Topic: Minimum price plan to end cheap alcohol sales

[Andy @ Allerton!]

And you seem obsessed with missing the point each and every time, and just want to portray me as someone who has a sip of alcohol and is intoxicated. Way to have an argument buddy, deliberately twist what the other is saying and then ignore their point and pretend they've said something else. Bet you are the whizz of your school's debating team.

We shall try once again.

Some people - as in a percentage and not all (thought that was self evident but obviously not) of those going out to drink and enjoy themselves

drink themselves insensible - as in they drink too much, which is clearly more than a 'few pints' and more likely either pre-loading or nearer double figures or mixtures of drinks over a long period without food.

as they think this is how to have a good time - as I clearly made obvious before, most people have a drink whilst having a good time but these kind of people (need to) get drunk to have a good time. Can you see the difference there??

and they lose inhibitions/control/memory and can get in trouble - as in my quote the police force commander supports.

Okay, I've tried and no doubt you'll twist it again.

You're overblowing the 'problem'. I go out all the time and I rarely see bother in Liverpool. When I've been down south, I rarely see bother. When I go elsewhere in this country - guess what - I rarely see bother. I see the odd absolutely wasted person and I see the very rare bit of trouble, but I'd estimate that 99.999999999% of people that go out don't get themselves into anything like the state that you seem to perceive as the norm. Reading your posts is like reading something from the Daily Fail. They make mountains out of molehills to sell papers. What's your excuse?

[JohnHobbes]

RedBeret, you're missing the point SP was trying to make. Passing a law doesn't cost much in the scheme of things but enforcement of it will cost plenty. The big supermarkets will fall into line easily enough but would still need to be checked. However, there are a huge number of small corner shops/cash and carry/booze shops/petrol stations/etc.. that would have to be monitored.

Keeping an eye constantly on them, giving them warnings, bringing in prosecutions would all cost a lost of money. Any VAT gained would most likely be swallowed up very quickly, so far from it bring a tax positive move this is a loss in all likelihood in a very short time.

[JohnHobbes]

You're overblowing the 'problem'. I go out all the time and I rarely see bother in Liverpool. When I've been down south, I rarely see bother. When I go elsewhere in this country - guess what - I rarely see bother. I see the odd absolutely wasted person and I see the very rare bit of trouble, but I'd estimate that 99.999999999% of people that go out don't get themselves into anything like the state that you seem to perceive as the norm. Reading your posts is like reading something from the Daily Fail. They make mountains out of molehills to sell papers. What's your excuse?

I give up. Again, you change the parameters under discussion and twist what I say. You never actually argue the point in question but keep accusing me of being a lightweight, a trouble maker and now a Daily Fail equivalent.

Can you not argue your case without having to resort to such tactics? Or is 'playing the man not the ball' your standard way of doing things? Either way, have fun with this topic.

[SP]

You're overblowing the 'problem'. I go out all the time and I rarely see bother in Liverpool. When I've been down south, I rarely see bother. When I go elsewhere in this country - guess what - I rarely see bother. I see the odd absolutely wasted person and I see the very rare bit of trouble, but I'd estimate that 99.999999999% of people that go out don't get themselves into anything like the state that you seem to perceive as the norm. Reading your posts is like reading something from the Daily Fail. They make mountains out of molehills to sell papers. What's your excuse?

I used to live on the High Street in a rather posh town in Hertfordshire. Even in those rarefied areas the level of antisocial drunken behaviour was significant, and was a primary factor in moving after we has our daughter. People do do stupid things when they are drunk. I certainly have. And those stupid things have an impact on other people. Other the bother is not that visible when you are out and drinking. The bother when it happens outside your front door is far clearer. There are still significant issue with drunken antisocial behaviour.

It is far from clear that minimum pricing is the way to tackle them.

[Andy @ Allerton!]

I give up. Again, you change the parameters under discussion and twist what I say. You never actually argue the point in question but keep accusing me of being a lightweight, a trouble maker and now a Daily Fail equivalent.

Can you not argue your case without having to resort to such tactics? Or is 'playing the man not the ball' your standard way of doing things? Either way, have fun with this topic.

I'm changing nothing. I'm disputing your conclusions. I accept that certain people act like idiots. I used to have friends that behaved that way. To them alchohol is a viable excuse. Like the fella that went into a nightclub with a knife. He's using alchohol as an excuse. But idiots are idiots whether drunk or sober. Take a look at the few experiments where people were conned into thinking they were drinking alchohol and weren't and look at their behavior. Not surprising. Because these people were using alchohol as an excuse for their actions.

