Alcohol misuse: tackling the UK epidemic - London

BMA Board of Science
Table 5: Those with chronic conditions who are drinking above recommended daily
guidelines on a regular basis
Condition Men (%) Women (%)
Hypertension 42 10
Coronary heart disease 34 6
Stroke 33 7
Diabetes 35 8
Kidney disease 26 6
Depression 42 16
Source: Safe. Sensible. Social: the next steps in the national alcohol strategy (HM Government, 2007)
The pattern of consumption is an important determinant in assessing the impact of alcohol on
health. Binge drinking is a particularly harmful form of alcohol consumption and significantly
increases the risk of alcohol dependence in men and women. 64
The frequency of heavy drinking by
the mother is also associated with the occurrence of a range of completely preventable mental and
physical birth defects collectively known as Fetal Alcohol Spectrum Disorders (FASD). 65
FASD are
lifelong conditions resulting from maternal alcohol consumption during pregnancy that can
significantly impact on the life of the individual and those around them. The rate of teenage
pregnancies in the UK is the highest in Western Europe 66
and with recent evidence suggesting that
67, 68
unplanned pregnancies are common, not only in young women but in women throughout their
childbearing years. 69
The BMA recommends that the only sensible message for women who are
pregnant or planning a pregnancy must be complete abstinence from alcohol. Further information
on the risks of alcohol consumption during pregnancy can be found in the 2007 BMA Board of
Science report Fetal alcohol spectrum disorders – a guide for healthcare professionals.
Alcohol-related morbidity, mortality and disability
Alcohol is a significant cause of morbidity, mortality and disability in the UK and internationally.
Information on alcohol-related morbidity alone is limited because of difficulties in assessing this in
an objective and standardised way. There is also no standard measure for quantifying the burden
of alcohol consumption where it is a contributory factor in illnesses such as cancer and CHD. There
is a need to improve data on alcohol-related morbidity and mortality through the use of alcoholspecific
code categories as in the ICD-10. This could be extended to include systems for routinely
recording alcohol involvement in injuries based on categories Y-90 (evidence of alcohol
involvement determined by blood alcohol level) and Y-91 (evidence of alcohol involvement
determined by level of intoxication) in the ICD-10.
Worldwide, alcohol causes 3.27 per cent of all deaths (1.8 million) and 4 per cent of disability
adjusted life years (DALYs) lost. 70
The burden is not equally distributed among countries. Alcohol
consumption is the leading risk factor for disease burden in low mortality developing countries
(accounting for 6.2% of DALYs lost) and the third largest risk factor in developed countries
(accounting for 9.2% of DALYs lost compared to 10.9% and 12.2% for blood pressure and
tobacco respectively). 71
In the UK, and internationally, alcohol-related mortality is closely linked to
the level of alcohol consumption. According to the ONS – which collects data on deaths directly
Alcohol misuse: tackling the UK epidemic 31