Health Improvement Officer (Alcohol & Drugs)
Aberdeenshire ADP/Health Improvement Team
Room G66 Summerfield House
2 Eday Road
Telephone: 01224 558657
Internal : 58657
Over the past 50 years, alcohol consumption has doubled and so has alcohol-related harm such that the World Health Organisation considers alcohol the third biggest risk factor for ill-health.
Alcohol-related problems cost Scotland more than £2.25 billion per year – in fact this is thought to be a gross underestimate (Scottish Government, 2008a). More than half of this figure is made up of the economic cost to society of people missing work due to alcohol consumption, being less productive, or dying younger due to illnesses caused by alcohol consumption. Although some of the cost is due to the care of people who are dependent on alcohol, a far higher proportion is due to the much greater number of people who drink more than the recommended limits.
We can describe the extent of the alcohol problem in Aberdeenshire using recently revised Scottish estimates of alcohol consumption which reveal that the proportion of the adult population (16+ years of age) drinking above sensible limits on a weekly basis is 34% for men and 23% for women. These levels are considered hazardous, potentially leading to harm for the individuals themselves or others. Recent studies have suggested that 1 in 16 (6.3%) of the population of Grampian and Tayside are alcohol dependent. For Aberdeenshire this could mean that more than 50,000 adults are already drinking at such hazardous levels. The proportion for whom this consumption may have already led to harmful effects is uncertain, but for most, this damage is still likely to be reversible, if tackled appropriately. Dependent drinkers, those for whom more specialist support may be needed, could number in the region of 14,000 individuals.
Alcohol is a contributory factor in a whole range of physical and mental health problems, including many cancers, depression, anxiety, stomach problems and many others. Excessive alcohol consumption can also affect non-drinkers in many ways. This includes the impact of parental drinking on children, violence (street and domestic), drink driving, fires and accidents, and the effect that drink has on relationships, families and a person’s ability to actively contribute to society through employment and/or community involvement. Alcohol consumption has increased in the past four decades, and so have deaths and diseases related to alcohol. Female drinking in particular has increased, and people are being diagnosed at a younger age with diseases such as liver cirrhosis.
Click here for hints and tips on how to enjoy alcohol sensibly.
What is an Alcohol Brief Intervention?
An alcohol brief intervention is a short, evidence-based, structured conversation about alcohol consumption with a patient/service user that seeks, in a non-confrontational way, to motivate and support the individual to think about and/or plan a change in their drinking behaviour in order to reduce their consumption and/or their risk of harm.
The component parts of the brief intervention can be described as follows:
Short: typically 5-20 minutes – perhaps involving little more than raising the issue, listening to the patient/service user’s response and a brief discussion, with the provision of information, which could include written material (e.g. a leaflet).
A motivational interviewing style is likely to enhance the effectiveness of brief interventions, and allows the practitioner to make the best use of a short consultation. Provision of a leaflet alone without any accompanying structured discussion would not constitute an evidence-based approach. Slightly longer interventions are more likely to include goal setting and relapse planning as well as motivation building. There is currently a lack of evidence to demonstrate whether longer interventions are more effective than shorter ones.
In practice, the duration of a brief intervention depends on the interplay between the wishes of the patient/service user and their readiness to change.
Why perform brief interventions?
SIGN Guideline 74 notes that there is very good evidence for the effectiveness of brief interventions, particularly in primary care settings (general practice and community nursing) and in interventions A & E departments (SIGN, 2003). This does not mean that brief interventions do not work in other settings, but merely that the research has not been done to the same extent, so we don’t know!
Brief interventions are appropriate for risky drinkers – that is, people who are regularly exceeding the recommended drinking limits.
The effect of a brief intervention in reducing alcohol consumption is small, but can last for up to a year. At a population level, small changes in consumption by many people could make a big difference to the level of alcohol problems in society as a whole: www.sign.ac.uk/guidelines/fulltext/74/index.html.
Our vision is of a healthier, happier and safer Aberdeenshire, free from harm due to alcohol and other drugs, where those in difficulty can access support to regain control over and live as meaningful and satisfying a life as possible as a valued member of society; and people are equipped to avoid suffering such difficulties in the first place.
We believe those who experience problems with their use of alcohol or other drugs have the capacity to pursue a journey of recovery and ultimately live a healthier more fulfilling life, even where such use has irreversibly impacted on their mental or physical wellbeing. Recovery involves far more than stabilisation of chaotic lives and minimisation of harm, but includes recovery of hope for the future. We therefore renew our determination to improve outcomes in the key areas of child wellbeing, family support and relationships, housing and employability. We also aim to improve access to treatment and support for those that want it, at the time and place they choose to begin their personal journey of recovery.
By the same token, we must deal with the harsh reality of those who have yet to reach a turning point in their life, but who threaten the safety and wellbeing of children and communities. We will strengthen our resolve to divert them out of criminal and antisocial behaviour, keep them safe and minimise risk to those around them. Problematic use of alcohol or other drugs should be a matter of concern for us all. We want more than just specialists to engage with the agenda, for example, by us all challenging attitudes that alcohol is a benign product that can continue to be consumed to excess without consequence. We will engage with a broader range of mainstream services to provide community based support and advice, thereby reducing delays and reserving alcohol and drug services for those activities only those specialists can deliver.
Achieving our vision of the future will be challenging and we cannot do it alone. The Aberdeenshire Alcohol and Drug Action Team will lead and co-ordinate joint efforts to work towards this vision but we rely on the sustained effort and collective resources of the whole Aberdeenshire community to implement this strategy.
For more information about the Aberdeenshire Alcohol and Drug Partnership visit www.aberdeenshireadp.org.uk/
To find out more information relating to alcohol or drugs visit:
 Tighe A. (ed) (2007) Statistical Handbook 2007, Brewing Publications Limited
 Global Burden of Disease Project, World Health Organisation
 Revised Alcohol Consumption Estimates from the 2003 Scottish Health Survey, Scottish Government, May 2008
 Rome A, Drummond C and Rice P. Problematic Drinking in Scotland: Estimating the Size of the Problem.
Figure 8 Consultancy Services & Institute of Psychiatry. Nov 2008
 Hay G, McKeganey N et al. Estimating the National and Local Prevalence of Problem Drug Misuse in Scotland, Glasgow, 2005
 General Register Office for Scotland. Drug Related Deaths in Scotland in 2007. August 2008