Raising the price of drinks doesn't do anything but.. er.. raise the price of drinks. Many things in society are caused, in my opinion, because people don't take responsibility for themselves or their actions. They have to find something else or someone else to blame. Get into a ruck? Blame alchohol or the other person. Doesn't wash with me.

The problems are social. They are nothing to do with alchohol or consumption. I accept that you do get the odd person kicking off when drunk - but you'll probably find that that person is borderline anyway even when sober. Look at countries where alchohol is cheap. Do they have social problems like the UK? Look at France and Spain and Italy and the like. Then look at countries where it is more expensive. Again. Makes interesting reading don't you think?

[Andy @ Allerton!]

I used to live on the High Street in a rather posh town in Hertfordshire. Even in those rarefied areas the level of antisocial drunken behaviour was significant, and was a primary factor in moving after we has our daughter. People do do stupid things when they are drunk. I certainly have. And those stupid things have an impact on other people. Other the bother is not that visible when you are out and drinking. The bother when it happens outside your front door is far clearer. There are still significant issue with drunken antisocial behaviour.

It is far from clear that minimum pricing is the way to tackle them.

People do stupid things when they are sober as well. Kids being gobby is nothing new. People lashing ale cans into gardens is nothing new either. Was happening 30 years ago. Alchohol isn't to blame. People are. They need to take responsibility for their own actions.

[Giovanni]

Yeah, because as a taxi driver once said to Stuart Lee, "You can prove anything with facts"

Sigh. 

No. Because I'm basing my opinion on articles and papers that I have read, not thoughts I'm just plucking from thin air so you can stop with the condescending bullshit attitude.

If you want to show me article X that backs your point up, I can show you literature Y that backs my view up. So stop talking like your view is world wide accepted as gospel, because it isn't.

[Red Beret]

RedBeret, you're missing the point SP was trying to make. Passing a law doesn't cost much in the scheme of things but enforcement of it will cost plenty. The big supermarkets will fall into line easily enough but would still need to be checked. However, there are a huge number of small corner shops/cash and carry/booze shops/petrol stations/etc.. that would have to be monitored.

Keeping an eye constantly on them, giving them warnings, bringing in prosecutions would all cost a lost of money. Any VAT gained would most likely be swallowed up very quickly, so far from it bring a tax positive move this is a loss in all likelihood in a very short time.

Which illustrates my point.  Given austerity measures on the police do you really think the resources to enforce this on the little fish in the high street will be made available?  There seems to be a hard enough job running sting ops to catch offies selling to under aged drinkers, let alone checking how much they're selling it for.

Andy is right, at least up to a point.  Alcohol is less to blame than people failing to take responsibility.  I say again: the government needs to be looking at what is driving people to do this to themselves in the first place, not simply making it more expensive for them to do it.

[armchair-fan]

I'm sorry, but the underlying reason behind why kids get fucked up is not because they can get a litre of vodka for a tenner, it's because they feel there is nothing else worthwhile to do. And that stems from the pathetic education system we have in place currently, and wide spread social welfare cuts further reducing opportunities for kids.

If the government was actually serious about getting kids drinking less and off the streets they would be increasing youth club funding not cutting it to the bare minimum.

While we're both opponents of this policy, I can't buy into what you're saying here.

'Kids' don't get 'fucked up' because there is 'nothing else worthwhile to do', it's because it's fun (well, usually it is).  It's a basic human desire.  May aswell say people have sex because there's  'nothing else worthwhile to do'.

You can build all the youth clubs you want, and have the most comprehensive welfare policy in the world and 'kids' will want to get fucked up.

I suspect you're banging your own personal political manifesto on this one, in a rather inappropriate way.

[Lucas DuoFlush]

While we're both opponents of this policy, I can't buy into what you're saying here.

'Kids' don't get 'fucked up' because there is 'nothing else worthwhile to do', it's because it's fun (well, usually it is).  It's a basic human desire.  May aswell say people have sex because there's  'nothing else worthwhile to do'.

You can build all the youth clubs you want, and have the most comprehensive welfare policy in the world and 'kids' will want to get fucked up.

I suspect you're banging your own personal political manifesto on this one, in a rather inappropriate way.

I think you're right in some respects. It is probably - quite - a natural thing in human beings (and other animals for that matter) to have 'fun' or be 'entertained'. However, that is a separate argument to the consumption of an effectively manufactured drug in the form of alcohol. We were not getting leathered to have fun at the genesis of man (even if we were shortly after).

