why the concern about alcohol? and what does it have to do with general practice? peter rice,...

WHY THE CONCERN ABOUT ALCOHOL?

AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE?

Peter Rice,Consultant Psychiatrist,NHS Tayside

ISD 2005ISD 2005

Alcohol Related Deaths in Scotland 1980 - 2003

Male Cancer Deaths in Scotland 1997 - 2007

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Female Cancer Diagnosis in Scotland 1997 - 2007

SCOTTISH ALCOHOL HARM or INTOXICATION ADMISSIONS:THE AGE and GENDER PROFILE

ISD 2005

THE AGE PROFILE OF HEALTH HARM

Chronic Liver Disease Mortality by Deprivation, Scotland (Men)

Male mortality rate for chronic liver disease per 100 000 population, 1980-2002

0

10

20

30

40

50

60

70

80

90

1 2 3 4 5 6 7

Deprivation category

dea

ths

per

100

000

p

op

ula

tio

n

1980-82

1991-92

2000-02

Alcohol related deaths in the UK, by local area, 1998-2004

Source: Office for National Statistics

• 15 of the 20 UK areas with the highest male death rates are in Scotland

• Dundee ranks 5th highest in the UK for men

• For women, the alcohol related death rate in Dundee ranks 2nd highest in the UK

Liver Cirrhosis Death Rates 1950 – 2006 :An International Comparison

UK Alcohol Consumption

- Coronary Heart Disease- Children’s Dental Care- Childhood Obesity- Suicide Prevention- Smoking Cessation- Breastfeeding and…….

Achieve agreed number of screenings using the setting-appropriate screening tool and appropriate alcohol brief intervention, in line with SIGN 74 guidelines by 2010/11

HEALTH IMPROVEMENT TARGETS 2008

First call on the additional funding should be to enable NHS Boards to meet these (HEAT) targets, and for brief interventions to become part of the standard services offered by NHS Scotland.

We anticipate that considerable work will be required in 2008/09 to establish delivery arrangements and build capacity across the priority settings of

-Primary Care, -A&E - Ante natal - Acute Care- Deprived populations

SCOTTISH GOVERNMENT PUBLIC HEALTH ALLOCATIONS 08/09

STAGE OF CHANGE Precontemplation “At the back of my mind.”

Contemplation Thinking about it  Preparation  Getting ready to do something

Action Doing something

 Maintenance Keeping it going

AUDIT SCORING

<8 Low risk

8-15 Hazardous Drinking

16-19 Harmful Drinking

>20 Possible dependence

1 Unit of Alcohol equals 10mls pure alcohol.