Levels of drinking
Alcohol has major public health implications and the harmful use of alcohol is a causal factor in more than 200 disease and injury conditions, such as liver cirrhosis, heart disease and cancer, according to the World Health Organisation.
In 2020 in Ireland, drinkers consumed 10.07 litres per capita over the age of 15 of pure alcohol; this corresponds to just under 40 (700ml) bottles of vodka, 113 (750ml) bottles of wine, or 436 pints of beer.
This consumption level is 40% above the HSE low risk drinking guidelines.
It is not just how much people drink, but the way we drink in Ireland that causes harm. The 2019-20 Irish National Drug and Alcohol Survey found that 40% of drinkers engage in monthly Heavy Episodic Drinking (HED) and nearly a quarter engage in HED on a weekly basis while the prevalence of alcohol use disorder (AUD) in the general population was found to be 14.8%, corresponding to one in every seven or 578,000 adults in Ireland.
It is of note, though, that people do not have to have a dependency problem to be at risk from alcohol. In a recent research paper published in 2019, the HRB found that the majority of alcohol-related harms in the population are accounted for by low to moderate risk drinkers, particularly those who engage in occasions of HED.
These patterns of alcohol use mean that a majority of drinkers in Ireland consume alcohol in a manner that is risky to their health.
Published in 2021, the Health Research Board’s latest report on alcohol consumption and harm, Alcohol consumption, alcohol-related harm and alcohol policy in Ireland, starkly outlines how the continuing high level of alcohol consumption in Ireland is affecting the nation’s health and well-being.
As the HRB reports points out, the consequences of our drinking patterns are reflected in our mortality data, which show that, on average, there have been three alcohol-related deaths every day since 2008 and at least 40,000 alcohol-related hospital discharges each year. Some of these discharges relate to liver disease which is well known, however less well known is that many relate to illnesses such as cancer, cardiovascular disease, respiratory conditions, diabetes and epilepsy in addition to injuries arising from alcohol use. Not only that, the HRB data finds that the greatest burden of health harm is experienced by younger people; two in three people who die in Ireland of alcohol-related causes are aged under 65 years and a similar trend is observed for hospital discharges.
Other serious consequences of harmful alcohol use include:
- Alcohol is responsible for 88 deaths every month in Ireland. That’s over 1,000 deaths per year. Of the 1,094 alcohol-related deaths that occurred in 2017, 125 deaths (11.4%) were due to poisoning, 159 (14.5%) were due to traumatic causes, and 810 (74.0%) were due to medical causes.
- From 2008 to 2017, there were 2,173 deaths with a diagnosis of liver disease. One in three (33.4%) of these were females, while two in three (66.6%) were males. Almost half (45.3%) of deaths from liver disease were among those in the 50–64-year-old age group.
- In 2018, there were 12,588 recorded episodes of self-harm in Ireland. Alcohol-related self-harm presentations accounted for almost one-third (30%) of all cases
- Alcohol is a significant factor in road traffic collisions fatalities. Over a third of road user fatalities with a toxicology result available, killed between 2013-2017, on Irish roads had been drinking. These fatalities were typically male, and under the age of 45. Pedestrian fatalities had the highest proportion of fatalities (45.8%), followed by drivers (39%).
- In 2020, around 1000 people in Ireland were diagnosed with alcohol-related cancers and around 500 people die from these diseases every year; one in eight breast cancers are alcohol related.
Alcohol’s harm to others
Beyond the serious health consequences, the harmful use of alcohol brings significant social and economic losses to individuals and society at large in Ireland.
The burden of alcohol harm is often experienced by those around the drinker, such as children and other family members, co-workers or innocent bystanders. Although not often visible in public, alcohol’s harm to others within the family can have very serious consequences for the safety and well-being of family members, with children the most vulnerable. Life-long damage, through foetal development disorders, can also be caused to the unborn child by alcohol consumption during pregnancy.
Research shows that:
- Alcohol is a significant contributory factor in many cases of child neglect and parental drinking has been identified as a key child welfare issue.
- Alcohol is a factor in many assaults, including sexual assaults, rape and domestic violence, and manslaughter.
- Alcohol is a factor in the vast majority of public order offences.
- Every day, 1,500 beds in our overcrowded hospitals are occupied by people with alcohol-related problems.
- Alcohol-related discharges from hospital cost the tax-payer €1.5 billion in 2012, which is equal to €1 for every €10 spent on public health. This excludes the significant costs of emergency cases, GP visits, psychiatric admissions and alcohol treatment services.
Public Health Alcohol Act
In 2018, Ireland legislated for progressive public health reform measures to tackle alcohol harm.
The Public Health (Alcohol) Act (PHAA) sets out a range of measures to protect public health and lower alcohol consumption in Ireland. This legislation treats our ongoing problem with alcohol use as the serious public health problem it is for the first time and aims to ensure that alcohol is no longer treated as just another ordinary commodity or grocery, but is regulated effectively to reduce alcohol harm in Ireland and improve public health, safety and wellbeing. When fully implemented it aims to reduce alcohol consumption by 3% annually over a seven-year period.
As noted by the Health Research Board: “In order for it to have a real impact, the Public Health (Alcohol) Act needs to be implemented in full as soon as possible.”