That then means that fun can be created in other forms - especially for a young 13 year old boy in a highly advanced and civilized society like 21st century Britain. A healthy life, where parents have disposable income, and act as reasonably good role models with social links that benefit the child, means that a kid is less likely to behave irresponsibly with alcohol.

Their lives are taken up by choirs, homework, school, watching television and learning various things like cooking. This life is much much less likely to result in the sort of behaviour that people with a right wing inclination attribute to alcohol consumption. To be clear, I'm not talking so much about class as about the economic flexibility of a family to live a reasonably logical and progressive life and pass that onto the child. That doesn't have to be a class issue, especially if we had more enlightened policies and manifestos.

Contrast what I have mentioned with much estate life, many single-parent families, especially single-parent families where there are serious social problems as a result of economic ones - e.g. a mother who can't pay the bills or provide a decent life for the child they love, being forced into a vicious cycle of a lack of self confidence, loss of pride, embarrassment and eventually alcoholism that comes with the intense psychological and social shame of the position they find themselves in. A position which, they are told in the media everyday, is one of 'scroungers', 'lowlifes', 'scumbags' and people 'rigging the system'. Not people truly stuck in a place, a social group and a life where there are literally no opportunities.

This is the root cause of the "crisis". This is why a child is brought up too lacking in pride to attend their local comprehensive, too scared to make social links with people so removed from them. They truant. They hang out with other kids they know from the area that have the same problems - no prospects, no money, no pride. They're too young to 'make something of themselves', and they're too poor to entertain themselves in a normal way. They want to get out and experience the social life that their peers are at school and in their comfortable (mainly) middle class houses. So they 'socialise' away from home - where they can truant without fear of reprisal from the parent - with the other kids. They're in the same boat, but they're stuck in a park - a field - a garage - a back garden, and they've got no Xbox to play out there. So they find other ways to have fun. Maybe its underage sex, substance abuse, smoking weed or cigarettes, or drinking alcohol. Because, yes, there is "nothing else to do", literally.

What I've described is the root cause of the drinking problem within a section of young people in society today. There is a vacuum of self-belief or ability to do anything constructive. Kenneth Clarke telling them they ought to do some carpentry or go round knocking on doors offering to clean windows is not a route out. The problem is much larger.

If the government want to address a crisis, address this one. Not the base cost of alcohol. It will do nothing to create a better society. It will make many people, including me, worse off. It will reinforce some of the problems at adult level: being priced out of enjoyable lager and ale. What happens when people are priced out of nice alcohol? They drink bad alcohol quickly.

I'm not sure where the people are from or what their backgrounds are on this board arguing for this legislation, but from reading their views it strikes me that they have very little idea of drinking culture. Maybe I'm wrong, but I think they still need to desperately move away from viewing this problem through alcohol consumption alone. Its bigger than that.

[Red Beret]

It's escapism from an unhappy reality.  But accepting there's something fundamentally wrong at the roots of society is asking too much of our politicians.  The concept is too big for them to grasp, much less the resources required to fix it.

[armchair-fan]

Lucas DuFlush & Red Beret, I'm not disagreeing with you that there is a strata of society with serious problems such as you've described - lack of parental control, economic issues, etc, etc.  Of course there are. 

However, and this is based on my own, anecdotal, experiences, middle class, middle income and (especially) posh rich kids, absolutely love to get fucked up on drugs and booze.  In my experience you're as likely to be getting 'on it' as a young teenager at a private school, than some rough inner city state school.  As much as anything, it's because these kids have more spare cash to be able to afford a bag of weed, a bottle of vodka, a wrap of speed or whatever, than their poorer contemporaries.  Perhaps because they are more likely to legitimately obtain the money, rather than go on the rob, or drug dealing themselves to pay for it, perhaps it's less visible and perceived as less of a problem?

I don't mean to get fixated on youth clubs, but no amount of ping-pong table provision is going to stop teenagers getting hammered. 

[andyrol]

its a stupid solution to a social problem. i would be in favour of raising the legal age for buying alcohol to 21, this too has its problems though, and giving better education to schoolkids on how to treat alcohol and making it less of a taboo so it lessens the urge to use ale as a rebelious act.  i think the changes in opening times was a good move and one which we wont see the benefit of till our children are old enough to drink. the uk has had a 'christ its 8 o'clock better start drinking cos we've only three hours left' attitude due to pubs etc shutting at 11 thus 'making' people 'race' their drinks. longer opening will eventually ease this.

[sparkiemark73]

It will soon be cheaper to take drugs than to get drunk.

Alcohol's not a drug, it's a drink.

