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Welcome to SHAAP’s (Scottish Health Action on Alcohol Problems) weekly media monitoring service.

April 23rd 2015

#MUPsaveslives

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This briefing aims to provide a ‘snap shot’ of latest news on alcohol and health policy. The inclusion of an article in the briefing should not imply that SHAAP approves or condones the content.

SHAAP provides a coordinated, coherent and authoritative medical and clinical voice on the need to reduce the impact of alcohol related harm on the health and wellbeing of the people in Scotland. SHAAP was set up by the Scottish Medical Royal Colleges, through their Scottish Intercollegiate Group (SIGA) and is governed by an Executive Committee made up of members of the Royal Colleges.



 

European Court of Justice Case on Minimum Unit Pricing Scheduled - May 6th


A legal challenge to the Scottish government's policy on minimum alcohol pricing,  referred to a European court by the Court of Session has been scheduled for a May 6th hearing.

Judge Lord Eassie said the Court of Justice of the European Union should give its opinion on the proposal.

The case was brought by The Scotch Whisky Association, which argued the legislation breached European law.

Holyrood ministers have said minimum pricing was vital to address Scotland's "unhealthy relationship with drink".


Edinburgh Airport Starbucks to serve alcohol



April 22nd - Edinburgh Evening News
 

Starbucks is moving into evening wining and dining after opening a new cafe at Edinburgh Airport – only its second in the UK to serve up dinner and alcohol.

Passengers can order a range of “shareable” hot and cold dishes such as prawn and chorizo skewers and pulled pork chilli. A ten-strong wine list, including prosecco and rose, is complemented by Peroni lager and Magners cider.

The move comes two weeks after sandwich chain Pret a Manger launched a trial dinner service, complete with tabletop candles, at its Strand branch in London’s theatre district.

Starbucks started evening menus in the United States five years ago, followed by Stansted Airport in February. Experts predicted the firms would extend the service to other airports and train stations, along with city centre areas still busy at night.

Leigh Sparks, professor of retail studies at Stirling University, said locations passed by many people and those with higher “dwell times” would be the leading candidates. He said: “We will see more and more experimentation at certain locations. The cafe market is very competitive and firms will want to maximise the use of their shops since they have fixed costs.

“They will be trading off brand recognition – like Mars extending into milk drinks and Tesco moving into banking.”

Prof Sparks said the companies were following the lead of pub chains such as Wetherspoons, which had successfully introduced coffee and food in the morning.

He said rival coffee chains might follow Starbucks and Pret a Manger, though some might decide instead to continue to focus on hot drinks, to mark themselves out as “specialists”.

Dr Eric Laurier, senior lecturer in geography and interaction at Edinburgh University, said the innovations could provide European-style venues for going out.

He said: “If you go out at night in a British city, it’s a young people’s place.

“Coffee shops are an alternative space for socialising, for women, families and older couples.

“In Italy, Spain or France, you can sit in a cafe in the evening, read a newspaper or watch the world go by – but it’s a way of living that still has not happened here.”

However, Helena Childe, a senior food service analyst at Mintel, said the transition to dinner and alcohol could be problematic for the coffee chains.

She said: “It means they will be competing against different types of outlets, and people may prefer having a drink elsewhere.”

Starbucks spokesman Ian Cranna said: “With 10 million people passing through Edinburgh Airport last year, this is a great opportunity for us to offer these customers our new ­evenings menu.”
 

Study finds high risk of death from alcohol, drug abuse among former prisoners



April 23rd - Medical News Today 
 

Around a third of all deaths among men and half of all deaths among women who have been released from prison are due to drug and alcohol abuse. This is according to a new study published in The Lancet Psychiatry.

According to lead study author Prof. Seena Fazel, professor of forensic psychiatry at the University of Oxford in the UK, and colleagues, death rates are high among individuals who have been released from prison.

"In the USA, the ex-prisoner population was estimated as 5.4 million people, who account for about 12% of roughly 250,000 deaths from external causes every year," say the authors.

However, they note that few studies have investigated the drivers behind high death rates among ex-prisoners.

Past research has suggested that substance use disorders and psychiatric disorders are common among former prisoners. In this study, Prof. Fazel and colleagues investigated the proportion of deaths among ex-prisoners that are attributable to such disorders.

To reach their findings, the researchers analyzed 47,326 men and women who had been imprisoned in Sweden since January 1st, 2000 and who were released before December 31st, 2009.

The team obtained data detailing incidence of substance use (including alcohol and drug abuse) and other psychiatric disorders - such as depression and schizophrenia - among the prisoners, and the causes of any deaths after release were recorded.

Findings 'support causal role for substance use disorders in post-release mortality'

Using the Cox regression model, the researchers calculated the proportion of deaths that could be attributable to substance use and other psychiatric disorders.

