Alcohol use and related harm in Northern Ireland

Alcohol harm is a problem across the whole of Northern Ireland, costing the public purse an estimated £900 million each year. Tragically, the number of alcohol-specific deaths recorded in Northern Ireland has also risen sharply in recent years. In this blog, Eunan McKinney, Head of Communications and Advocacy at Alcohol Action Ireland, takes a closer look at the stark statistics and explores why alcohol harm continues to rise.

2019 has been one of the most devastating years on record for alcohol related harm with a litany of statistical records being broken both in Northern Ireland and elsewhere in the UK. Behind each statistic are individuals, families, friends and colleagues who continue to feel the impact long after the media headlines have moved to another story.

In 2019, there were 7,565 deaths registered in the UK that related to alcohol-specific causes, the second highest since the data time series began in 2001. Northern Ireland had its highest rates of alcohol-specific death in 2019 (18.8 deaths per 100,000 people). Since 2001, the alcohol-specific death rate has risen significantly for both men and women in Northern Ireland.

While Scotland had the highest alcohol-specific death rate for males in 2019, Northern Ireland wasn’t far behind. There were 24.2 deaths per 100,000 males in 2019; a 42.2% since records began in 2001.

Equally concerning, the female rate of alcohol-specific deaths in Northern Ireland increased significantly from 8.2 to 13.6 deaths per 100,000 females (an increase of 65.9%), the highest in UK.

The Health Survey Northern Ireland – 2019/20, conducted by the Department of Health outlines the pattern of alcohol use across Northern Ireland.

77% of adults aged 18 and over, drink alcohol
Half of all drinkers’ report drinking at least once a week
Two-thirds (62%) of drinkers had drank alcohol in the last week with 8% having drank over 14 units on the day they drank the most

Latest figures published by Northern Ireland Statistics and Research Agency (NISRA) show that the number of alcohol-specific deaths in 2019 was the highest on record, with 336 deaths being due to alcohol-specific causes. This is over a third (34.9%) more than was recorded 10 years ago (249).

Looking at trends over time, the majority of those who died with alcohol-specific underlying causes each year since 2009 have been in the 45-54 and 55-64 age groups, together accounting for between 59.2% and 68.5% of all alcohol-specific deaths each year.

80% of males in Northern Ireland were drinkers, with 26% of males reporting that they drank above weekly limits:
7% of males reported that they thought they drank quite a lot or heavily
Almost a fifth of male drinkers (19%) drank on 3 or more days per week
Of those males who drank in the last week, on the day they drank the most, 37%had consumed up to five units and 20%had consumed over 14 units.

Three-quarters of females (73%) were drinkers, with 9% of females reporting that they drank above sensible weekly limits.

3% of females reported that they thought they drank quite a lot or heavily
A tenth of female drinkers (10%) drank on 3 or more days per week
Of those females who drank in the last week, on the day they drank the most, 58%had consumed up to five units and 4% had consumed over 14 units.

While all the usual market drivers of alcohol use are prevalent throughout Northern Ireland, the backdrop of societal upheaval over a generation of the ‘Troubles’ (1968-1998) cannot be ignored. Equally, a significant imprint of persistent health inequalities, evident amongst lower socio-economic cohorts within both communities, plays an important role in accentuating the shocking level of alcohol specific deaths.

A report on the mental health impact of the civil conflict in Northern Ireland, ‘Troubled consequences’ published in 2011, prepared for the Commission for Victims and Survivors by the Bamford Centre for Mental Health and Wellbeing at the University of Ulster sheds considerable light on the relation between trauma and health. The Report reveals the pervasive and protracted toxicity of psychological trauma on the health of the Northern Irish community.

An estimated 39% of the study population have experienced a conflict-related traumatic event.

Overall, an estimated 53% of individuals who experienced a conflict-related traumatic event had a mental health disorder at some point in their life, while 32% had a mental health disorder in the 12 months previous to the NISHS interview.

Almost 44% of individuals who experienced a conflict-related traumatic event had a ‘post-conflict’ disorder following their first experience of conflict (i.e. had a disorder that first developed after their first experience of conflict).

Following traumatic experience people can develop one or more psychological disorder and a greater likelihood of developing other problems – co-morbid disorders. Coping with such disorders people can radically change their lifestyle and many develop high levels of harmful alcohol use. Alcohol abuse amongst those individuals who have experienced conflict related trauma is estimated at 19.5% while only 7.2% amongst those who did not, while alcohol dependency stands at 3.9% while only 1.1% amongst those who did not.

The absence of a specific political focus has contributed to the continuing worsening of the Northern Ireland situation, with a devolved administration only been re-established in January 2020 after nearly three years of direct UK rule. In establishing a new power sharing administration neither of the larger political parties who command nearly 60% of the vote share sought the health portfolio.

The current Minister for Health, Mr Robin Swann MLA, when launching a public consultation on his department’s “Making Life Better – Preventing Harm and Empowering Recovery: A Strategic Framework to Tackle the Harm from Substance Use” said: “Alcohol and drug use is one of the biggest public health and societal issues facing Northern Ireland. The cost of alcohol related harm alone is estimated to be as much as £900 million every year. Add in the cost of the harms from other drugs and the figure could be well over £1bn annually.”

It is anticipated that this new strategy will be published sometime this year and that new ways to tackle this societal crisis will be explored. It is expected that the strategy will include a commitment to holding a full public consultation on the introduction of Minimum Unit Pricing for Alcohol in Northern Ireland. However, any potential implementation of such a measure has been pushed beyond the mandate of this Assembly.

In this context and having previously sought a simultaneous action with Northern Ireland, the Irish government, having consulted with the NI Administration, is now released to pursue its implementation of minimum unit pricing immediately. Indications are that the Government of Ireland will now press ahead with commencing minimum pricing, a central measure within the 2018 Public Health Alcohol Act, which set a minimum price of 10 cent (0.087p) per gram of alcohol. This, coupled with action already established in Scotland and Wales, will bring an added impetus to addressing a tragic public health alcohol crisis in Northern Ireland.

Written by Eunan McKinney

This blog was published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Alcohol Health Alliance or its members.

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