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WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

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Page 1: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

WHY THE CONCERN ABOUT ALCOHOL?

AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE?

Peter Rice,Consultant Psychiatrist,NHS Tayside

Page 2: 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

Page 3: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside
Page 4: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

Male Cancer Deaths in Scotland 1997 - 2007

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Page 5: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

Female Cancer Diagnosis in Scotland 1997 - 2007

Page 6: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

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

Page 7: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

ISD 2005

THE AGE PROFILE OF HEALTH HARM

Page 8: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

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

Page 9: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

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

Page 10: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

Liver Cirrhosis Death Rates 1950 – 2006 :An International Comparison

Page 11: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

UK Alcohol Consumption

Page 12: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

- 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

Page 13: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

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

Page 14: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside
Page 15: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside
Page 16: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside
Page 17: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

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

Page 18: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside
Page 19: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside
Page 20: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside
Page 21: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside
Page 22: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

AUDIT SCORING

<8 Low risk

8-15 Hazardous Drinking

16-19 Harmful Drinking

>20 Possible dependence

Page 23: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside
Page 24: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside

1 Unit of Alcohol equals 10mls pure alcohol.

Page 25: WHY THE CONCERN ABOUT ALCOHOL? AND WHAT DOES IT HAVE TO DO WITH GENERAL PRACTICE? Peter Rice, Consultant Psychiatrist, NHS Tayside