investment in alcohol treatment and recovery services so that people can access them as soon as they need to, and are provided with the support they need to enable recovery.

While this range of measures will undoubtedly have a direct impact on reducing alcohol harm and deaths, as we as a country recover from the effects of the pandemic we must do all we can to bring an end to poverty and build a society where we are better connected, less isolated and treat each other with compassion. Then we’ll all be a lot better off.

Elinor Jayne is director of Scottish Health Action on Alcohol Problems (SHAAP)

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