Alcohol-related deaths increase in Scotland since before pandemic, report finds

Deaths wholly linked to alcohol increased in Scotland since before the pandemic, despite consumption decreasing in general, new Public Health Scotland (PHS) figures have found.

The research discovered these deaths were 9% higher in 2020 (1,190) than the annual average in 2017-19 (1,093).

The increase was driven particularly by males and those aged 45 to 64 years, groups that already had among the highest alcohol-specific death rates before the pandemic.

There were fewer hospital admissions involving a diagnosis entirely attributed to alcohol, with rates 7.3% lower in 2020 than the 2017–19 average, the research found.

But the report warned there were “substantially reduced hospital admissions overall”, with a 30% reduction in all admissions to general acute hospitals in Scotland between 2019/20 and 2020/21.

PHS researchers said the figures show there is concern that groups more prone to alcohol-specific deaths increased their consumption even more during the pandemic, and, having reduced access to hospital treatment for alcohol-related conditions, this could have potentially led to them experience higher rates of mortality as a consequence.

Lucie Giles, Public Health intelligence principal at PHS, said: “Taken together, the evidence points to increased drinking amongst some groups, coupled with a reduction in the number of people accessing hospital treatment and greater rates of death caused by alcohol.”

She said tackling alcohol consumption and harms, particularly among high-risk groups, should be a “critical objective” of any Covid-19 recovery plans.

Most alcohol-specific deaths in both time frames were due to alcoholic liver disease (64%) and mental and behavioural disorders due to alcohol use (27% in 2020 and 26% in 2017–19).

The general sales and consumption of alcohol in Scotland, however, had decreased when Covid hit compared to 2017–19, the findings showed.

Overall, total combined alcohol sales (litres of pure alcohol per adult) were 9% lower in 2020 and 16% lower in 2021 (January to May) than the annual average for these time periods in 2017–19.

On-trade alcohol sales, such as in pubs and bars, were also “substantially lower” in 2020 (66% lower) and 2021 (95% lower between January and May) compared to 2017-19.

The pandemic and related restrictions, however, are likely to have contributed to this decrease, the report noted.

Despite the overall slump in alcohol sales, purchases for consumption off premises, such as from supermarkets and shops, increased throughout the pandemic.

They noticeably “spiked” in the week before the first national lockdown, and subsequently went up by 13% in 2020 and 15% in 2021 (January to May), compared with the average for 2017–19.

The report said this was “likely a consequence of the closure of on-trade premises on 21 March 2020 and stockpiling due to a national lockdown looking likely”.

These off-trade sales then remained markedly higher than the 2017–19 average throughout most of the first lockdown and, from January until May 2021, when on-trade premises were closed again, off-trade sales per adult were consistently higher than average, the data showed.

Alcohol consumption was also above recommended levels between the start of Covid-19 restrictions in March 2020 and May 2021.

A total of 17 units (171 ml) of pure alcohol were sold per adult each week on average, 16 (162 ml) of which have been from off-trade premises – enough alcohol to put every adult in Scotland over the Chief Medical Officer’s low-risk weekly drinking guideline of 14 units, the report said.

In response to the study, Alison Douglas, chief executive of Alcohol Focus Scotland, which works to prevent alcohol harm, said: “While it is positive that overall Scots drank less during the last two years, this needs to seen in the context of the devastating rise in deaths caused by alcohol during the same period.

“Drinking habits appear to have become polarised; some have cut down, while others – particularly heavier drinkers – have increased their drinking.

“In addition, it has been challenging for people to access the support they need, with reports of services being reduced or operating online for periods of time.”

Ms Douglas echoed conclusions from the report saying helping people to reduce how much they drink “must remain a priority as part of Scotland’s recovery from Covid-19”.

She said this can be achieved both through measures such as increasing the minimum unit price to 65p per unit, introducing restrictions on alcohol marketing, and reducing the ready availability of alcohol.

Public health minister Maree Todd said the Covid pandemic had impacted society in many ways, adding that “since the beginning we’ve taken action to assist those who are drinking at harmful levels”.

She stated: “Throughout the pandemic we allocated additional funding to extend outreach initiatives which identify people at risk, address their immediate health concerns, and get them the support they need.

“We’re determined to go further, which is why we are focusing on reducing harms where they are greatest.

“To help achieve this we are consulting on potential restrictions on alcohol advertising, reviewing the level of the minimum unit price, and improving health information on product labels.”

Investment in tackling problematic alcohol and drug use has been increased, along with that for residential rehabilitation, the minister added.

She said: “Work on reducing alcohol harms is ongoing, and there is more to understand about the impact of the pandemic on these harms.”

But Labour public health spokesman Paul O’Kane said: “It’s all too clear that the pandemic has led to a rise in alcohol-related deaths across Scotland.

“This is deeply concerning – we cannot allow the progress made in recent years to slip away.

“The SNP has taken its eye off the ball and allowed cuts to drug and alcohol beds. It is also failing to provide adequate financial resource to key services – including Alcohol and Drugs Partnerships – to deliver more focused support around alcohol consumption. This is unacceptable.

“We need to put tackling problem drinking at the heart of our recovery from the pandemic so that lives that not lost.”

And Alex Cole-Hamilton, the leader of the Scottish Liberal Democrats, said that “raising the minimum unit price to 65p, in line with the original ambition of the policy, would cut alcohol misuse and reduce the pressure on our health and justice systems”.

“Alcohol misuse can wreck lives, communities, and families,” said the MSP.

“The health secretary’s current plan is not sufficient to avoid these preventable deaths, and the SNP’s inaction over time has allowed inflation to erode the impact of the original policy. Scotland urgently needs fresh measures to address its harmful relationship with alcohol.”

Sue Webber, the Scottish Conservative’s shadow public health minister, said that Scotland “continues to have significant issues in dealing with alcohol and it is clear that the SNP’s current strategies are simply not working”.

“It is deeply concerning alcohol deaths rose during the Covid pandemic. As we look beyond this crisis, that simply cannot continue,” the MSP said.

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