Home > The inclusion of alcohol in a national substance misuse strategy.

Fanagan, Sarah (2006) The inclusion of alcohol in a national substance misuse strategy. Drugnet Ireland , Issue 19, Autumn 2006 , pp. 8-9.

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In July of this year (2006), an Oireachtas committee published a report which considered the question of whether or not alcohol should be included in a national substance misuse strategy.1 Having examined the issues, the committee was ‘unequivocally of the view that alcohol should be included in the drugs strategy.’

The committee made this recommendation following a review of the prevalence and range of alcohol-related problems currently experienced in Ireland; consideration of the political and administrative impediments to the implementation of an integrated, national alcohol policy to date; and having examined the possibility of extending the mandate of the National Drugs Strategy to include alcohol.

As the report explains, it is now widely acknowledged that alcohol-related problems extend beyond a single disease category (alcoholism) and include a range of social and health issues which may be either chronic and ongoing or acute and once-off in nature.  It is also necessary to consider the effects of alcohol-related problems on others (family members, friends, neighbours or work colleagues) and the financial burden on society as a whole when attempting to formulate a suitable policy response. 

The two reports from the Strategic Task Force on Alcohol, 2002 and 2004, have compiled very clear evidence to document the wide range of negative effects which alcohol consumption has on Irish society.  Over the past forty years, research carried out in the biomedical and social sciences has confirmed that the kinds of alcohol-related problems experienced in this country are a direct reflection of our national drinking habits and that the only effective solution is to use social measures aimed at changing these drinking habits. 

The committee reported a disparity between the preventative strategies for which there was popular support and those for which there was evidence of effectiveness.  The most popular strategies were education (of the general public and of school-going children); the provision of alternative (alcohol-free) recreational activities for young people; and the expansion of treatment systems for those with alcohol dependence.  Evaluation research indicates that these approaches have little or no positive effect. 

The strategies which are demonstrably effective in improving public health and public order include fiscal measures to increase the price of alcoholic beverages, restrictions on the numbers of retail outlets and days and hours of sale, tougher drink driving countermeasures, and bans or restrictions on alcohol advertising and promotion.  There are two main reasons why these strategies are perceived to be politically difficult.  Firstly, they are threatening to the drinks industry, an industry which contributes to the economic well-being of the country and has well-established links to Irish political life; and secondly, they may prove to be electorally unpopular since they are aimed at the drinking population in general (rather than at specific subgroups within this population). 

It is interesting to note that criticism of this report from the Drinks Industry Group of Ireland (DIGI) focused on the amount of alcohol being consumed per person and per adult (defined as 15 years and older) in Ireland between 2001 and 2005.  Since 2001 the amount of alcohol being consumed has fallen among these groups by 5.9% and 6.8% respectively.  The committee reported European figures from the 1990s and DIGI attributes the peak in consumption levels during this period to the large proportion of the population aged between 18 and 25 years.  The DIGI acknowledged that there are serious issues with the misuse of alcohol among sections of the population and that the industry was committed to addressing these problem areas.  However, it stated that ‘we do not believe it is necessary, fair or wise to demonise the majority of people who enjoy a drink responsibly, simply because of problems caused by a minority’.

In response, the chairperson of the committee, Cecilia Keaveney, stressed that it was not the intention of the report to demonise drink.  She said that ‘in some cases alcohol had beneficial effects, but rather than picking holes in data, the various interests should be working together to resolve the problem.’  Indeed, the committee noted that public support for alcohol control measures is growing, as evidenced in the recent attitudinal survey published by Alcohol Action Ireland (2006).

Researchers have long recognised that alcohol is an issue which cuts across many different sectors of government and that the different sectors do not necessarily operate from an agreed policy agenda.  For over thirty years the WHO has recommended that national governments should create management structures which facilitate the drafting and implementation of integrated, national alcohol policies based upon research findings. 

While the evidence-based strategies have been known in Ireland for more than twenty years and have been recommended in policy documents on several occasions, this has not led to ongoing implementation.  No permanent management structures have been established to give effect to such recommendations. 

The report shows how problems relating to illicit drugs, which have a much shorter history, are being managed through the National Drugs Strategy.  Reform of the Irish public sector under the Strategic Management Initiative (SMI) in the late 1990s, which aimed to improve the management of cross-cutting issues and create ‘joined-up government,’ provided the model for the National Drugs Strategy.  The structures set in place combine ‘top-down’ co-ordination with ‘bottom-up’ or community-level participation in the policy process.

These structures have facilitated the emergence of a policy process over the past ten years in which policy objectives are clearly stated; actions necessary for the realisation of objectives are identified; the agencies which have specific responsibility for working towards the attainment of the various objectives are identified; and key performance indicators and timeframes are established.  A detailed policy framework, Building on Experience: National Drugs Strategy 2001–2008, was published in 2001 following a national consultation process.  A mid-term review of this strategy was published in 2005.  While the mid-term review offered evidence of mixed outcomes regarding the implementation of the strategy, it provided evidence that the structures have succeeded in keeping all the major stakeholders (statutory and non-statutory) involved in an on-going process of working towards agreed objectives.  The committee argues that the National Drugs Strategy has brought consistency and coherence to the complex arena of Irish drug policy.

It is significant that during the public consultation process before Building on Experience was drafted, members of the public, particularly those outside Dublin, identified alcohol as their major source of concern.  The committee argues that this concern with alcohol issues and the accompanying sense of frustration that alcohol is not part of the National Drugs Strategy continue to be reflected in the work of the regional drugs task forces.  It concludes that the five-pillar model of the National Drugs Strategy (supply reduction, prevention, treatment, research, and rehabilitation) appears to offer an ideal framework for a comprehensive policy approach to alcohol issues.  

1.    Houses of the Oireachtas Joint Committee on Arts, Sport, Tourism, Community, Rural and Gaeltacht Affairs (2006) Ninth Report: The inclusion of alcohol in a national substance misuse strategy. Dublin: Stationery Office.

Item Type:Article
Issue Title:Issue 19, Autumn 2006
Date:July 2006
Page Range:pp. 8-9
Publisher:Health Research Board
Volume:Issue 19, Autumn 2006
EndNote:View
Accession Number:HRB (Available)
Subjects:VA Geographic area > Europe > Ireland
B Drugs and alcohol substances > Alcohol
MP-MR Policy, planning, economics, work and social services > Programme planning, implementation, and evaluation > Programme planning (strategy)
MP-MR Policy, planning, economics, work and social services > Policy > Policy on drugs and alcohol

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