This report provides strong evidence of the impact of alcohol-related illness on hospital services, according to Dr Deirdre Mongan, Research Officer at the HRB and lead author of the report. The number of people discharged from hospital with alcohol-related problems or injuries increased by almost 90% in the ten years between 1995 and 2004. In 2004, people with alcohol-related illness used 117,373 bed days in hospital � more than double the figure of 55,805 bed days in 1995.
"These figures from the Hospital In-Patient Enquiry* (HIPE) scheme are remarkable," says Dr Mongan. "Moreover, because HIPE does not record people attending Accident and Emergency who are not actually admitted to a hospital bed, it is fair to assume that these figures actually underestimate the pressure of problem alcohol use on acute hospital services." The figures show that people were admitted to hospital both for acute problems such as alcohol-related accidents and for chronic problems such as alcohol dependence. But the largest increase was in the number of discharges with alcohol-related liver disease, which increased by 147% between 1995 and 2004.
Gender and age breakdown
Men accounted for 75% of discharges from hospital with an alcohol-related illness, and women accounted for 25%. Discharges peaked in the 50-59-year age group. There were over 26,000 discharges aged 30 years or under in the period 1995�2004. Four out of five of these had acute problems, and just over 5,000 had long-term alcohol-related problems such as liver disease. This is extremely worrying, given that it takes a number of years of hazardous drinking to develop chronic conditions.
The results also highlight some serious implications for women's health. The age profile of the women discharged from hospital was much lower than that of the men; women accounted for 47% of all discharges under the age of 18. "This is a very high proportion, but it really should not be a surprise as a lot of evidence has indicated that young girls are drinking a lot more in the last 10 years," Dr Mongan said. "The point is, women develop alcohol-related complications earlier in their 'drinking career' than men. So, if the current trend continues, there will be significant increases in long-term illness and a greater risk of death linked to problem alcohol use among middle-aged women."
Alcohol and death
A total of 1,775 people died as a result of problem alcohol use between 1995 and 2004. The General Mortality Register shows that the number of alcohol-related deaths doubled in this period. The figures show that men are more likely to die from alcohol-related causes. A total of 68% of these deaths were in people aged 60 or under. "To put this in perspective, only 21% of deaths in the general population in this period were under 65 years of age, which highlights the increased risk of premature death associated with alcohol use," Dr Mongan said.
"This Overview emphasises the need to reduce alcohol consumption in Ireland," says Dr Long, Head of the Alcohol and Drug Research Unit at the HRB. "There is a clear link between levels of consumption and alcohol-related harm. For example, this report shows that the two years of highest consumption - 2001 and 2002 - coincide with the highest numbers of alcohol-related deaths and discharges; and in 2003, the first decrease (of 6%) in consumption coincides with the first decrease (of 2%) in alcohol-related discharges," she says.
"If we want to see a fall in consumption, it is important that we look at the international evidence for measures that have worked. Strategies that have proved effective in reducing alcohol-related harm include alcohol taxation, regulating the physical availability of alcohol, and measures against drink-driving," says Dr Long. "It is also essential that we get a clear picture of the problem. It is hoped that the information in this Overview will be used to assess levels of hazardous drinking, and will lead to the introduction of appropriate interventions where they are needed," she concludes.
During 2005, 5,527 people received treatment for problem alcohol use, according to the HRB National Drug Treatment Reporting System (NDTRS); and 2,995 people were admitted to psychiatric units with an alcohol-related illness, according to the HRB National Psychiatric In-Patient Reporting System. Data from the NDTRS also show that 2,827 people entered treatment for the first time in 2005. "Because not all alcohol-treatment agencies are participating in the NDTRS, it can be reliably assumed that the number presenting for treatment is actually higher", says Dr Long. "Treatment figures also show that one in five people receiving treatment for problem alcohol use are using at least one other drug. This is increasingly common among young people; 8% of people treated for use of more than one drug were aged 17 or under. In comparison, just 1.6% of those treated for alcohol only were in this age group," she explains.