During an average 5-year follow-up, 6% (2,874) of the prisoners died after being released from prison. Of these deaths, 44% (1,276) were due to potentially preventable external causes, such as accidents or suicide - accounting for around 3% of all external-cause deaths in Sweden in 2000-09.

The researchers found that a history of alcohol and drug abuse significantly increased the risk of death among former prisoners.

Even after accounting for criminological, sociodemographic and genetic factors, substance and alcohol abuse accounted for 34% of deaths among male ex-prisoners following release and 50% of deaths among female ex-prisoners.

What is more, the researchers found that 42% of deaths from external causes among male ex-prisoners were a result of drug and alcohol abuse, as were 70% of external-cause deaths among female ex-prisoners.

Commenting on the findings, the authors say:

"Our results show high mortality in people released from prison, and the substantial contribution of substance use disorders to this mortality.

We provide evidence that supports a causal role for substance use disorders in post-release mortality, and that these disorders might be useful to identify high-risk groups."

Unlike previous studies, the researchers say they found no association between other psychiatric disorders and increased risk of death among individuals who were released from prison.

Substance abuse treatment for ex-prisoners 'could prevent 9% of external-cause deaths'

According to Prof. Fazel, these findings "show the potential for preventive and therapeutic programs to significantly reduce the number of deaths from alcohol and substance misuse."

The researchers estimate that in the US, around 9% of deaths from external causes could be prevented if former prisoners were treated for alcohol and drug use disorders.

The team says future research should investigate the cost-effectiveness of substance abuse treatment programs in custody, as well as identify the best ways to continue such treatment once prisoners are released.

"In many countries, jails and prisons are an important opportunity to treat substance use disorders in individuals who are out of the reach of conventional health care systems," say the authors. "Such efforts could not only reduce mortality in people released from custody, but also improve both public health and safety."

In an editorial linked to the study, Sarah Wakeman, of Harvard Medical School in Boston, MA, and Josiah Rich, of Brown University in Providence, RI, say addiction treatment for prisoners is severely underutilized in the US.

They note that among people with drug use disorders in state prisons, only 0.8% receive detoxification treatment, 0.3% receive maintenance pharmacotherapy, 6.5% receive professional counseling and 9.5% undergo treatment in a residential facility.

"The withholding of evidence-based treatment for prisoners is arguably unethical and certainly unwise," say Wakeman and Rich. "The absence of care in this deeply affected population translates into high costs to society and the communities that these individuals return to. As the article shows, these costs also translate into avoidable deaths from a treatable illness."

HIV-positive men are more affected by alcohol



23rd April - The Spirits Business
 

The research by Yale University and reviewed data on more than 2,600 men enrolled in the Veterans Aging Cohort Study, and asked both HIV-infected and uninfected veterans how many alcoholic drinks it took for them to feel a “buzz” or “high”.

They found that HIV-infected men were more sensitive to the effects of alcohol than uninfected men, and felt the effects after drinking, on average, a quarter less of a drink than uninfected men.

Dr Amy C. Justice, professor of medicine and public health at Yale, said: “All else equal, people who have HIV infection have a lower tolerance for alcohol than similar people without HIV infection.

“It’s not clear whether HIV-infected individuals are simply more susceptible to alcohol or if they achieve higher concentrations of alcohol in the blood from the same number of drinks.”

The finding also brings into question how compliant HIV-infected men who drink may be with their medication.

Justice added: “Once people have HIV, alcohol makes it less likely they will take their antiretroviral medications.”

The study was published April 17 in the journal AIDS and Behaviour.

Following the findings, researchers suggest HIV-infected patients should be better informed that they are more susceptible to the effects of drinking.
 

Alcohol price warning over violence


22nd April - Mail Online
 

Cheap alcohol in supermarkets is fuelling violence, and making booze more affordable now the economic downturn is over would be a mistake, experts have warned.

Releasing figures that show the number of people injured in serious violence dropped by 10% in 2014 compared to 2013, researchers said that more than 200,000 people going to emergency departments in England and Wales every year because of it is "still far too many".

As in other years, the bulk of the violence still being committed involves males between the ages of 18 and 30, mainly taking place in urban streets at night.

Researchers attributed the reduction to a combination of factors including an increase in CCTV leading to police intervening in fights more quickly; better sharing of anonomised data between A&E departments; police and local government; and people drinking less due to alcohol being more expensive and having less disposable income.

Lead author of the study and director of the Violence Research Group at Cardiff University, Professor Jonathan Shepherd, said a recent study of where people got their last drink before attending an alcohol treatment centre in Cardiff found that "strikingly", 70 people went there from their home within five months without going in a pub at all.

"I think what that highlights is that alcohol in the supermarkets is still far too cheap and we know that cheap alcohol increases consumption and then the harm that develops reflects consumption levels," he added.

