Speech for Minister for Health and Children, Mr. Micheál Martin, T.D. at the launch of the Guidelines for the Management of Alcohol Problems in a General Hospital
I am very pleased to be here today to launch this new information sheet. As all of you here today are probably aware, the issue of the inappropriate use of alcohol is one which is becoming more and more serious. It is an issue which is becoming more urgent because the rate of alcohol consumption in Ireland is increasing at an alarming rate.
In the last decade, Irish Society has changed, many of us would say, dramatically. Many of these changes are positive ones. We would like to think of ourselves as more open, less restricted by repressive factors, like economic, religious, social and other traditional factors.
However, there can also be a reverse aspect to these changes. Greater financial freedom and less social control, for want of a better word, have created a climate where one sometimes get the feeling that anything goes.
This is probably no more true than in relation to alcohol. Ireland has seen many changes which have influenced the context and nature of drinking and increased alcohol related problems.
We in Ireland, today, are a more affluent society. Not just the, let us say, more mature people, but those starting out, and indeed those still at school have more disposable income. We hear of students working all weekend and spending their money on drinking and are then too tired and hung-over to put in a satisfactory performance in the classroom.
With this greater affluence has come greater alcohol consumption. We, in Ireland, have had the highest increases in alcohol consumption among EU countries. Between 1989 and 2001, alcohol consumption per capita in Ireland increased by 49%, while ten of the European Union Member States showed a decrease and three other countries showed a modest increase during the same period. In 2001, Ireland ranked second after Luxembourg for alcohol consumption with a rate of 11.4 litres of pure alcohol per capita. The EU average is approximately 9.1 per capita.
We all know the adverse effects of alcohol consumption. They extend beyond the physical health issues to mental, social, emotional and financial. The consequences of excessive alcohol consumption can affect everyone across the community.
We all know of the fights, the accidents, the failure to turn up for work, the financial difficulties, the cancers, the liver problems, the general deterioration which eventually and inevitably impacts on the individual and his or her world.
And yet though we are all fully au fait with the problems which exist because of alcohol abuse, we all are in collusion with the perpetuation of the problem. I feel that in the last year in particular, there has been the beginning of a realisation that we have, in relation to alcohol, a culture of acceptance.
We often excuse the friend or colleague for unacceptable behaviour with “sure he had a few too many”. We often give an amused and tolerant smile if someone we know behaves inappropriately when they have had too much to drink.
Maybe this amused tolerance is prompted by embarrassment or an inability to deal effectively with the issue. I don´t know -but I do know that by not addressing the issue we collude in the status quo in relation to alcohol misuse.
I often hear that it is the forty plus age group who will take a couple of drinks and drive. The younger age groups will appoint a designated driver who is bound not to drink for the night. It has become socially unacceptable, among younger age groups at least, to drink and drive.
It has to become socially unacceptable to be drunk and disorderly, drunk and rude, drunk and disrespectful of someone or their property. We must remember not to excuse, and that it is not an excuse, for someone to be drunk.
Apart from the personal cost to the individual and his family there are also huge costs involved for Irish society in general. Alcohol related problems are estimated to cost Irish society€2.4 billion per year arising from healthcare costs, road accidents, alcohol related crime and lost productivity.
Because of the seriousness of the problem I established a Strategic Task Force on Alcohol early in 2001, whose remit was to provide advice to Government and public bodies on measures to prevent and reduce alcohol harm.
The Interim Report of the Task Force was published in May last year and provides a series of recommendations aimed at tackling alcohol related problems. I brought a memorandum based on these recommendations to Government a few weeks ago and the Government has agreed the decision sought in the memorandum. My Department will now work with other Government Departments and Agencies to progress the recommendations contained in the Interim Report of the Strategic Task Force on Alcohol and to establish an Inter-Departmental group to co-ordinate their responses to the Task Force recommendations.
I am particularly glad to see initiatives such as I one being launched today however. You are all probably familiar with the National Health Promotion Strategy 2000 – 2005. In that document it was stated that “there is clearly a need for greater inter-sectoral and multi-disciplinary approaches to address the impact which social, economic and environmental factors have on the physical, mental and social well-being of individuals and communities.” While we can address individual topics such as alcohol, we need this approach to target the topics effectively.
That is why the settings approach has become increasingly important in the area of health Promotion. This approach means combining healthy policies in a healthy environment with complementary education programmes and initiatives. Settings include schools, the youth sector, the workplace and communities. There are initiatives ongoing in many of these settings which are very necessary in educating communities and helping them to implement healthy lifestyle options.
For example, the development of the national curriculum in health education (Social, Personal and Health Education), the promotion of school policies on alcohol and drugs, the greater involvement of parents and communities under the health promoting schools concept ensures a comprehensive and effective long term approach in education.
In response to a growing concern about alcohol promotion practices on campus, high risk drinking among students and its impact on student academic achievement and student attrition, the Health Promotion Unit of my Department devised A framework for the development of a college alcohol policy in association with the Heads of Colleges and USI. The framework provides guidelines for a comprehensive approach which include measures on controlling promotion, sponsorship and marketing. The aim of the guidelines is to limit harm in the drinking environment, increase awareness and education, encourage alternatives and choices and provide campus support services. Each third level institution can adopt the guidelines to reflect the needs and aspirations of their own campus environment.
The Health Service is also identified as one of these strategic settings and is ideally placed to promote health in partnership with other sectors of the community. The challenge in this setting is to find a balance between health promotion, disease prevention and illness treatment.
For this reason, I must congratulate Dr Sheehan on his work. His pilot project – Alcohol and Injuries Study conducted in association with Mr Eamon Brazil, which I am pleased to have been able to support has been invaluable in raising awareness of this issue of alcohol abuse. This project has now been expanded nationwide and the results I believe will be available in about a year. The study will, I´m sure provide invaluable information on the nature and pattern of alcohol injuries and the context in which the drinking has taken place. In addition it will help further inform policy in this area.
Research over the past few years conducted at the Mater Misericordiae Hospital has shown that 30% of male admissions, 10% of female admissions and almost 25% of A & E attendances met diagnostic criteria for Alcohol Misuse or Dependency. This placed the attending doctor in a unique and crucial position to intervene. Dr Sheehan recognized this and has produced these guidelines contained on a simple information sheet. Although people were treated for their presenting problem, many patients´ alcohol problems were not detected and hence went untreated. These Guidelines will help to increase awareness of alcohol problems, improve detection and provide straightforward instructions on how to manage alcohol problems in a general hospital setting.
Tackling alcohol abuse in society involves many players and involves national, regional, local and individual approaches and initiatives. Dr Sheahan has certainly played his part in tackling this issue and I must thank, and congratulate him once again for the development of these Guidelines. It is an example of a very focused, practical, pro-active and apt initiative which I am sure will bear real, worthwhile results.
In conclusion, I would like to thank Dr Sheehan for inviting me to launch this important project. I look forward to hearing the results of your research and I wish you every success in the future.