Director of Public Health Annual Report 2019: Alcohol and us
Who is drinking alcohol?
Current alcohol consumption
How we drink and consequently the amount of harm that alcohol causes in our society changes all the time. Drinking patterns in England have changed over the last 50 years. Fifty years ago, adults in the UK drank an average of 7.4 litres of pure alcohol every year. By 2004, this had risen to 11.6 litres, and currently stands at 11.4 litres.
Thirty years ago, most of the alcohol consumed in the UK was drunk as beer – and it was drunk in the pub, mostly by men. The proportion of alcohol consumed as wine has increased and much of what we buy is drunk in the home.
This increase was driven by increased alcohol consumption by women, a move to higher strength products and increasing affordability of alcohol. In 2017 alcohol was 64% more affordable than it was in 1980.
Drinking patterns in the population vary by age, gender, income and occupation. Much of the data on how much people drink is self-reported and prone to under reporting.
82% of adults in England drank alcohol in the last 12 months in 2014. 85% of men and 79% of women reported drinking alcohol and 15.5% of all adults do not drink alcohol at all.
In Buckinghamshire, it is estimated that 9.2% of adults (37,982) do not drink alcohol, which is lower than the England figure.
In Buckinghamshire, according to the latest figures published by Public Health England, 28.6% of adults aged 18 and older drink over the recommended limit of 14 units of alcohol in a week, which amounts to 118,073 people (2011-2014), which is slightly higher than the England average of 25.7% but not statistically significantly different.
Nationally, in recent year, self-reported alcohol consumption has declined and the proportion of people not drinking alcohol at all has increased.
Age and gender
Surveys of children aged 11 to 15 years also show a steady decrease in drinking among this group in recent years. In 2016, 44% of pupils aged 11 to 15 years said they had ever had a drink, compared with 61% of pupils of same age 2003. Older pupils were more likely to have consumed alcohol - 15% of 11 year olds compared to 73% of 15 year olds had ever had a drink.
Twenty years ago, much of the most harmful alcohol drinking was thought to be among younger drinkers. However, since that time, drinking among young people has fallen considerably.
Young people aged 16 to 24 years in Great Britain are less likely to drink than any other age group but when they do drink, consumption on their heaviest drinking day tends to be higher than other ages. In England between 2005 and 2017, never drinking alcohol increased for those aged 16 to 44 years and decreased for those aged 65 and over.
Higher risk drinking (i.e. drinking more than 14 units of alcohol per week) is higher in older age groups in England from 55-64 and 65-74 years for women and men respectively.
More women are drinking now than in the past, which is resulting in a greater number of women experiencing alcohol-related health problems. However, men still consume more alcohol than women in England. Men are twice as likely to drink over 14 units a week as women and also more likely to binge drink.
The NHS Health Check is available for people aged 40 to 74 without a pre-existing condition. As part of the check, people are asked questions about their drinking. In Buckinghamshire, the NHS Health Check found that 24% of patients in this age group who reported they drink alcohol and completed an AUDIT C questionnaire are drinking too much.
Income and employment status
The proportion of people who report drinking alcohol in the last week increases with increasing income levels. Amongst people who earn over £40,000 per year, 79% report they drank alcohol in the last week compared to 47% of those who earn up to £9,999 per year.
Drinking habits also vary by occupation, approximately 7 in 10 people (69.5%) in England, who said they worked in managerial and professional occupations, drank alcohol in the week before interview, compared to 1 in 2 (51.2%) people working in routine and manual occupations.
The Health Survey for England looked at those drinking over the recommended 14 units and divided them into increased risk (14-35 units for women a week and 14-50 units a week for men) and higher risk drinking (35+units for women and 50+ units a week for men).
The proportion of adults usually drinking at increased or higher risk of harm was highest in higher income households for both men and women, with 35% of men and 19% of women drinking at this level.
In the lowest income households, 20% of men and 12% of women drink at increased or higher risk of harm. When looking just at higher risk, there were no differences by income.
Percentage of those over 16 years old drinking at an increased of higher risk of harm (Health Survey for England,2017)
How life events can trigger harmful drinking – one resident’s story
A resident of Buckinghamshire who has recently used the local One Recovery Bucks alcohol services provides his story. He discusses how redundancy impacted his drinking and the result on his wellbeing and his family.
Boredom and opportunity were my undoing – redundant in my early fifties, home alone a lot of the time and my enjoyment of alcohol were a pretty lethal combination.
We all know about the effects of occasionally drinking too much – the hangovers, the sickness and the dreaded next day haze of ‘did I really say or do that?’ What I didn’t know, and did nothing about because I wasn’t strong willed enough, was the effects that kick in once you’ve really started to hit the bottle.
It started with severe memory loss and mood swings. My mobility deteriorated to the point that I was walking with a stick and then there was the utter lack of sleep, loss of appetite, liver damage and the shakes. And depression too, although whether I was drinking because I was depressed or depressed because of my drinking I’m not quite sure.
I was so hooked that I ignored the signs that things were getting serious until I collapsed four or five times. The final collapse was the worst – I ended up in the middle of the night on the kitchen floor and simply couldn’t move. My wife and son were away and found me in the early evening. By the time the ambulance came I had been on the floor for 24 hours.
Although I wasn’t overly lucid, I realised that there was a simple choice – carry on (and no doubt drink myself to death and before that lose my family) or get better. The doctor who saw me in hospital took the time to understand my situation and she offered me immediate access to a detox programme – she offered me a lifeline.
Although all this happened only a few months ago, my life is transformed and I had forgotten how good life could be. Simple things like eating, sleeping and mobility are all back to normal. My energy levels are back again, the shakes have gone and my liver has regenerated. I do voluntary work in a charity shop and have a part time paid job, both of which I really enjoy and have given me back my lost sense of purpose. Now I do things because I want to, not to stop me being tempted to have a drink.
Is it easy? No, it’s not, but do I want to go back to drinking like I was? Definitely not. Might I have a lapse or a relapse? Maybe I will but I’ve got plenty of positives and supports in my life that I hope will help me to prevent this happening. My family, my GP and the hospital staff have all been amazing and they really are there to help. Last, but very definitely not least, One Recovery have been fantastic.