Ymunwch â’r Sgwrs! Join the Conversation! Alcohol Awareness Toolkit 1 Welcome to the Alcohol Awareness Toolkit This toolkit has been developed by Public Health Wales in partnership with Alcohol Concern using many of the resources and images provided by Change 4 Life. The toolkit is intended for use by any person or organisation who would like to raise awareness of alcohol use and misuse with colleagues, communities, families and friends. It will provide all the necessary tools and resources to plan, run and evaluate an alcohol awareness campaign. Alcohol is a major preventable cause of death and illness. Around 1,500 deaths in Wales are attributable to alcohol each year (4.9% of all deaths).1 Problem use of alcohol can cause serious social, psychological and health problems, affecting work, social and personal relationships. Health risks associated with heavy drinking include: Liver Disease cirrhosis of the liver Alcohol Related Psychiatric Anaemia Disorders and Nutritional Disease Health Risks Associated with Heavy Drinking Chronic Alcoholic Calcifying Dementia Pancreatitis Heart Muscle Damage cardiomyopathy 1. Public Health Wales Observatory 2014. Alcohol and Health in Wales 2014. Wales Profile. 2 Alcohol in Wales and Hywel Dda Alcohol has recently been identified as the third highest risk to health in developed countries (Alcohol Concern, 2006). The most recent data from the Welsh Government (2015)2 on referrals to substance misuse treatment services show an increasing trend in substance misuse with alcohol related referrals being the main problematic substance. An overview of these findings are provided below: There were 26,385 referrals for treatment of alcohol or drug misuse notified to the database in 2014-15. This represents a substantial rise in referrals, following two years of falling numbers (2011-12= 25,518; 2012-13= 24,691; 2013 – 14 = 24,001). Based on 20,671 referrals (due to referral exclusions), 54 per cent of referrals were related to alcohol as the main problematic substance. Males accounted for 62 per cent of referrals for alcohol and the median age for alcohol referrals was 42 years. According to the Welsh Health Survey (2014) 39 per cent of adults in Hywel Dda report drinking above guidelines on at least one day per week and 23 per cent of adults report binge drinking on at least one day in the past week. Table 1 below provides an overview of the Welsh Health Survey Data by county. Adults who reported drinking above guidelines on at least one Adults who reported binge drinking on at least one day in the past week day in the past week Source: Welsh Health Survey (2014) Per Cent Age- Age- Observed Standardised Observed Standardised Person Person Person Person Ceredigion 42 41 26 24 Pembrokeshire 35 36 18 20 Carmarthenshire 39 39 24 24 Hywel Dda 39 39 22 23 Wales 41 41 25 25 Drinking in children and young people remains a concern with 17% of males and 14% of females aged 11 – 16 in Wales drinking alcohol at least once a week. This is higher than in Scotland, Ireland and England.3 2. Welsh Government (2015) Treatment Data – Substance Misuse in Wales 2014 – 2015 3. Public Health Wales Observatory 2014. Alcohol and Health in Wales 2014. Wales Profile. 3 Why do people drink? There are a number of reasons why people drink alcohol and these reasons may vary considerably from person to person. By beginning to think about these different reasons, you will begin to gain some useful insight into the nature of alcohol use in our culture. It may also give you ideas for conversations you could have to encourage people to start thinking about their relationship with alcohol. Listed below are the most common reasons that people give for drinking on a regular basis: People often enjoy a drink to ‘wind down’ and it is seen as a Reward reward after a stressful day at work Some consider having a drink as ‘me time’ once the children To Relax are in bed, or as one consumer described it, ‘part of my relaxation package’. A number of people acknowledge that their patterns of routine drinking become difficult to disrupt. This leads to a Routine belief that they might be too set in their ways to be able to break the pattern. In this context, alcohol is frequently described as an Alcohol Enhances The ‘essential ingredient’, helping consumers to ‘fit in’ or be more Social Experience confident in social situations. People often use alcohol as a way to manage stress, anxiety Coping Mechanisms and/or depression. Boredom Feeling down Additional Reasons Pressure from others for example: ‘oh go on I am having one’ Cheaper having a drink at home and more convenient What about older adults? As people get older, their bodies change so when alcohol is consumed it is broken down more slowly, and they become more sensitive to the effects of alcohol. There are many factors and life changes associated with alcohol use by older adults. Factors