Alcohol 'could kill 210,000 in next 20 years'

Medical experts say “210,000 people could die from alcohol abuse in next 20 years”, according to the Daily Mirror.

Several other newspapers have highlighted the estimate, based on the latest alcohol-related harm statistics released from the UK’s Office of National Statistics. These figures show that there were 6,317 alcohol-related liver deaths in 2010, slightly up from 2009. Based on this data, researchers calculated the future toll of drinking and estimated that there could be up to 210,000 preventable alcohol-related deaths over the course of the next 20 years.

However, the researchers’ projections varied quite widely. Their report stated that the death rate seen in coming years will depend on the effectiveness of government policies designed to tackle problem-drinking. They added that it is “within the power of the UK government to prevent the worst-case scenario of avoidable deaths”, and discussed implementing a minimum price per unit of alcohol.

The BBC and other media covered this story accurately.

Where have the current reports come from?

In 2011 The Lancet published an article containing projections of alcohol-related liver deaths in England and Wales, and now doctors have published updated projections of the number of drink-related liver deaths expected to occur over the next 20 years. These latest projections were made using alcohol-related harm statistics released by the UK’s Office of National Statistics (ONS) in January 2012. Today’s article, published online, was written by experts from University Hospital Southampton, the University of Liverpool and Nottingham University Hospital.

Although alcohol-related liver deaths fell from 6,470 in 2008 to 6,230 in 2009, they began increasing again in 2010, up to 6,317 in total. Based on available data, the expert team produced a range of estimates looking at the potential death toll in years to come, factoring in how interventions such as government policy changes could prevent deaths.

In the best possible scenario, alcohol-related liver deaths, which account for approximately one quarter of alcohol-related deaths, would gradually fall to 2,500 a year over the next 20 years. This is the same number of alcohol-related liver deaths a year currently seen in the Netherlands, Sweden, Australia, New Zealand and Norway. In this “best-scenario” case, there would be an estimated 73,000 alcohol-related liver deaths over the coming 20 years. However, if alcohol policy in England and Wales was to remain the same, the experts predict that alcohol-related liver deaths would be nearly twice as high over the same period, with 143,000 deaths in total.

The experts say that the difference between the two scenarios is due to 70,000 “avoidable deaths”. This is a moderate improvement from the projection of 77,000 avoidable alcohol-related liver deaths presented in last year’s study.

When the researchers considered alcohol-related deaths from all causes, they estimated that the number of avoidable deaths expected over the next 20 years has actually fallen from last year’s projections, from 250,000 down to 210,000. The experts suggested that this fall in the number of alcohol-related deaths may be due to alcohol sales having been curbed during the recession, but added that alcohol policy in England and Wales still needs to be amended to prevent these avoidable alcohol-related deaths. They discussed the possibility of bringing in a minimum price per unit of alcohol. This policy has been put forward by Scotland as a bill to debate in its parliament, with Northern Ireland and the Republic of Ireland considering following suit. England is due to publish a new alcohol strategy in 2012.
 

How will alcohol cause these deaths?

Alcohol consumption can contribute to acute (sudden) deaths, such as from accidents, violence and suicide. It can also contribute to the development of potentially fatal chronic diseases, including liver disease, hypertension, stroke, cardiovascular disease and cancers of the breast and gastrointestinal tract. Deaths due to alcohol-related liver disease are reported to account for approximately one quarter of all alcohol-related deaths.

Who is at risk?

In the UK, the peak age bracket for alcohol-related deaths is 45 to 65, and alcohol is a contributing factor in over a quarter of all deaths in men aged 16 to 24 years.

There is no “safe” limit for drinking, but risk can be reduced by drinking no more than two to three units a day for women, or three to four units for men. Regularly exceeding these limits increases the risk of certain chronic diseases and alcohol-related problems, including fatigue, depression, weight gain and poor sleep. The more the recommended limits are exceeded, the greater the risk to your health.

How much do we drink in the UK?

The NHS Information Centre (NHSIC) statistics for England found that in 2009 the average weekly consumption of alcohol was 16.4 units for men and 8 units for women, with 26% of men reporting drinking more than 21 units in an average week and 18% of women reporting drinking more than 14 units.

To put this into context, there are:

• 3 units in a pint of high-strength lager (strength 5.2%)
• 2 units in a standard can of lager, beer or cider (strength 5%)
• 2.1 units in a standard glass of wine (175ml, strength 12%)
• 1 unit in a small measure of spirits (25ml, strength 40%)

See our page on alcohol units for more information.

How much should I be drinking?

The NHS and Department of Health (DH) advise that:

• Adult women should not regularly drink more than two to three units of alcohol a day.
• Adult men should not regularly drink more than three to four units of alcohol a day.

“Regularly” means drinking on most days of the week or on every day of the week. The DH also advises taking a 48-hour break from alcohol after a heavy drinking session to allow your body to recover.

NICE recommends that pregnant women should avoid drinking alcohol during the first three months of pregnancy as drinking may increase the risk of miscarriage. If a woman does choose to drink during pregnancy, it's important not to drink more than one to two units, once or twice a week (while there is no certainty of a “safe” level of alcohol consumption, at this low level there is currently no evidence of harm to the unborn baby). Binge-drinking in pregnancy (7.5 units or more on a single occasion) may be harmful to the unborn baby and should be avoided.