Home > Seanad Eireann debate. Alcohol consumption: statements.

[Oireachtas] Seanad Eireann debate. Alcohol consumption: statements. (17 Oct 2012)

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Acting Chairman (Senator Pat O'Neill): I welcome the Minister of State at the Department of Health, Deputy Alex White. 


Minister of State at the Department of Health (Deputy Alex White): I am pleased to be back in the Seanad and welcome this opportunity to discuss the difficult and challenging issue of alcohol misuse in our country. The national substance misuse strategy steering group identified the following four key harms of alcohol. First, 88 people died every month in 2008 from alcohol. Second, in 2007 the total estimated cost of alcohol misuse to the health care and justice systems, the economy and from alcohol-related road accidents was €3.4 billion. Third, alcohol is a contributory factor in half of all suicides, which means it was a contributory factor in the suicides of 245 people in 2010. Fourth, the group noted that alcohol was consumed in four in every ten episodes of self-harm in Ireland in 2010 and was a factor in 4,764 episodes of deliberate self-harm in 2011.


[Deputy Alex White: ] In addition, the 2011 Annual Report of the National Registry of Deliberate Self Harm Ireland declared the following: "In line with previous years, misuse or abuse of alcohol is one of the factors associated with the higher rate of self-harm presentations on Sundays, Mondays and public holidays around the hours of midnight."