associated with higher rates of alcohol use Emotional and social Health Other Bereavement Physical disabilities Family history Loss of friends and social Chronic Pain Personality status Insomnia Long term prescribing Sensory deficits Available finances 4 Factors associated with higher rates of alcohol use Emotional and social Health Loss of occupation Reduced mobility Impaired ability to function Cognitive impairment Family conflict Disrupted sleep Reduced self esteem Caring for an elderly partner or family member Loss of independence Needing Stress Depression Social Isolation and loneliness Retirement Adapted from Dar 2006 Dar, K. (2006). Alcohol use disorders in elderly people: fact or fiction? Advances in psychiatric treatment 12(3):173-181. Alcohol and Medication The combination of alcohol with medications can also cause problems. Older people receive more prescriptions than any other age group and are often dispensed multiple medications. Many medicines, both prescription and over the counter, interact with alcohol. These interactions may increase the effect of a medicine (e.g. the sedative effect of a hypnotic), exacerbate a side effect (e.g. the drowsiness associated with anti-histamine use), or result in a new syndrome (e.g. the unpleasant effects of combining alcohol and some antibiotics). DID YOU KNOW? Over 45s are three times more likely to drink alcohol every day. People who work are more likely to drink alcohol than unemployed people. Around 200,000 people come to work with a hangover every day. Alcohol is the second biggest risk factor for cancer after smoking. Alcohol Concern UK 5 Benefits to cutting back on alcohol There are loads of benefits to cutting back on the alcohol. The most important one is the reduced risk to your health, but there are lots of others too – you might be surprised! Heavy drinking can be linked Too much alcohol can really to depression, and pile on the pounds. If you sometimes a hangover can drink 10 pints a week, you leave you feeling low. could be taking on more than 120,000 calories a year. If you already feel anxious or sad when you are sober, And there are more calories drinking can make this in a single measure of spirits worse. than in the same volume of single cream. So cutting down may put you in a better mood generally. So if you cut back you will start to feel in better shape. Feel In Better Mood Better Shape Benefits to cutting back on alcohol Health Sleep Soundly Once you start cutting back, Alcohol can disrupt your you will probably notice the sleep patterns and stop you benefits quite quickly: from sleeping deeply. Feeling better in the mornings, having more So cutting down on alcohol energy and feeling less tired should help you feel more during the day, and your skin rested when you wake up. may start to look better. Cutting down on alcohol can reduce the chances of suffering from more serious health harms such as: alcohol-related cancers, heart disease, high blood pressure, stroke, liver 6 Source: disease, pancreatitis and NHS Choices, UK reduced fertility. Why your setting should get involved… Workplace: Alcohol can play a significant role in and around the workplace. It is often perceived as a stress- reliever and an antidote to the daily pressures of demanding roles, as well as a way to socialise and to network with colleagues and clients. However, drinking can lead to decreased organisational productivity and long-term health problems. Up to 17 million working days are lost each year because of alcohol-related sickness and the cost to employers of sick days due to drink is estimated at £1.7bn.4 The total annual cost to the economy is estimated to be £7.3bn (2009/10 prices).5 The workplace provides an ideal setting to target interventions around raising awareness of alcohol related harm and on reducing alcohol consumption – it provides access to an established population of adults, and provides a great opportunity to improve the health and wellbeing of staff. The impact of alcohol on the workplace: Raised blood alcohol levels while at work affect both efficiency and safety - meaning increased likelihood of mistakes, errors of judgement and accidents. Hangovers affect attendance and performance. Persistent heavy drinking may lead to serious social, psychological and medical problems which are associated with work attendance and performance – for example, increased sickness absence. Source: Alcohol in the workplace: Institute of Alcohol Studies Factsheet, 2014 4. National Institute for Health and Clinical Excellence (June 2010), 'Business case: Alcohol-use disorders: preventing harmful drinking', p. 13 5. Home Office (November 2012), 'Impact Assessment on a minimum unit price for alcohol', p. 5 7 Communities: Communities provide an ideal setting to target interventions around raising awareness of alcohol related harm and on reducing alcohol consumption.