Alcohol: health harm
Excessive consumption of alcohol can result in a wide range of health problems. Some may occur after drinking over a relatively short period, such as acute intoxication (drunkenness) or poisoning (toxic effect). Others develop more gradually, only becoming evident after long-term drinking, such as damage to the liver and brain. In addition to causing physical problems, excessive alcohol consumption can lead to mental health problems such as dependency.
Alcohol-related general and psychiatric hospital discharges
Alcohol-related hospital discharge statistics are published annually by Information Services Division of NHS National Services Scotland. The latest report, Alcohol Related Hospital Statistics 2015/16 (650 KB), was published on the 25th of October 2016. Some key points from this publication are:
In 2015/16 there were almost 35,000 alcohol-related inpatient hospital admissions in Scotland. Over this period around 23,400 Scottish residents had at least one admission to hospital with an alcohol-related condition, of whom around 11,400 had not been admitted in the previous 10 years or were admitted for the first time.
In 2015/16 the rate of alcohol-related inpatient stays are similar to the previous year, reducing by less than 2%. Overall, there has been a steady decline in alcohol-related hospital stays since 2008/09 both in general acute hospitals and in psychiatric hospitals.
- In recent years, there has been an increase in hospital admissions for alcoholic liver disease and alcohol withdrawal state during a period where overall alcohol-related admissions have been decreasing.
In recent years, there has been an increase in the number of people having multiple alcohol-related admissions within a year. This may be contributing to the slowing of the overall decreasing trend in alcohol-related admissions.
There continues to be an inequality gap for alcohol-related admissions between those living in the most and least deprived parts of Scotland.
The rate of alcohol-related hospital stays will vary between different geographical areas in Scotland. Information by NHS Boards and Alcohol & Drug Partnerships can be found in the ScotPHO Alcohol Profiles.
Primary care consultations
Practice Team Information (PTI) was a system that collected consultation data from general medical practices in Scotland. Data were collected from a sample of practices covering 6% of the Scottish population and included every face-to-face contact between a patient registered with the practice and a member of the practice team. This sample was broadly representative of the Scottish population in terms of age, sex, deprivation and urban/rural mix and allowed consultation estimates to be produced for Scotland. The estimates reported here are based on recording of Read codes directly attributable to alcohol therefore are likely to be an underestimate of the total burden of morbidity due to alcohol in primary care. PTI is no longer supported and is due to be replaced by SPIRE in 2016.
The most recent PTI figures on numbers of alcohol-related consultations, patients seen for alcohol-related conditions and their co-morbidities, their age and gender and deprivation can be found in these Excel tables: Alcohol-Primary-Care-2012-13.xls (78Kb). Key points are:
In 2012/13, there were an estimated 94,630 alcohol-related primary care consultations by 48,420 patients, a substantial fall from 109,170 consultations by 57,470 patients in 2011/12.
Forty-six percent of the patients seen for alcohol misuse in 2012/13 were aged between 45 and 64, but consultation rates were highest for those aged 65 years and over.
In patients aged between 18 and 44 who consulted their GP for alcohol misuse in 2012/13, men were more than twice as likely to consult for anxiety or for depression compared to all males who consulted a GP, whereas females were around three times more likely to consult for anxiety or for depression compared with all females who consulted a GP.
There were two-and-a-half times more patients consulting for alcohol misuse in the most deprived quintile compared with the least deprived quintile.
Mortality and morbidity partly attributable to alcohol
Alcohol is linked to many disease conditions and is one of the major risk factors for burden of disease in established market economies. These conditions may be acute or chronic diseases or injuries. In order to measure the total burden of morbidity and mortality attributable to alcohol, all these conditions must be identified and the proportion attributable to alcohol calculated. Conditions where alcohol is 100% contributory include alcoholic liver disease, mental and behavioural disorders due to use of alcohol, etc. Partly attributable conditions include for example Cancer of the lip, oral cavity and pharynx, coronary heart disease and stroke. The proportions of these conditions attributable to alcohol (the population attributable fractions or PAF) can be identified from literature reviews and/or primary analysis. For a particular disease or injury it can be interpreted as the proportion of the total cases that would not have occurred in the absence of exposure to the risk factor.
Alcohol PAFs for Scotland were calculated using the best possible estimates based on the current evidence available in the epidemiological literature, augmented where necessary by primary data and specific estimates of population drinking in Scotland from the 2003 Scottish Health Survey. These were then applied to mortality and morbidity data to estimate more fully the burden of alcohol attributable harm in Scotland. The results can be found in the ScotPHO report, Alcohol attributable mortality and morbidity: alcohol population attributable fractions for Scotland.