Prof Shepherd said situational factors such as better street lighting and the use of plastic glasses in pubs also contributed to the reduction in violence - while he suggested people are increasingly possessing more self control.

"I think we are becoming a more empathetic society with a better connectivity with social media, etc," he added.

He said the reduction in violence involving males aged 18 to 30 represented the "greatest savings for society - for A&E departments who are hard pressed at the weekends".

"This is where we get the biggest benefit really, in terms of numbers," he added.

The study found an estimated 211,514 people attended Emergency Departments (EDs), Minor Injury Units (MIUs) and walk-in centres in England and Wales for treatment following violence in 2014 - 22,995 fewer than in 2013.

Recorded acts of violence against children showed an even greater fall of 18%.

Prof Shepherd said the figures related to children being hurt in the street or at school rather than as a result of domestic violence, which would be unlikely to see them attend A&E - although he suggested improved child safeguarding policies in the wake of the Baby P tragedy could have had some effect.

He also said better safeguarding and surveillance in schools and improved anti-bullying measures have made a difference, along with children being taken to school in cars more as it means they are spending less time out on the street.

"These substantial year-on-year decreases in serious violence are welcome news for citizens and communities across England and Wales," he said.

"Moreover, costs imposed on health services and the criminal justice system by violence have been substantially reduced along with burdens on stretched emergency departments.

"And yet it isn't all good news; our findings suggest that the issue of alcohol-related violence endures, with violence-related emergency department attendance consistently at its highest levels on weekends.

"As we emerge from the economic downturn we must ensure that the affordability of alcohol does not increase. Over 200,000 people across England and Wales going to emergency departments with injuries caused by violence are still far too many."

The data was gathered from a scientific sample of 117 EDs, MIUs and walk-in centres in England and Wales, all certified members of the National Violence Surveillance Network (NVSN), which has published an annual report for the past 15 years.

Apart from a 7% increase in 2008, there have been decreases in every year since 2001.

An NSPCC spokesman said: "The fall in children attending A&E due to violence-related injuries is encouraging and in line with a longer term decline in violence towards children causing injury or death.

"These improvements are most welcome and in stark contrast to other forms of abuse - such as neglect or emotional abuse - which do not appear to have declined in recent years.

"With research showing one in 20 children suffering sexual abuse and one in 14 children being physically abused, there's still a long way to go to ensure that children are protected from harm."
 

Alcohol bill to be published during summer, Varadkar says



April 23rd - Irish Times
 

The Public Health (Alcohol) Bill will be published this summer with a view to being made law by the end of the year, Minister for Health Leo Varadkar has said.

The bill will put in place minimum pricing for alcohol, and will regulate alcohol advertising and sponsorship targeted at young people, including a broadcast watershed.

However, the Public Health (Alcohol) Bill does not propose an outright ban on sports sponsorship by drinks companies, despite pledging to review the issue in three years time.

Fine Gael TD Michael Creed said that while the legislation was far reaching, the continuation of sports sponsorship by alcohol companies is its “Achilles heel”.

Independent TD Séamus Healy said it was time for the Government to “grasp the nettle” and put an end to the relationship between alcohol and sports sponsorship.

Alcohol legislation

Mr Varadkar said he expects the bill to be published before the Dáil summer recess.

“This legislation has been bandied around for 3-4 years and it wasn’t possible to get agreement on this. We’re in year four of the parliament and I want to get good stuff done,” Mr Varadkar told the Joint Oireachtas Committee on Health and Children.

Mr Varadkar said minimum unit pricing would be based on the number of grams of alcohol in a drink but no price had been agreed yet.

“It needs to be low enough so that it eliminates very cheap alcohol but not so high that it affects the price of a glass of wine in the pizzeria.

“The price of alcohol remains very affordable, particularly in supermarkets. A woman can reach her low risk drinking limit for €6.30 while a man can reach his limit for less than €10.”

Mr Varadkar said he would not consider raising excise duty on alcohol as it would make premium drinks more expensive and it would not target high volume drinkers.

Lower incomes

Sinn Féin spokesman for health Caoimhghín Ó Caoláin said minimum unit pricing is not “the panacea” and that it disproportionately targets those on lower incomes.

Mr Ó Caoláin said people who could afford more expensive alcohol were also a risk to themselves and others and that it isn’t just an issue for those on low incomes.

Mr Varadkar said there is a corollary between poverty and alcohol consumption: “People who are on low incomes are more likely to abuse alcohol. There is a correlation between social class and alcohol abuse. Those who are poorer are more likely to abuse alcohol. In many ways, alcohol perhaps contributes to poverty and poverty contributes to alcohol.

“The research does show those in low income groups spend more on alcohol and drink more heavily. It’s not an issue of visibility or that there’s large numbers of wealthy people secretly drinking expensive alcohol.”

