Alcohol-related deaths are higher in Scotland than in England and Wales where death rates are high by international standards. Although there has been a downward trend in deaths since the mid-2000s this may now have levelled off. As well as the number of deaths, alcohol causes or exacerbates many health conditions and has implications for families of drinkers, the justice system and society in general. The cost of alcohol misuse in 2007 was estimated to be £2.25 billion5. In 2009, the Scottish Government issued a new alcohol strategy, ‘Framework for Action’, which set out policies to reduce both alcohol consumption and the associated harms.

The impact of the 2009 strategy has now been evaluated7 and work is underway to refresh the strategy. Scottish Health Action on Alcohol Problems (SHAAP) was commissioned by the Scottish Government in December 2017 to lead work to enhance understanding of the circumstances of and contributory factors to alcohol-related deaths (ARD) to inform recommendations for evidence-based services that will support prevention, early intervention, treatment and recovery from alcohol-related problems. This document reports the results of that exercise.