By Dr James Nicholls, Director of Research and Policy Development, Alcohol Concern / Alcohol Research UK

Download the briefing paper.

You’ve probably heard of ‘six degrees of separation’: the idea that if you take everyone you know, and everyone they know and so on, after just six levels you have a connection to anyone in the world. But how many levels would it be before reaching someone with an alcohol problem? One, maybe two? 

Alcohol problems don’t exist ‘over there’; they are all around us, affecting people we know, love, care for, and admire. They can arise for a whole range of complex reasons, most of which we probably don’t fully understand. People with alcohol problems need support.

As it stands, around 600,000 people in England alone need specialist alcohol treatment, but less than 20% of them are currently getting it. Without support, it’s not only those individuals who suffer: there are 200,000 children living with a dependent parent or carer. Partners, parents, siblings and friends need support too.

And things are getting worse. The number of new people presenting for alcohol treatment has fallen by 19% in the last five years alone, while the numbers dying from alcohol-related conditions such as liver disease continue to rise. This problem is intensified by the enormous cuts in treatment budgets across the country. Slashing funding doesn’t cut the number of people who need help; it just increases the number left without support.

Cutting funding for treatment is also the worst kind of false economy. Alcohol is a factor in 7% of all hospital admissions in England, and it  costs the NHS £3.5 around billion per year. Catching people early reduces heath care costs at a time when the NHS is creaking under cuts of its own.

Take, for example, people with very complex needs. This relatively small proportion of dependent drinkers may also have mental health issues, other substance use problems, and they may be homeless. They rarely receive much political interest – exclusion can be a vicious circle. Aside from the moral imperative to help people with serious, ongoing needs, this group – without specialist support – are much more likely to attend A&E, be admitted to hospital, require an ambulance call-out, or face arrest than the general population. It is estimated that just the 9% of dependent drinkers with the greatest needs are linked to 59% of all alcohol-related hospital admissions.

Supporting these individuals often requires an intensive approach, where service providers actively reach out to engage them with services. This comes at a cost, but the savings are enormous in terms of reduced attendances at A&E, hospital visits, ambulance call-outs and more. Estimates show that every £1 spent on this kind of support could lead to savings of up to £3.42.

So alcohol treatment, properly funded, is critical to saving the NHS money. But where is the money to come from? All public services are struggling and alcohol often seems to languish near the bottom of the list of political priorities.

To address that problem, we have today published a briefing paper calling for a 1% increase in alcohol duties, ring-fenced to support better funding for treatment services. This would generate around £100 million each year, potentially increasing treatment budgets by over 50%.

Of course, this would add a small amount to the cost of alcohol – which raises an obvious question: why should all drinkers pay a little more to support those with problems?

Most people drink moderately, or not at all; but very many don’t - or can’t. Our favourite drug can also be a source of devastation. The money that heavy and dependent drinkers generate through the alcohol they buy is an absolute fortune – around £8 billion each year from just the 4% of heaviest drinkers, or 23% of alcohol industry revenue – but only a fraction of this figure is spent on helping them to turn their lives around. Creating a clear link between tax and treatment makes sense.

Alcohol duties are now lower than they were in 2012; 2% for wine, 8% for cider and spirits, and 16% for beer. Under this proposal, the cost of the average beer would increase by 3p per pint, and a bottle of wine by 5p per bottle. Were duties raised a little higher – the Alcohol Health Alliance suggests 2% – the increase in price would still be small.  An extra £100 million, however, would help save many lives.

Alcohol treatment funding needs urgent change. The financial and human cost of inaction is huge.  We are calling on the Government to adopt this common-sense proposal to ensure that those who are hit hardest by alcohol – individuals, families and communities – can get the help they need.

For all references in this blog, please see the briefing paper

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