Mr Varadkar said statistics for 2014 show pure alcohol consumption increased from 10.6 litres to 11 litres.

He said the figures were worrying because it indicated that economic recovery will see a rise in alcohol consumption.

 

Is There Such A Thing As A Decent Non-Alcoholic Beer?


April 23rd - Londonist
 

For many of us, a large part of our social life revolves around pubs and bars. Quite right too — they’re great. But does our appreciation of pubs and bars mean that we have to drink alcohol whenever we visit one? If someone fancies a night or two off the booze, does this condemn them to an evening of sipping uninspiring generic soft drinks? Or can a beer-fancier enjoy a night drinking beer without necessarily getting drunk?

To help answer these questions, we were invited to a tasting of no-alcohol and low-alcohol beers, hosted by Bethnal Green’s Mother Kelly’s bottle shop and bar, and organised by Club Soda — an organisation that provides help and resources for people who want to cut down or give up drinking. For our part, as beer obsessives, we were curious to discover whether beers with low (or very low) levels of alcohol could pass muster when compared to their boozier brethren.

The tasting took place around a long table in Mother Kelly’s tap room, a bright, high-ceilinged space under a railway arch on Paradise Row. A dozen or so tasters were guided through samples of 10 beers: five were classified as ‘no alcohol’ or ‘dealcoholised’ (0.5% ABV or less); five were ‘low or light alcohol’ (less than 3% ABV). The beers covered a wide variety of styles — from lagers to stouts, via pale ales, wheat beers and saisons — from brewers around the UK and Europe (and one from Texas), so there was much discussion and debate to be had around which styles were best suited to the reduction in alcohol.

And in terms of that discussion and debate, it soon became clear that many of the beers were going to divide opinion. We found that the less pedestrian beer styles tasted better than the more ubiquitous options in their reduced alcohol format, so we preferred the stouts (which actually tasted more like black IPAs) and farmhouse-style beers over the pale ales and lagers. In particular, Bad Seed Brewery’s Berliner Weisse worked well for those who were not put off by the decidedly cheesy aroma and tart finish, whereas the inevitable Beck’s Blue tasted as insipid as ever.

The tasting was led by Club Soda’s resident beer expert, Dani Neal, who had clearly done her homework in researching and choosing the beers, and was able to impart nuggets of information such as Erdinger’s Alkoholfrei, a 0.5% ABV weissbier that tasted more like a soft malt beverage than a beer, being marketed as an isotonic sports recovery drink. Strange, but apparently true. We don’t expect to see tables of dealcoholised beer along the route of the London Marathon this Sunday, but we approve of the principle.

Club Soda launched in January, aiming to provide people with an alternative to drinking alcohol on a night out. As well as events such as this beer tasting (they’re planning another one for June), they organise workshops and social meetups, and intend to work with bars and pubs to encourage them to provide a more appealing range of non-alcoholic drinks than the boring old coke, lemonade or lime-and-soda fallbacks. Founder Laura Willoughby told us that the club currently has about 2,500 registered members, so they’ve obviously struck a note.

So, what’s the verdict? Are no-alcohol or low-alcohol beers likely to tempt beer drinkers away from their usual beer choices?

Yes and no. Based on this tasting, we would say that beer-lovers who have no specific desire to avoid alcohol would be unlikely to see reduced alcohol beers as much of an alternative to normal strength beers, based on taste alone. (One possible exception was Drink’In The Sun, from Danish craft brewing pin-ups Mikkeller, whose 0.3% and 2.8% ABV beers fared very well with some of the tasters.) However for drinkers who want, or need, to reduce their intake of alcohol on a night out, some of these beers certainly could be a welcome alternative to soft drinks, or form part of a jolly decent shandy, and so could claim a well-deserved place in London’s pubs and bars.
 

Lincoln alcohol centre could close amid funding row



April 23rd - BBC
 

A "lifesaving" alcohol support centre could close six months after it opened.

Charity Framework, which runs the Corner House in Lincoln, said the county council was withdrawing funding.

But the authority said, while it gave money to start the project off, it had no responsibility to continue to fund it.

A user of the residential centre for people with chronic alcohol problems, including street drinkers, told the BBC it saved her life.

The Corner House opened in Friars Lane in November as a centre to treat people with long-term alcohol dependencies.

Residents are referred by partners, including the NHS, GPs, housing providers and the criminal justice system.

'Visible problem'

Framework services director, Lisa Del Buono, said there was an "implicit understanding" the council would continue to contribute to the service.

"These individuals aren't some cosy little client group who haven't had very many problems," she said.

"We are talking about the poster boys and poster girls for street sleeping, street drinking and anti-social behaviour, which is very prominent in Lincoln.

"This is a service which is making a very big difference for a perpetual problem, a very visible problem, on the streets of Lincoln."

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