[Red Beret]

Lucas DuFlush & Red Beret, I'm not disagreeing with you that there is a strata of society with serious problems such as you've described - lack of parental control, economic issues, etc, etc.  Of course there are. 

However, and this is based on my own, anecdotal, experiences, middle class, middle income and (especially) posh rich kids, absolutely love to get fucked up on drugs and booze.  In my experience you're as likely to be getting 'on it' as a young teenager at a private school, than some rough inner city state school.  As much as anything, it's because these kids have more spare cash to be able to afford a bag of weed, a bottle of vodka, a wrap of speed or whatever, than their poorer contemporaries.  Perhaps because they are more likely to legitimately obtain the money, rather than go on the rob, or drug dealing themselves to pay for it, perhaps it's less visible and perceived as less of a problem?

I don't mean to get fixated on youth clubs, but no amount of ping-pong table provision is going to stop teenagers getting hammered.

Well then, that again just illustrates my point that there is something seriously wrong with our society.  If things are as you say, fine the parents; name and shame them.  But don't punish the sensible majority for the idiocy of a few who do it 'because they can'.

[Red Beret]

Alcohol's not a drug, it's a drink.

Don't fool yourself.  Try going without drinking tea or coffee for a week. 

[Lucas DuoFlush]

its a stupid solution to a social problem. i would be in favour of raising the legal age for buying alcohol to 21, this too has its problems though, and giving better education to schoolkids on how to treat alcohol and making it less of a taboo so it lessens the urge to use ale as a rebelious act.  i think the changes in opening times was a good move and one which we wont see the benefit of till our children are old enough to drink. the uk has had a 'christ its 8 o'clock better start drinking cos we've only three hours left' attitude due to pubs etc shutting at 11 thus 'making' people 'race' their drinks. longer opening will eventually ease this.

Not sure I agree. As a 'kid' growing up then (21 now) all of us were actually priced out of drinking sensibly at clubs and pubs. That means we had to pre-drink from say eight until eleven. Because of our absurd taxes on alcohol we also had to buy shit beer and usually offers on big crates. Because we couldn't go to pubs we'd go to a friends house and because we were there we'd have to drink what we had as there was no option to take it home or store it there. So you end up getting hammered on 8,9,10 shit lagers that you guzzle down because they taste like shit then heading to a club at 11-12. When you get to the club you can't really afford to buy more than 1 or 2 drinks anyway.

[sparkiemark73]

Don't fool yourself.  Try going without drinking tea or coffee for a week. 

I did, I ended up on Electric White (8.4%)... an infinitely superior drink to gold blend.

To paraphrase carelessly from some posters above.... 'You can't blame the cheesecake for making you fat'.   

[Slick_Beef]

if the government really meant business they'd address the underlying social causes of binge drinking, but it's far easier for them to take a sledgehammer to the nut representing mere symptoms of a much deep rooted problem than tackling the real issues.

Spot on, imo.

[Red Beret]

I did, I ended up on Electric White (8.4%)... an infinitely superior drink to gold blend.

To paraphrase carelessly from some posters above.... 'You can't blame the cheesecake for making you fat'.

Alcohol may not be set up to be deliberately addictive in the same way ciggies are, but alcoholism destroys lives and wrecks families.  It's a real issue.  My point is cranking up the cost of the ale ain't the solution.

Like I said, ciggies cost a bomb and smoking itself is highly restrictive, but it doesn't stop people buying and using them.  The US banned booze and it didn't stop people drinking; there's plenty of illegal drugs freely available.

Fact is, as I keep saying, if people want to drink, they'll drink, and hang the cost.  All this posturing about saving NHS money, saving lives and reducing anti social behavior is so much statistical twaddle.  It will not affect hard core binge drinkers at all.

[armchair-fan]

Well then, that again just illustrates my point that there is something seriously wrong with our society.  If things are as you say, fine the parents; name and shame them.  But don't punish the sensible majority for the idiocy of a few who do it 'because they can'.

I'm not sure it's something that's 'wrong' with society, it just is.  As the gay campaigners say, 'People are gay, get used to it', and I don't think government of any persuasion will stop people getting high, any more than people, even in societies where gay sex is a crime, stop having sex.

[Mutton Geoff]

Cant see the logic here, if they want to stop problems from alcohol how about scrapping the 24 hour drinking , our culture isn't the same as the Europeans, we are too used to drinking in the race to 10-30 or 11pm and we dont do slow drinking very well even now.

this price rise will not stop an alcoholic drinking, it wont really impact on the Champagne Charlie's. but it will impact on the person who has a few cans for the weekend or the elderly person who has a bottle of spirits to help keep them warm in the winter or just because they like a dram.

one point does this idea give them an extra revenue as well? If so i can see some logic after all. Another tax increase for the working class.