Alcohol has been found to be a consistent factor in the admission of trauma patients who require to spend 3 or more days in hospital or who die as a result of their injury. The Scottish Trauma Audit Group (STAG) publishes information on trauma admissions where there was evidence that alcohol was implicated. There is evidence to suggest that alcohol was involved in 1 in 5 of minor trauma patients in 2013/14, rising to 1 in 3 of major trauma patients who met the STAG entry criteria. Alcohol was either ingested by the trauma patient or another person involved in the trauma incident. In 2013/14, alcohol was almost twice as likely to be a factor in male trauma patients compared to female patients (31% vs 16% respectively). More information on the STAG inclusion criteria can be found at www.stag.scot.nhs.uk
National Records of Scotland (NRS) annually publish information on the numbers of deaths which are classified as 'alcohol-related' on the basis of the current definition (which was agreed with the Office for National Statistics and the Northern Ireland Statistics and Research Agency in 2006). Further information on the coverage of alcohol related death statistics is available on the NRS website.
NRS also produce some age standardised deaths rates for certain selected causes which includes alcohol-related deaths.
A summary of the key points from the latest report, Alcohol-related deaths in Scotland, 1979 to 2015, is provided below:
In 2015, there were 1,150 alcohol-related deaths, on the basis of the current definition. There has been little change compared to 2014 when the number of deaths was 1,152.
- Over the years since 1979, there have been roughly twice as many male deaths as female deaths. Of the alcohol-related deaths in 2015, 764 (66%) were male deaths and 386 (34%) were female deaths
In 2015, the largest proportion of alcohol-related deaths 43% (491) occurred in those aged 45-59 years followed by 36% (412) occurring in those aged 60-74 years. The number of deaths in these age groups has increased over the previous three years at a time when deaths have fallen or remained the same for other age groups.
In 2015, there were 130 alcohol-related deaths in those aged 30-44 years; this is the lowest number of deaths for this age group since 1995.
A small proportion of alcohol-related deaths occur in those aged under 30 years, usually around 1-2% since 1979.
In 2015, 9% (108) of alcohol-related deaths occurred in those aged 75 and over. The number has decreased by 8% since 2014 but is still almost double the number of deaths occurring in this age group in 1995.
Tables 2 and 3 give figures for each NHS Board area and council. As the figures can fluctuate markedly from year to year, 3-and 5-year averages are shown for NHS Boards and 5-year averages are shown for councils. This should indicate better any overall trend.
In 2014 there were 6,831 alcohol-related deaths in England, this is a decrease from 2013 (6,592). While Scotland had the highest alcohol-related death rate in 2014, it was the only constituent country of the UK with significantly lower rates than 10 years ago. However please note that the ICD 10 codes used for the analysis in England vary from ISD methods. These issues should be taken into account when comparing the figures.
Local data on alcohol-related mortality can be found in the ScotPHO Alcohol Profiles.
The number of drink-drive accidents and casualties can be found in the publications Reported Road Casualties Scotland from the Department of Transport. Table 22 of the latest publication (October 2014) shows the estimates (made by the Department for Transport) of the numbers of injury road accidents involving illegal alcohol levels in 2013. They are higher than the number of drivers with positive breath test results (or who refused to take the breath test - see Table 19) because they include allowances for the numbers of cases where drivers were not breath tested because of the severity of their injuries, or because they left the scene of the accident. Information about the blood alcohol levels of road users who died within 12 hours of being injured in a road accident is supplied by the Procurators Fiscal.
- The estimated number of drink-drive accidents fell by 56% between 2003 and 2013 (the latest year for which estimates are available), from a rounded estimate of 750 (in 2003) to roughly 330 (in 2013).
- The number of casualties fell by 60% from around 1,130 in 2003 to some 450 casualties in 2013.
- While fluctuating from year to year, the number of casualties killed as a result of drink-drive accidents is estimated to have fallen by 60%, from about 50 in 2003 to around 10 20 in 2013.
- The number of serious casualties is estimated to have fallen by nearly 70% (from roughly 230 in 2003 to some 70 in 2013).
Please note: If you require the most up-to-date data available, please check the data sources directly as new data may have been published since these data pages were last updated. Although we endeavour to ensure that the data pages are kept up-to-date, there may be a time lag between new data being published and the relevant ScotPHO web pages being updated.