Alcohol misuse: tackling the UK epidemic - London

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BMA Board of Science Abbreviations A&E accident and emergency AERC Alcohol Education Research Council ANARP Alcohol Needs Assessment Research Project ASA Advertising Standards Agency AUDIT Alcohol Use Disorders Identification Test BAC blood alcohol concentration BCS British Crime Survey CHD coronary heart disease CNS central nervous system DALY disability adjusted life year DCMS Department for Culture, Media and Sport DEFRA Department for Environment, Food and Rural Affairs DES direct enhanced service DH Department of Health DHSSPS Department of Health, Social Services and Public Safety DSD Department for Social Development ESPAD European School Survey Project on Alcohol and other Drugs EU European Union FASD fetal alcohol spectrum disorders FAST Fast Alcohol Screening Test FCAC Framework Convention on Alcohol Control FCTC Framework Convention on Tobacco Control GHS General Household Survey GP general practitioner ICD-10 International Classification of Diseases (Tenth revision) LGB lesbian, gay and bisexual MAST Michigan Alcoholism Screening Test NES national enhanced service GMS general medical services NHSS national healthy school standard NICS Northern Ireland Crime Survey NWPHO North West Public Health Observatory OCJS Offending Crime and Justice Survey ONS Office for National Statistics PAT Paddington Alcohol Test PCT primary care trust PMSU Prime Minister’s Strategy Unit PND penalty notices for disorder POST Parliamentary Office for Science and Technology PSHE personal, social and health education QOF quality outcomes framework RASG Retail of Alcohol Standards Group SALSUS Scottish Adolescent Lifestyle and Substance Use Survey SCS Scottish Crime Survey SEHD Scottish Executive Health Department SHS Scottish Health Survey SIGN Scottish Intercollegiate Guidelines Network UK United Kingdom USA United States of America WHO World Health Organisation Alcohol misuse: tackling the UK epidemic v
vi BMA Board of Science Glossary Note An alcoholic beverage is a drink containing ethanol (ethyl alcohol). For this report, the term alcohol refers to ethanol rather than the broader definition of alcohol that incorporates other compounds including methanol, propanol and butanol. Alcohol abuse A term in wide use but of varying meaning. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) defines psychoactive substance abuse as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period: recurrent substance use resulting in a failure to fulfil major role obligations at work, school, home (eg repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household) recurrent substance use in situations in which it is physically hazardous (eg driving an automobile or operating a machine when impaired by substance use) recurrent substance-related legal problems (eg arrests for substance-related disorderly conduct) continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (eg arguments with spouse about consequences of intoxication, physical fights). 1 The term is not used in the World Health Organisation (WHO) International Classification of Diseases 10th revision (ICD-10), where harmful and hazardous use are the equivalent terms. In common usage, the term ‘abuse’ is sometimes used to refer to any use at all, particularly of illicit drugs. In other contexts, abuse refers to persistent or sporadic excessive drug use inconsistent with or unrelated to acceptable medical practice. 2 The term alcohol abuse is used predominantly in the United States of America (USA). Alcohol misuse The use of alcohol for a purpose not consistent with legal or medical guidelines. 2 Alcohol dependence syndrome Alcohol dependence syndrome is classified by the ICD-10 as a cluster of behavioural, cognitive, and physiological phenomena that develop after repeated alcohol use and that typically include a strong desire to consume alcohol, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to its use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state. 2 Alcoholism A term of common use and variable meaning, generally taken to refer to chronic continual drinking or periodic consumption of alcohol which is characterised by impaired control over drinking, frequent episodes of intoxication, preoccupation with alcohol, and the use of alcohol despite adverse consequences. 2 Alcoholism is not included as a diagnostic term in ICD-1O. Alcohol misuse: tackling the UK epidemic
Page 1 and 2: BMA Board of Science Alcohol misuse
Page 3 and 4: ii BMA Board of Science Editorial b
Page 5: iv BMA Board of Science Acknowledge
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Page 11 and 12: x BMA Board of Science Alcohol misu
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Page 21 and 22: 8 BMA Board of Science Measures to
Page 23 and 24: 10 BMA Board of Science Introductio
Page 25 and 26: Litres of pure alcohol per inhabita
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44 BMA Board of Science Pedestrian
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46 BMA Board of Science Alcohol mis
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48 BMA Board of Science The sub-sec
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50 BMA Board of Science Recommendat
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52 BMA Board of Science Legal age o
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54 BMA Board of Science Recommendat
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56 BMA Board of Science Box 5 - the
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BAC (mg/100ml) 58 100 90 80 70 60 5
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60 BMA Board of Science Understandi
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62 BMA Board of Science Early inter
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64 BMA Board of Science At present
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66 BMA Board of Science treatment s
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68 BMA Board of Science Internation
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72 BMA Board of Science Appendix 2
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74 BMA Board of Science Licensing i
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80 BMA Board of Science 23 Hughes T
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82 BMA Board of Science 67 Dex S &
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84 BMA Board of Science 118 Edward
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86 BMA Board of Science 164 McKnigh
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88 BMA Board of Science 209 Babor T
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90 BMA Board of Science 253 Scottis
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British Medical Association Board o
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Board of Science and Education This
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vi Contents Introduction...........
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viii
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2 heavier smoking, drinking and mor
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4 Nutrition, exercise and obesity N
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6 The data for 1998 shows a 21 per
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8 Interventions in adolescent nutri
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10 The efficacy of traditional educ
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12 The treatment of individuals wit
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14 Smoking, drinking and drug use A
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16 The use of illicit substances, a
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18 smoking prevalence was highest a
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20 Interventions in adolescent drug
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22 be expensive given the amount co
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24 is potential to use the media, n
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26 Summary Adolescents in the UK ar
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28 Mental health problems in adoles
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30 Risk factors for conduct, depres
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32 Currently, specialist mental hea
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34 Sexual health Adolescents and se
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36 interferes with the adolescent
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38 Interventions in adolescent sexu
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40 The timing of educational interv
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42 Helping adolescent parents The h
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44 are more difficult to reach than
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46 The way forward This report has
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48 Annex 1 BMA policy on adolescent
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50 References 1 Lobstein T J, James
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52 56 Social Exclusion Unit (1998)
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54 115 Charles Gallichan (2003) Pub
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56 173 NHS Centre for Reviews and D
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Subject: Young People and Alcohol D
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Call for Evidence: Children and You
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5. Do you know of any international
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Alcohol misuse: tackling the UK epidemic - London

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