[spen71]

Glad I quit the damn stuff!

[Tomo!]

Quite a lot of stereotyping of what the actual target group is in this thread.

The poor, uneducated, students, and teens. Recent statistics show that it's upper middle classes that are the largest group of excessive drinkers in this country, the group that's most able to absorb the price rises without having to change there drinking habits.

[♠Dirty Harry♠]

Quite a lot of stereotyping of what the actual target group is in this thread.

The poor, uneducated, students, and teens. Recent statistics show that it's upper middle classes that are the largest group of excessive drinkers in this country, the group that's most able to absorb the price rises without having to change there drinking habits.

That's one of the points I was trying to make earlier, the poorer folk are going to be most affected even though they're not the main demographic responsible for the statistics being bandied about on the issue, hence why it's a dumb idea.

Jesus I'd dare say most on this forum would fall under the government's 'binge drinker' category.

[SP]

Quite a lot of stereotyping of what the actual target group is in this thread.

The poor, uneducated, students, and teens. Recent statistics show that it's upper middle classes that are the largest group of excessive drinkers in this country, the group that's most able to absorb the price rises without having to change there drinking habits.

The misunderstanding of that point is not in this topic. It is in the people proposing the legislation...

It was raised in the topic as an explanation as to what the government were trying to do.

[Sir Harvest Fields]

Alcohol's not a drug, it's a drink.

Hahahahahahaha funniest thing ive seen on here for a while.

[Red Beret]

For the record, I just want to point out that I'm not solely referring to deprived people from shitty backgrounds.  We live in a high stress, high anxiety world.  You've got people slogging their guts out, all the hours God sends them, in many case just to stand still.  They fear for their jobs, holding onto their homes, providing for their families.  Even the kids are under pressure to meet performance targets ffs.

This is what I mean by a broken society; where everything is being measured and tallied up and the first person who sneezes could be out on their arse.  Is it any wonder so many people want to get decimated on booze at the first opportunity?

This isn't just about poor people or homeless alcoholics.  It's about being being driven like cattle into an early grave because successive governments wont address some fundamental problems in our society - the most prevalent of which is most people have been stressed to the point that they hate their lives.

[gordonchas]

For the record, I just want to point out that I'm not solely referring to deprived people from shitty backgrounds.  We live in a high stress, high anxiety world.  You've got people slogging their guts out, all the hours God sends them, in many case just to stand still.  They fear for their jobs, holding onto their homes, providing for their families.  Even the kids are under pressure to meet performance targets ffs.

This is what I mean by a broken society; where everything is being measured and tallied up and the first person who sneezes could be out on their arse.  Is it any wonder so many people want to get decimated on booze at the first opportunity?

This isn't just about poor people or homeless alcoholics.  It's about being being driven like cattle into an early grave because successive governments wont address some fundamental problems in our society - the most prevalent of which is most people have been stressed to the point that they hate their lives.

The main problem with your analysis is that alcohol consumption in the UK has actually been falling over the past six years.

[Andy @ Allerton!]

For the record, I just want to point out that I'm not solely referring to deprived people from shitty backgrounds.  We live in a high stress, high anxiety world.  You've got people slogging their guts out, all the hours God sends them, in many case just to stand still.  They fear for their jobs, holding onto their homes, providing for their families.  Even the kids are under pressure to meet performance targets ffs.

This is what I mean by a broken society; where everything is being measured and tallied up and the first person who sneezes could be out on their arse.  Is it any wonder so many people want to get decimated on booze at the first opportunity?

This isn't just about poor people or homeless alcoholics.  It's about being being driven like cattle into an early grave because successive governments wont address some fundamental problems in our society - the most prevalent of which is most people have been stressed to the point that they hate their lives.

People live longer today than they ever have.

[Red Beret]

The main problem with your analysis is that alcohol consumption in the UK has actually been falling over the past six years.

If that is the case then you're effectively saying there's nothing wrong to fix, aren't you?  Or perhaps certain groups have already been priced out of the alcohol market?

I believe it was armchair-fan who first stated that it was more likely that middle class kids would have the disposable income to get wasted on various substances, booze being only one of them.  Drink is not the only vice people have to play with.  There's drugs, sex, smoking, games, internet - a whole smattering of stuff. 

