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CHEAP DRINK AND its contribution to alcohol abuse, has long been a huge problem in Ireland. It’s no secret that 2020 has been a difficult year, but despite the closure of pubs for most of it, Irish people have continued to consume and often abuse alcohol with abundant purchases at their local supermarket or convenience store.
This week, Donegal has joined Dublin in Level 3 restrictions, which is a very difficult time for people in both counties. In the midst of the discussion around restrictions and the spread of the virus, we’ve heard much of house parties and gatherings in the home.
Reducing the supply of cheap alcohol, as other countries have done, should be part of the Government’s Covid battle plan; alcohol and social distancing remain poor bedfellows.
And while there has been some concern about so-called ‘wet pubs’ as centres of transmission, drinking parties in houses, particularly when that alcohol has been bought for ‘pocket-money’ prices, should be a real concern too.
It’s been more than 700 days since the public health alcohol policy, framed by the Public Health Alcohol Act, enacted minimum unit pricing (MUP) for alcohol products as a proven measure to reduce alcohol use especially amongst the most hazardous of drinkers.
This establishes a floor price for all alcohol products beneath which they cannot legally be sold.
This would ensure that the cheapest, strongest alcohol, carefully selected by drinkers in search of the greatest high for the lowest price – that €11 bottle of Irish Whiskey, the €12 bottle of Gin or the 2-litre dynamite flagon of Irish cider, so evident throughout the retail landscape – would become a thing of the past.
The Covid effect
Despite all the pubs being closed from the end of March through to early July because of Covid-19, and only half-opened since then, indications are that Ireland’s alcohol use has only declined by 4%.
During lockdown and since, however, trade data consistently shows that off-trade sales are booming, as more and more drinkers shift their alcohol use into their homes having unearthed the exceptional affordability of alcohol in the retail market.
Price is central to demand and off-trade price surveys consistently show how affordable alcohol is, with men’s low-risk drinking weekly guideline of 17 standard drinks within reach for as little as €7.65. A woman’s weekly 11 standard drinks can be bought for less than a fiver at €4.95.
The 2020 programme for government renewed a ‘longstanding’ commitment to implement MUP but ‘in consultation’ with the Northern Ireland Executive.
Back in 2015, the then Executive announced it would proceed with an alcohol minimum unit pricing policy having commissioned research that suggested that such a policy would lead to a reduction in alcohol use by 5.7% and could reduce alcohol-related deaths in Northern Ireland.
The recent announcement by the Northern Ireland’s Minister for Health Robin Swann to consult on the possible introduction of such a measure, however, suggests further interminable delay.
A cross-border issue
In the North, the rate per hundred thousand of alcohol-related deaths stands at 15.09 per 100,000 (NISRA 2018); Ireland’s rate currently stands at 21.2, according to the Health Research Board’s 2013 alcohol-related deaths.
While ideological objections and spurious considerations of cross border trade have stalled implementation, we cannot allow economic concerns to block and delay measures that can contribute to reducing alcohol harm and improving public health.
Only one of the five alcohol products in Northern Ireland is lower than the floor price to be established by the proposed law in the Republic. There are many reasons why people choose to shop in Northern Ireland such as currency fluctuations and VAT.
These factors, added to consumer choices, ultimately determine the purchase point of alcohol for communities both sides of the Irish/UK border.
Distance and proximity to the border are also important considerations. Over 60% of the estimated value (€458m; CSO:2018) of current Ireland to Northern Ireland cross-border shopping is done by those who live closest to the Border.
Booze is not the border draw
‘The AA’ (Automobile Association) seasonal consumer cross-border survey demonstrates that fashion items and cosmetics feature higher than any other products in motivating such cross-border shopping.
Around a third of those who shop cross border ‘intend on picking up alcohol’ where there is also a 13% difference between the VAT rate on alcohol products in the UK (20%) than in Ireland (23%).
Ensuring that cheap, strong alcohol cannot be sold in Ireland beneath a certain price is unlikely to contribute any further to cross-border shopping.
Since 2013, when the government agreed to introduce MUP, there have been 875 deaths from direct alcohol poisoning alone, likely induced by acute alcohol episodes. The Global Burden of Diseases would estimate that 19,530 deaths related to alcohol use have occurred in this period.
In a judgement from the UK Supreme Court (2017) rejecting a legal challenge by the Scotch Whisky Association et al to the proposed introduction of minimum pricing in Scotland, Lord Mance, delivering a unanimous decision, and reflecting on the incomparable values of health or economic impact on producers, stated ‘the courts should not second-guess the value which a domestic legislator puts on health’.
Ireland can no longer wait. It must lead. Implementation must proceed and pandering to vested interests can no longer be a rational government position to delay the commencement of a democratically approved public health measure.
