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As the annual cost to the NHS of alcohol abuse soars to £3.5billion, what role can doctors play in tackling this worrying trend?


Dr Goodall says: “I have worked in the maxillo-facial field for a number


of years and the majority of facial trauma coming in – such as lacerations and fractured cheek bones – is in some way linked to alcohol use. Most facial trauma is the result of interpersonal violence amongst people – often young people – drinking to excess.” The surgeon has often seen the same patients return with facial


trauma time and again, a trend which she says can be “soul destroying”. It was this trend that prompted her and a group of fellow maxillo-facial surgeons to set up MAV in 2008 in a bid to influence attitudes to violence among young people. She believes doctors – and particularly junior doctors – can play a key


preventive role in the wider campaign against violence. She says: “I think it is important for doctors not just to see their role


as one that focuses solely on repairing the damage caused by violence. It’s about making a leap from thinking ‘that’s not my job’ to believing this is something in which they can make a positive change. It is important not to be put off by the scale of the task, but to do what you can. “Young doctors are key to this as they will have the opportunity to


adopt this approach early in their careers. One thing is for sure, if things don’t change then the medical profession will be mopping up the fall-out from alcohol abuse for many years to come.” Dr Goodall believes even small changes can help to tackle the


problem. One example is the practice of nurse-delivered brief interventions for problem drinkers who are suffering facial trauma. Dr Goodall led a study in 2007 that found the practice of nurses offering advice and support to this group of patients helped many reduce their drinking, even after 12 months. Dr Goodall says: “There’s a tendency within the medical profession


not to think so much about prevention of violence or alcohol abuse in the way there is with smoking. But there would be huge benefits to both the health service and to people’s health if more doctors engaged with this approach. “It is now standard treatment in the maxillo-facial unit at the Southern General for nurse intervention amongst trauma patients who are problem drinkers. It doesn’t take up a lot of time and it is making a difference.”


Political plans While medical professionals can play a part in tackling the rising problem of alcohol abuse, their efforts need support from official bodies such as PCTs, Trusts and health boards as well as government. In their 2011 report Making alcohol a health priority – Opportunities


to reduce alcohol harms and rising costs the charity Alcohol Concern found services for alcohol misuse in England “have remained shamefully under-invested in” with specialist treatment only available for fewer than six per cent of dependent drinkers. It calls on GP consortia to engage with the issue of alcohol misuse and for the government to “double our current investment, leading to improved public health savings of £1.7billion a year for the NHS.” The charity also calls for comprehensive strategies to be drawn up at both local and national levels to tackle the problem. Political moves are already underway in some parts of the UK and


have been widely supported by the medical profession. Under the Alcohol Act 2011, the Scottish Government banned discount deals on alcohol sold in shops and tightened restrictions on alcohol advertising. It now plans to reduce the drink driving limit (from 80mg per 100ml of blood to 50mg) and set a minimum alcohol price of 50p per unit. A study from Sheffield University suggests a 50p unit price would cut


drinking by 5.5 per cent and save 60 lives in the first year, rising to 300 per year after 10 years. The study suggests there would be 1,600 fewer hospital admissions in the first year, rising to 6,500 fewer admissions after 10 years. A number of organisations have backed the moves including Alcohol


Concern, drinks producer Tennent’s, Scotland’s Chief Medical Officer Dr Harry Burns and BMA Scotland. BMA Scotland chairman Dr Brian Keighley says: “A minimum price, as


part of a wider strategy, could end Scotland’s heavy drinking culture” and “will also reduce the toll of alcohol on the health service.” There are plans to introduce a similar raft of measures in England and


Wales, including a 40p minimum alcohol price, under the government’s new Alcohol Strategy. An inquiry into the proposals is being carried out by the Commons Health Committee.


Joanne Curran is an associate editor of FYi


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