All your point does is illustrate the absurdity of the proposal; if alcohol consumption is falling then why have a minimum unit charge?  Clearly somebody somewhere believes that in key sections of society alcohol abuse remains high, if not rising.

There's either a problem or there isn't.  If there is a problem, then this isn't the way to tackle it.  If there isn't a problem, then this is just a scam.

Cost of administration isn't an issue; as I said earlier, it's not like road tax gets spent on roads.  I'm pretty sure money raised from a minimum unit price and resultant VAT rises wont go on administering enforcement or treatment either.

Society is fucked up and people will do everything within their means to take their minds off it.  If people stop feeling miserable then they'll likely stop trying to drink themselves under the table.

[gordonchas]

All your point does is illustrate the absurdity of the proposal; if alcohol consumption is falling then why have a minimum unit charge?  Clearly somebody somewhere believes that in key sections of society alcohol abuse remains high, if not rising.

There is no doubt there's a perception that things are getting worse, but everyone in government knows that's not the case. There's plenty of evidence and anyone can find it with a cursory search.

But this is the sort of thing politicians love. It has no cost from the public finance perspective, nobody likes binge-drinking yobs, and it gives the very clear impression that government is taking action.  If this measure is brought in and the trend simply continues as it has been, they'll claim success for this measure.

As I said in an earlier post, consumption has been falling for six years and that's especially true of the 16-24 age group and school-age teenagers. The measure being taken is supposed to reduce consumption, but as consumption has already fallen, whatever benefits are being claimed must therefore already have been seen.

[Red Beret]

There is no doubt there's a perception that things are getting worse, but everyone in government knows that's not the case. There's plenty of evidence and anyone can find it with a cursory search.

But this is the sort of thing politicians love. It has no cost from the public finance perspective, nobody likes binge-drinking yobs, and it gives the very clear impression that government is taking action.  If this measure is brought in and the trend simply continues as it has been, they'll claim success for this measure.

As I said in an earlier post, consumption has been falling for six years and that's especially true of the 16-24 age group and school-age teenagers. The measure being taken is supposed to reduce consumption, but as consumption has already fallen, whatever benefits are being claimed must therefore already have been seen.

In other words, as several of us have stated, it is in fact just a back-door tax on drinking.  Or, to lift a partial quote from another thread:

It's the product of truly stupid people intent on pursuing scapegoats rather then looking at a bigger picture.

[gregor]

Alcohol's not a drug, it's a drink.

An overdose of heroin is fatal - in the short term. But there has been no research whatsoever into long term effects.

[Andy @ Allerton!]

An overdose of heroin is fatal - in the short term. But there has been no research whatsoever into long term effects.

An overdose of water is fatal as well

[xavidub]

There is no doubt there's a perception that things are getting worse, but everyone in government knows that's not the case. There's plenty of evidence and anyone can find it with a cursory search.



As I said in an earlier post, consumption has been falling for six years and that's especially true of the 16-24 age group and school-age teenagers. The measure being taken is supposed to reduce consumption, but as consumption has already fallen, whatever benefits are being claimed must therefore already have been seen.

Liver disease deaths 'up by 25%'


Thursday March 22 2012
Drink has helped fuel a 25% rise in liver disease deaths
Fatal cases of liver disease are rising, according to media reports today. In under a decade there has been a 25% increase in deaths from the condition, with alcohol causing more than a third of total cases. In contrast, other major causes of death, such as heart disease and cancer, have been in decline in recent years.
These disturbing new figures have come from a report by the NHS National End of Life Care Programme, as one of a range of reports looking at the nature of death in England. The report also points out that the vast majority of liver deaths are in people under the age of 70, with liver disease now accounting for 10% of deaths among people in their 40s.
The report also found that more liver deaths occur among men than women and that alcohol-related liver disease deaths are more common in the most deprived areas of England. The report also says that over two-thirds of people with liver disease end up dying in a hospital rather than at home.
What did the report look at?

The new report “Deaths from Liver Disease – implications for end of life care in England”, is reportedly the first to provide a high-level overview of deaths from liver disease in England. It looks at numbers of deaths from liver disease, the underlying causes and how the figures break down by age, sex, region and socioeconomic region.
The NHS National End of Life Care Programme has produced the report as the first in a series on end-of-life care for patients with liver disease. The report also looks at the setting where people with liver disease died, whether at home or in hospital. The primary aim is to help inform decisions on end-of-life care by policy makers, commissioners and providers, as well as to inform patients and carers.
 
What is liver disease?

