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Tuesday, September 14, 2004

Binge-drinkers in Casualty to be offered counselling

People who turn up at accident and emergency departments injured as a result of alcohol will be asked to undergo counselling in an attempt to reduce record rates of binge-drinking.

The government is to roll out a series of initiatives this autumn that will see excessive drinkers being questioned about their boozing habits before being given a date for a counselling session. The strategy is a bid to curb the soaring rates of alcohol-related harm that are putting enormous pressure on hospitals.

Casualty consultants are alarmed that young victims of heavy drinking are increasingly turning up on Thursday nights as well as at the weekend, and that around a quarter of them are young women.

Ministers have become convinced they have to act before 24-hour drinking laws come into force next summer. Cheaper drinks, sweet alcopops - which contain up to five units of alcohol in a single bottle - and an influx of clubs into city centres have created what doctors are describing as an epidemic of binge drinking.

The strategy is aimed at bringing home to people the reality of their problems. Patients who turn up to a casualty department with a drinking-related injury, such as head injury or the result of an assault, will be treated before being asked about their habits. If a man admits drinking more than eight units of alcohol in one evening, or a woman more than six, they will receive counselling.

At the Royal Liverpool, one of several hospitals where the strategy has been piloted, patients are kept in overnight and see the specialist nurse the following day - he or she can refer them for extra help if necessary. The counsellor explains that, if they don't cut down on their drinking, they are storing up long-term health problems, such as liver damage or infertility.

Professor Robin Touquet, A&E consultant at St Mary's Hospital in west London, said the government had to put more investment into alcohol-related health services. 'Binge-drinking is getting worse, particularly among women. The emancipation of women has meant bad things as well as good have been emancipated.'
He will present research this year to show that 'brief interventions' encourage patients to cut down on their drinking and reduce the number of visits to A&E.

Many intensive care cases are also drinking-related, says Martin Shalley, president of the British Association for Accident and Emergency Medicine. 'There's no doubt we are in for an epidemic of alcohol-related disease - chronic as well as acute - in the next 10 to 15 years,' he told the Health Service Journal.'

It is not only casualty departments that bear the brunt of the crisis. Liver specialists have reported an increasing number of men and women in their twenties with a condition known as acute alcoholic hepatitis, which carries between a 30 and 90 per cent mortality rate.

Dr Charles Millson, consultant hepatologist at St James' Hospital in Leeds, said: 'They don't put a warning about this condition on a bottle of alcopop, but it is very serious and we are hearing more and more about it.

'District general hospitals ask us if we can do a liver transplant for these patients, which we can't [because of the shortage of organs]. The problem is that everyone has a different genetic susceptibility and a lot of people think they can drink a great deal more than they can.'

Earlier this year Tony Blair warned that binge-drinking was becoming a big social problem and warned the industry to curb 'happy hours' and other incentives that encourage the lads and ladettes culture.

Last week the industry's voluntary body, the Portman Group, produced a campaign warning that too much drink can ruin women's skin and cause weight gain and broken veins under the skin.

It pointed out that, among women aged 16 to 24, the proportion drinking more than 35 units of alcohol a week has risen from 3 per cent in 1998 to 10 per cent in 2002

Jo Revill, health editor
Source: The Observer - 29.8.04

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