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Thursday 31st May 2012

I wrote, yesterday, that ‘when it comes to the psychoactive substances, that there is a huge amount of new material being generated’ but I didn’t know at the time how true that would prove.

Today, a total of 848 pages of information were published in just three documents that have come to my attention. Luckily, one of them is a paperback book so I can defer trying to digest that until Amazon delivers but that only buys me a day or two.

The book is ‘Drugs - Without the Hot Air’ by Prof David Nutt and its publication has attracted some media attention to his suggestion that there would be less harm in the world if people could use Cannabis sativa, marijuana, rather than drinking alcohol and his view that, eventually, all motor vehicles will have an inbuilt breath test before the engine can be started.

The second publication is from the NHS and is ‘Statistics on Alcohol: England, 2012’¹. It is report on reports, that is it draws together information from a number of previously published reports to focus just on what they had to say about alcohol consumption and the resulting harms.

It highlights a problem before getting started. Current guidelines are that adult men should not regularly drink more than 3-4 units of alcohol a day and adult women should not regularly drink more than 2-3 units a day and after an episode of heavy drinking, it is also advisable to refrain from drinking for 48 hours to allow tissues to recover. But surveys tend to ask about total units per week and the consumption on the heaviest drinking day. This means that no conclusions can be reached about how well the guidelines are being followed.

A quick skim through throws up one very puzzling result. Whilst the surveys all show a long-term trend towards a smaller percentage of both adults and young people drinking alcohol, the figures from healthcare all show a long-term upward trend in the number of people suffering health problems as a result of alcohol.

Looking deeper shows that, within the overall downward trend, there is a much smaller reduction in the percentage of men drinking more than 8 units on at least one day in the week before being surveyed and, for women, the percentage drinking more than 6 units on at least one day has increased from 8% in 1998 to 12% in 2010. But that ‘all ages’ results from a fall for 16-24 year olds and a large increase for 25-64 year olds. For men, the fall is all due to 16-24 year olds with 25-64 year olds being more or less unchanged.

It seems to suggest that fascination with drinking at hazardous levels is moving through the age bands and shifting from men to women. It also suggests that whilst the number of people at risk from alcohol is falling the degree of risk faced by the rest may be on the increase.

The third, and longest, document is the 2011 report from the European School Survey Project on Alcohol and Other Drugs (ESPAD)². This is a once every four years look at the use of alcohol tobacco and other substances amongst children in what is not 36 countries in Europe. It is a very thorough, very long document but, happily, the Centre for Public Health at Liverpool John Moores University (CPH) has extracted the data for 15-16 year olds in the UK and published it as an eight page report.³

This summary, not surprisingly, shows that what the NHS found for 16-24 year olds is also true for 15-16 year olds. That is substance use of all sorts has fallen since 1995 but, within the totals, the number of heavy drinkers is largely unchanged and there has been a switch towards more girls being heavy drinkers.

The authors of the CPH summary stress the importance of the ESPAD surveys but are concerned that other curriculum pressures and ‘a lack of national school research coordination’ could, in future, compromise the validity of the data collected.

The ESPAD survey is one I’ll tuck away for reference when I want information on a particular country. I had a quick look at Portugal, for example, and the figures for students seem to reflect what has been reported for adults since Portugal introduced its revised control regime. That is, there are no dramatic results but overall the change does seem to have been beneficial.  

References

^1.Statistics on Alcohol: England, 2012 NHS 31st May 2012
^2.The 2011 Espad Report Substance Use Among Students in 36 European Countries European School Survey Project on Alcohol and Other Drugs 31st May 2012
^3.Substance use among 15-16 year olds in the UK Centre for Public Health at Liverpool John Moores University 31st May 2012

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