Liver disease (also called hepatic disease) is a broad term to describe several disorders that affect the liver. The report categorises these into:
Alcoholic liver disease: liver damage caused by alcohol misuse and which covers a range of stages and conditions (see below), including fatty liver, hepatitis and cirrhosis.
Fatty liver disease: in which there is too much fat in the liver. It is one of the most common forms of liver disease and leads to more advanced conditions such as hepatitis or fibrosis. It can be caused by excess alcohol (leading to alcoholic fatty liver disease) but also other conditions such as diabetes (causing non-alcoholic fatty liver disease).
Other chronic liver diseases such as cirrhosis and fibrosis: these are the result of continuous long-term liver damage. They may be the final stage of alcoholic liver disease but there are other causes, such as when a virus damages the liver. Fibrosis describes scarring of the liver, and cirrhosis describes scarring and the formation in the liver of hard irregular bumps called nodules. These conditions stop the liver from functioning properly. The damage is irreversible.
Liver cancer: primary liver cancer (cancer that begins in the liver) is rare in England. Risk factors include alcohol misuse, the viral infections hepatitis B and C, and obesity.
Viral liver disease: hepatitis literally means “liver inflammation”. This can have several causes, including viruses (most commonly the hepatitis viruses but there are others), alcohol or drugs (both prescription drugs and illegal). The term “viral liver disease” refers to the forms of liver inflammation following viral infection, which can range from acute hepatitis or chronic hepatitis, fibrosis and cirrhosis, and liver cancer.
Pancreatitis: inflammation of the pancreas, most commonly caused by alcohol, which can lead to jaundice and abnormal liver function. As the report says, it can sometimes be hard to tell whether abnormal liver function is due to disease in the liver, biliary ducts or pancreas.
With the exception of the brain, the liver is reported to be the most complex organ in the body. Its functions include filtering toxins from the blood, regulating blood cholesterol levels and helping to fight infection and disease.
The liver is very resilient and is capable of regenerating itself, but only to a certain extent: certain factors such as excess alcohol misuse over several years can cause long-term, sometimes severe, damage. Often there are no symptoms in the early stages of liver disease.
 
How many people does it affect?

According to the British Liver Trust (BLT), liver disease is now the fifth largest cause of death in the UK, after heart disease, cancer, stroke and respiratory disease. The report says that liver disease kills more people than diabetes and road deaths combined.
However, the BLT points out that there are many more people living with liver disease and others who have a liver disease but are not aware of it. It estimates that around 2 million people have a liver problem at any one time.
 
What did the new report find?

Below are the key findings from the report on deaths from liver disease in England:
Liver disease causes approximately 2% of all deaths.
The number of people who die from liver disease in England is rising: in 2001 it killed 9,231 people, but in 2009 this rose to 11,575 deaths.
More men than women die from liver disease (60% are men, 40% women).
Liver disease disproportionately affects younger age groups: 90% of people who die from liver disease are under the age of 70 and more than 1 in 10 deaths of people in their 40s are from liver disease, mostly alcoholic liver disease.
Alcoholic liver disease accounts for well over a third (37%) of liver-disease deaths.
There are three times as many deaths from alcoholic liver disease in the most deprived areas of England compared with the least deprived.
Overall, the North West of England, with a rate of 24 deaths per 100,000, has the highest death rate from liver disease. The East of England has the lowest, with a death rate of 12.9 per 100,000.
People dying from liver disease often have complex end-of-life care needs and over 70% die in hospital.
The report also points out that death from liver disease often carries stigma, due to the fact that as well as coming from deprived socioeconomic backgrounds those dying of alcoholic liver disease may have mental health or drug dependence problems which complicate their social and family circumstances.
 
What do the authors say on their results?

Commenting on the report, Professor Martin Lombard, National Clinical Director for Liver Disease, said:
“This report makes for stark reading about the needs of people dying with liver disease. Over 70% end up dying in hospital and this report is timely in helping us to understand the challenges in managing end-of-life care for this group of people. The key drivers for increasing numbers of deaths from liver disease are all preventable, such as alcohol, obesity, hepatitis C and hepatitis B. We must focus our efforts and tackle this problem sooner rather than later."
 
What are the signs of liver disease?

Most types of liver disease do not usually cause any symptoms until the liver has been extensively damaged. Signs and symptoms, if present at all, may be non-specific, and liver disease is often diagnosed during the course of testing for other conditions. In the case of alcoholic liver disease, later symptoms can include:
nausea
weight loss
loss of appetite
pain or soreness around the liver
yellowing of the eyes and skin (jaundice)
swelling in the ankles and abdomen
confusion or drowsiness
See symptoms of alcoholic liver disease for more information.
 