I am sure that these kinds of figures on deaths, self-harm and monetary costs register with every Member of this House and make us wonder about the reason we are letting alcohol do that and the reason our legal regime governing the direct and indirect sale of alcohol - in the form of advertising - is a factor in all of this harm. If those four harms were not enough there is another series of problems that alcohol is causing according to the National Substance Misuse Strategy Steering Group. One in four deaths in young men was estimated to be due to alcohol; alcohol increases the risk of more than 60 medical conditions, including many cancers; it is associated with 2,000 beds being occupied every night in Irish acute hospitals; it is associated with a quarter of injuries presenting to emergency departments; it is estimated to be associated with 16% of child abuse cases; it has been reported that alcohol was a trigger in one third of domestic abuse cases in 2005; and it is associated with harms to infants as a result of mothers drinking during pregnancy, and a range of disorders known as foetal alcohol spectrum disorders are caused by mothers drinking alcohol in pregnancy. This series of harm patterns for alcohol would therefore seem to represent an insurmountable wall of harm, as it were, for a huge number of Irish people.
We cannot deny that alcohol is associated with many aspects of our social and cultural life; that is self-evident. It is part of our custom for sociability, relaxation and enjoyment. The pub often plays an important role in community life and it is also an attraction for tourists. The paradox of alcohol, however, is that its consumption for pleasure and hospitality, along with its economic benefits, is overshadowed by the harm and health problems it causes when it is misused or consumed in a harmful and hazardous way.
Worryingly, Irish adults binge drink more than any other European country; 25% of Irish adults have reported that they binge drink every week. Irish children are also drinking from a younger age, and drinking more than ever before. Over half of Irish 16 year old children have been drunk, and one in five is a weekly drinker according to studies that have been prepared. Ultimately, 1.5 million Irish adults drink in a harmful pattern according to the steering group.
Senators will be aware that there has been a proliferation of outlets and stores that sell alcohol, and not just in urban areas. Supermarkets, convenience stores and petrol stations now sell alcohol. I suggest it is not unreasonable to link elevated levels of alcohol consumption by the Irish population with this proliferation of availability. We must do something about that because if we do not, we risk ignoring the body of evidence that is plain for all to see.
The normalisation of alcohol in Irish society has been achieved partly at least by the manner in which it is promoted through various media. It is almost as if alcohol has become a basic everyday grocery product to be purchased with everyday consumables such as bread, milk and butter. On the contrary, alcohol is no ordinary commodity, to borrow the title of the World Health Organisation-sponsored study by Babor and others some years ago. It has major public health implications, and the State has a responsibility to preserve and protect public health and the general well-being of society. Furthermore, alcohol is a psychoactive substance that can impair motor skills and judgment, and its effects on the individual can occur at various points across a spectrum. It is a drug of dependence and can act as a gateway to the use of illicit drugs for some people.
It is imperative that we reduce the overall level of alcohol consumed in our society and tackle the problems of alcohol misuse. As Senators are aware, the report of the National Substance Misuse Strategy Steering Group was published last February. The steering group's objective was to set out an evidence-based framework which identifies effective policies and actions to tackle the harm caused to individuals and society by alcohol use and misuse.
The report made a range of recommendations that focused on key issues in the area of the misuse of alcohol. These issues include the supply, pricing, availability and marketing of alcohol along with preventive strategies including treatment, rehabilitation, alcohol and substance dependency research and information.
Some of the key recommendations within the report include the following - increase the price of alcohol so that it becomes less affordable; introduce a legislative basis for minimum pricing, along with a social responsibility levy on the drinks industry; commence section 9 of the Intoxicating Liquor Act 2008, which deals with structural separation of alcohol from other products in supermarkets and other outlets; introduce legislation and statutory codes to provide for a 9 p.m. watershed for alcohol advertising on television and radio; there could not be that type of advertising prior to 9 p.m.; alcohol advertising in cinemas to be associated with films classified as being suitable for those over 18 only; prohibition of all outdoor advertising of alcohol; all alcohol advertising in the print media to be subject to stringent codes, enshrined in legislation and independently monitored; phase out drinks industry sponsorship of sport and other large public events by 2016; develop a system to monitor the enforcement of the provisions of intoxicating liquor legislation; establish a clinical directorate to develop the clinical and organisational governance framework in order to underpin treatment and rehabilitation services; and develop early intervention guidelines for alcohol and substance use across all relevant sectors of the health and social care system. This will include a national screening and brief intervention protocol for early identification of problem alcohol use.
As stated earlier, the steering group noted that children are drinking sooner and drinking more than ever before. The group was wholly cognisant of children when framing its recommendations, as Senators will see from the document. These recommendations are generic and apply to all cohorts of the population, including children.
Members will see from the recommendations that there was a strong public health dimension to the steering group's work in dealing with alcohol misuse. Our agenda now is to protect and improve the health of Irish people on foot of the recommendations that have been made. The steering group's report was stark as to public health and protection given that it reported that potentially 1.5 million people in Ireland are drinking in a harmful way.
The burden of alcohol on our society and systems is overwhelming. This is an evidence-based statement based on what the National Substance Misuse Strategy Steering Group found and reported. These problems are patently obvious - the burden of hazards and pain that alcohol misuse causes; the trauma it is responsible for; the waste it provokes in the case of lost economic output, absenteeism and more; the adverse effects it has on families and children as a result of a family member misusing alcohol. It has been estimated that adult alcohol problems are associated with 16% of child abuse and neglect cases, and alcohol has been found to be a trigger in one third of domestic abuse cases.
The steering group covered issues pertinent to children and families where it addressed the treatment and rehabilitation of people due to the misuse of alcohol. These include addressing gaps in child and adolescent service provision, and developing multi-disciplinary child and adolescent teams, along with developing an approach to addressing the needs of children and families experiencing alcohol dependency problems.
The extent of alcohol misuse warrants strong and effective policies that can address this pervasive threat to Irish public health. One such policy recommended by the steering group is a regime of minimum pricing. Minimum pricing is ultimately a mechanism of imposing a statutory floor in price levels for alcohol products that must be legally observed by retailers. The primary function of this measure is to reduce at risk levels of alcohol consumption, especially by those who drink in a harmful and hazardous way.
