On 1 November the Alcohol and Drug Research Unit of the Health Research Board published Overview 6, Health-related consequences of problem alcohol use.¹ The purpose of this Overview was to compile and analyse the available data on problem alcohol use in Ireland and its health-related consequences.  It is hoped that this will help determine what approaches are likely to be effective in reducing alcohol-related harm, and identify gaps in current knowledge so as to inform future research needs in this area. 

Ireland has one of the highest levels of alcohol consumption in the European Union.  In 2006, the average rate of consumption of pure alcohol per adult (aged 15 years or over) was 13.36 litres.  This compares to a rate of 11.38 litres in 1995 and represents an increase of 17%.  Alcohol consumption increased steadily between 1995 and 2001, when it peaked at 14.3 litres per person.  The first notable decrease occurred in 2003, when consumption decreased by 6%, which is widely attributed to the increase in excise duty on spirits in the 2002 budget.  Since 2003, the level of alcohol consumption has remained static.

As well as being among the highest alcohol consumers in Europe, people in Ireland engage in drinking patterns that are excessive and problematic, with heavy and binge drinking now the norm for a substantial number of people.  A number of population studies have confirmed this, both in adults and in young people.

In order to study alcohol-related harm in Ireland, data from the Hospital In-Patient Enquiry (HIPE) scheme, maintained by the Economic and Social Research Institute (ESRI), and from the General Mortality Register (GMR), maintained by the Central Statistics Office (CSO), were analysed for the years 1995–2004.  Alcohol treatment in Ireland was analysed using data from the National Drug Treatment Reporting System (NDTRS) and the National Psychiatric In-Patient Reporting System (NPIRS), both of which are maintained by the Health Research Board.

According to the HIPE data, there were 139,962 alcohol-related discharges n the 10 years between 1995 and 2004. Annual figures rose from 9,254 in 2005 to 17,378 in 2004.  People with alcohol-related illness used 117,373 bed days in hospitals in 2004, accounting for 2.9% of all bed days that year, compared to 55,805 bed days in 1995.

Men accounted for 75% of the cases discharged from hospital and women accounted for 25%. Discharges peaked in the 50–59 age range.  Over 26,000 discharges were aged 30 or under. Four out of five of this group had acute problems, but over 5,000 had chronic conditions or alcohol-related liver disease. This is extremely worrying, given that it takes a number of years of hazardous drinking to develop chronic conditions.

The results also highlight some serious implications for women’s health. The age profile of the women discharged from hospital was much lower than that of the men. While women accounted for just 25% of all discharges in the 10-year period, in 2004 they accounted for 47% of discharges under the age of 18.  This is not surprising as a number of studies have indicated that alcohol consumption has increased substantially among young girls since 1995.  If alcohol consumption among young Irish women continues to follow current trends, it is likely that the number of middle-aged women experiencing alcohol-related morbidity will increase in the future.

A total of 1,775 people died from alcohol-related causes between 1995 and 2004, with men twice as likely to die from an alcohol-related cause. A total of 68% of these deaths were in people aged 60 or under.  To put this in perspective, only 21% of deaths in the general population in this period were under 65 years of age, highlighting the increased risk of premature death associated with alcohol use.

During 2005, 5,527 people received treatment for problem alcohol use, according to the NDTRS, and 2,995 people were admitted to psychiatric units for alcohol-related illness, according to the NPIRS. Data from the NDTRS reveal that 2,827 people entered treatment for the first time in 2005. However, as coverage for alcohol treatment agencies is still incomplete, it can be reliably assumed that the number presenting for treatment is actually much higher.  Treatment figures also show that one in five people receiving treatment for alcohol are using at least one other drug. This is increasingly common among young people, with 8% of people treated for use of more than one drug aged 17 or under, compared to 1.6% of the same group treated for alcohol only.

This Overview emphasises the need to reduce alcohol consumption in Ireland. There is a clear link between levels of consumption and alcohol-related harm. For example, the two years of highest consumption – 2001 and 2002 – coincide with the highest numbers of deaths and discharges; and in 2003, the first decrease (of 6%) in consumption also coincides with the first decrease (of 2%) in alcohol-related discharges.  International evidence supports alcohol taxation, regulating the physical availability of alcohol and drink-driving countermeasures as effective strategies for reducing alcohol consumption and related harm.  This Overview also highlights the need for accurate and complete data on those receiving treatment as well as greater integration of alcohol and drug services, given the high level of polydrug use.  There is also a need to identify those with hazardous drinking patterns in a variety of settings before they begin to experience alcohol-related harm.  (Deirdre Mongan)

1. Mongan D, Reynolds S, Fanagan S and Long J (2007) Health-related consequences of problem alcohol use. Overview 6. Dublin: Health Research Board.