How much should I be drinking?

The recommended daily limits for alcohol consumption are:
no more than three-to-four units of alcohol a day for men
no more than two-to-three units of alcohol a day for women
A unit of alcohol is equivalent to 10ml of pure alcohol, which is roughly half a pint of normal strength lager, a small glass of wine or a single measure (25ml) of spirits. For both men and women, having some alcohol-free days each week is also recommended. You are putting your health at risk if you regularly exceed the recommended daily limits.
Women who regularly drink more than six units of alcohol a day (or more than 35 units a week) and men who regularly drink more than eight units a day (or 50 units a week) are at the highest risk of alcohol-related harm.
Links to the headlines

Liver disease deaths up a quarter: report. The Daily Telegraph, March 22 2012
Drink kills 25% more in 8 years. The Sun, March 22 2012
Drinking sends liver deaths rocketing 25% in the last ten years. Daily Mirror, March 22 2012
Deaths from liver disease up by a quarter in a decade fuelled by drinking boom in Britain. Daily Mail, March 22 2012
Liver disease deaths reach record levels in England. BBC News, March 22 2012
Alcohol abuse contributes to big rise in deaths from liver disease. The Guardian, March 22 2012
Booze fuels record deaths. Daily Express, March 22 2012
Further reading

NHS National End of Life Care Intelligence Network: New report warns more people are dying from liver disease than ever before. March 22 2012

http://www.nhs.uk/news/2012/03march/Pages/liver-disease-death-alcohol-increase.aspx

[Red Beret]

Is that increase in Liver disease a reflection of of past drinking trends?  If drinking is, in fact, on the decline at the moment, will we see a drop in these figures 10 or 20 years down the line?

[gordonchas]

Is that increase in Liver disease a reflection of of past drinking trends?  If drinking is, in fact, on the decline at the moment, will we see a drop in these figures 10 or 20 years down the line?

Thank you for saving me the trouble of pointing that out.

[xavidub]

Is that increase in Liver disease a reflection of of past drinking trends?  If drinking is, in fact, on the decline at the moment, will we see a drop in these figures 10 or 20 years down the line?

No. The sharp drop in the average age of people presenting with alcohol-related disease means that these figures reflect drinking trends of the very recent past. It isn't unusual now for people to present with liver damage from excessive drinking even though they are in their twenties, something that was almost unknown in the past. There is evidence that the fall in alcohol consumption has led to a polarisation of drinking whereby more individuals are abstinent while others are excessive drinkers.

The long pathology of cirrhotic diseases means that it will be essential to redouble efforts to curb drinking as these people will have to manage their disease for much longer than has been the case before yet will be even more sensitive to alcohol abuse than ever.
Partially as a consequence of this increased sensitivity, while overall consumption of alcohol is falling, alcohol-related admissions to hospital are increasing, as the UK reaps the reward of previously lax alcohol policy.  The morbidity costs associated with managing cirrhosis in an individual for perhaps 40 years are simply enormous.

Ultimately, this is similar to the climate change argument. The entire medical and scientific community are united in saying that public policy measures to reduce alcohol abuse are needed.

The alcohol industry and people like neo-liberals say that nothing needs to be done.

I am with the 'reality-based community' on this.

[Guz-kop]

There is no doubt there's a perception that things are getting worse, but everyone in government knows that's not the case. There's plenty of evidence and anyone can find it with a cursory search.

But this is the sort of thing politicians love. It has no cost from the public finance perspective, nobody likes binge-drinking yobs, and it gives the very clear impression that government is taking action.  If this measure is brought in and the trend simply continues as it has been, they'll claim success for this measure.

As I said in an earlier post, consumption has been falling for six years and that's especially true of the 16-24 age group and school-age teenagers. The measure being taken is supposed to reduce consumption, but as consumption has already fallen, whatever benefits are being claimed must therefore already have been seen.

The falls in  onsumption you mention are probably due to increased education and intervention leading to abstinence rather than a true reflection of drinking culture. The numbers of problems in A&E secondary to alcohol would suggest its still a huge problem in our society and needs further work.

The two main issues that need to be addressed from my point of view are...

1. Increasing funding to help deal with chronic alcoholism. There is an unexplained gulf in the,money spent on treating drug misuse compared with alcohol misuse.

2. On a related point increased awareness in schools that alcohol IS a drug and in excess is extremely harmful. Public health research has shown that drinking culture has changed over the last 30-40 years, particularly in youngsters and that really needs to be addressed.