[Deputy Alex White: ] It also would have a greater impact on discouraging children to drink. In turn, this could then diminish the effect the misuse of alcohol and over-consumption would have on a range of social areas, including public services, crimes and public health, together of course with productivity in the economy. One cannot be ambivalent when it comes to the pattern of alcohol consumption and the harms for which alcohol is responsible. Ambivalence on alcohol is now inexcusable and the report of the steering group has made sure of that. The national substance misuse strategy points the way for the future direction of policy to deal with the use and misuse of alcohol. There are challenges with some of these recommendations and this is both clear and perhaps inevitable. Nonetheless, my Department is preparing a concrete set of proposals on the basis of the national substance misuse strategy report to which I have alluded. The intention is to submit these proposals to the Government for consideration and approval as soon as possible.
Senator Labhrás Ó Murchú: I welcome the Minister of State to the House and wish him well in his new office. This is not the first time Members of this House have had a debate on the misuse of alcohol. In fact, such a debate has been held in virtually all the years I have been a Member. Over those years, it was usually a knee-jerk reaction to some incident or report after which it seems to have been left at that. I wonder whether any other Parliament in the world also is discussing the misuse of alcohol. I doubt it and therefore there are two questions to be asked. Is it the case that they do not have misuse of alcohol or is it because we are more concerned here to try to do something about the effects of the misuse of alcohol? At the outset, I compliment the Minister of State because this was an absolute breath of fresh air. On previous occasions when Members debated the misuse of alcohol, the contributions made in this Chamber contained too many "ifs" and "buts". Even though everyone on the street knew the truth, Members kept adding riders to their points for various reasons. Perhaps they were looking over their shoulders at the drinks industry or perhaps they did so out of a fear they might offend people who simply have a social drink every day. However, this report is an absolute wake-up call. I will not reiterate the statistics, which are all readily available but it is not simply a matter of drinking to excess. All the other issues that arise therefrom, including suicides, deaths and child abuse are connected. Members are aware that whenever the issue of drugs has been discussed in this House in the past, they get very excited about it and rightly so. They work on legislation and seek more severe action to ensure there will be a clampdown. However, alcohol is every bit as much a drug and the statistics leave no doubt but there is widespread harm and damage being inflicted.
This morning, Members discussed the issue of St. Patrick's Institution on the Order of Business. The point again was made, not simply about alcohol, that many of the young people concerned have been damaged by the misuse of alcohol. For every issue of concern raised in this House, in some way there is a connection back to alcohol itself. The sad thing is Members are in a position to control the alcohol issue much more easily than is the case with the illegal sale of drugs because an industry exists in respect of the former and it should be possible to interact with that industry. I do not mean merely with a cosmetic exercise. We do not even have a health warning in respect of alcohol in the same way as we do in respect of smoking. There is a certain similarity in that when restrictions were introduced on smoking in public places, there was an outcry but it only lasted a short time. This was because when the debate took place, it became quite evident that cigarette and tobacco smoking was injurious to health. Once that message got across, people were prepared to accept highly restrictive measures in respect of smoking. People do not question it any more and it now is the norm in their lives. However, if one looks back a few years, it seemed like an immense hurdle to overcome at that time.
At present, drink is freely advertised on television and no matter what one might say, it is not done in a subtle manner. I note that half of 16-year-olds have admitted to being drunk at some point, which is a frightening statistic. However, if they are looking at television and the consumption of alcohol is associated with manliness, having a good time or whatever else in some way, the young mind undoubtedly will absorb a certain amount of that. For instance, I always have been disappointed after games in which a team won a cup that the first thing done was to fill the cup with alcohol and to pass it around to young people. Hopefully, in years to come when this is corrected, we will look back with horror on the fact we allowed this to happen with young people in local communities and that no one shouted, "Stop". Where does most of the action take place in the television programmes "Fair City" and "Coronation Street"? In the pub. It must be influencing the viewer when one sees famous actors and actresses on television and sees that drink is part of their lifestyle. Moreover, this is going out as a message. One can also look back to the time when the cigarette was in fashion. When one was being trained in drama groups, the big difficulty one had as an actor was what to do with one's hands on the stage. The prop that people generally were given was a cigarette. Even if one looks back at the films of those days, with professional actors and actresses such as Humphrey Bogart or whoever else, one may observe how often a cigarette was used. This is no longer the case and it gradually is being phased out. There must be some way to do something similar. I do not blame RTE, the BBC or anyone else as this is the culture that exists at present. This is the reason I call this a breath of fresh air. Members can promulgate this message strongly to the public in respect of the statistics they have not quantified but which they knew were there. For instance, they could suggest to RTE, in respect of "Fair City", that it would be wonderful for the station to take the first opportunity in that particular industry to ask whether it would be possible to phase out that type of glamorisation of drink. This would be absolutely vital.
As I noted, Members have had this debate several times previously but each time I see antisocial behaviour on the streets, I do not get angry towards the young people concerned. Instead, I feel absolutely sad and sorry for them because they never had the opportunity of developing in the way young people did years ago. What is happening is that before they are even sufficiently responsible to know what drink is doing, they become absolutely immersed. I acknowledge it may be peer pressure as well. I note 16-year-olds are mentioned and refer to a survey conducted five or six years ago that children of 13 years of age were not necessarily becoming drunk but were imbibing hard spirits. Therefore, is it any wonder that later on in life, they find themselves in difficulties and troubles? Incidentally, Members should not be criticising the young people but should be criticising themselves, as they had the opportunity to legislate, to put pressure on the drinks industry and to ban advertising. The big question in respect of this document, the statistics and the report of the steering group will be whether Members have the sense of responsibility to act on it. If they do, it will be the greatest contribution they will have made, particularly to young people and to families in which there is abuse and in respect of depression and suicide because that is what this is all about. It all is embraced within that and as far as that is concerned, I can only say, "Well done" to the Minister of State. I hope Members stick by it and have the courage to follow it to a successful conclusion..... 

[For the rest of the debate, click here]

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