Eunan McKinney is Head of Communications and Advocacy at Alcohol Action Ireland.
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Just want to say how brave you are. I lived with my mam who was scziophrenic since she was 23 years old. The meds she was put on turned her into a zombie. She slept some days for 20 hours. In the last years of her life I barely got to speak to her. Nobody will ever get how it feels to see your mam in a state of total confusion, when she didn’t know who she was, or who her children were. The stigma we dealt with as a family will stay with me forever, her illness caused us to turn a blind eye to anything physical that occurred because we didn’t know if it was her or her alter egos. Finally she died 3 days after being admitted to hospital with a massive tumour in her lungs from smoking. She hated doctors and would never go, so it was too late. I watched her die on my 28th birthday 2.5 years ago. I am sending you positive vibes and hope that you can overcome whatever life throws at you. Nobody will understand, unless they have been there or have lived with someone with this cruel illness. I wish you the best of luck.
Very informative and thoughtful point of view.
Excellent excellent
Great article.
Thanks for that article Nicola a very interesting point of view about meds and there affects. Best of luck in the future. Respect!!
Best article on the Journal in months. Well done Nicola. Thoughtful and insightful.
I wish you the best in life for your brave decisions. My Mam suffered from schizophrenia from the age of 23. The stigma we dealt with as a family my whole life has shaped how I feel about people to this very day. The meds she was on left her like a zombie. I never got to have a drink with my mam, go shopping with her on a whim, or just have a “normal” life with her. People will never understand it, and I do feel like I was robbed of all those things that everyone else takes for granted. Her illness was ultimately what led to her downfall, she would not go to a doctors when sick. So the massive tumour that took over her lungs in her final 3 days went un-diagnosed and I got l few hours with her before I had to watch her die on my 28th birthday. The only people who will get what I’m going through are those who know someone with this illness. It destroys lives, it destroyed mine and my family’s. I wish you all the best in life and I think you are so brave. Take care x x
Nicola you’re article is dangerous. It could encourage people who need medication to come off it too quickly. The vast majority of people with schizophrenia need medication. People with schizophrenia have killed themselves and others after coming off medication too soon.
My family member went off her medication (clozaril) and it proved to be an absolute disaster for them.The anxiety attacks,delusions & the hallucinations,came back stronger than ever.Four years later and they are just starting to ‘improve’ again..Be very careful people…
Hi Nicola, how long are you now off medication please?
@Francis Mc Carthy: I totally agree, this article is completely dangerous for society at large. My sister is a schizophrenic and without medicine anyone who is near her is in physical danger. She is also highly educated and able to write as competently as the journalist today, because they have good days. What happens to society when they have a bad day with no medicine…especially someone who drives. My sister drives and had to be ran off the road for everyone’s safety when she decided to take to the wheel without medicine. My god, I am really horrified that this article got any space. Please, please print a responsible article on the subject. For clarity sake, my sister is not special, all schizo’s act this way and worse at some stage if not medicated.
@Jack Bowden and Amy M:
It clearly says she is an exception (a few times) and that she came off them slowly and gradually. Also that she would go back on them if needs be. It doesn’t glorify not taking meds at all. This is a considered piece of writing that may give some hope indeed to others but by no means says just stop taking everything everyone its all good.
Please do not use the term ‘schizos’. Your sister is a person suffering with schizophrenia, one of the toughest metal illness that can effect any of us at any time.
Editor should ensure that reader knows how long a person with schizophrenia is off medication to give some clue to this personal experiment’s effectiveness. I believe that the NUJ has agreed guidelines for responsible reporting of mental health issues.
Thank you Nicola, the voice of reason.
Courageous and honest account. More info on the non-pharma recovery methods referred to please. Others may find that helpful. I wonder often is Ireland’s economic dependence on pharmaceutical FDI, the unhealthiest close ties between senior government ministers (now enjoying numerous sinecures on boards of biotech companies as reward for her efforts) in past and doubtless future governments, the unhealthy relationships including massive junkets between the psychiatry profession in particular, and big pharma, have any causative role in the Irish over medication scenario? Correlation not always causation but..
Regards to the author of this important piece in any event. Doing her bit to help destigmatise mental illness in a country where attitudes towards it range from 19th century to downright medieval.
I have a big interest in the brain chemistry (biochemistry) of mental health. I try to minimise using medication by using nutrient therapy. The reality is that in anybody who has had an episode of psychosis the relapse rate is close to 90% and hopefully you will be one of the lucky 10%. I find that more than 50% with depression can get off meds provided they use the individualised doses of nutrients. Anxiety rarely requires medication long-term if they take their nutrients. Autistic children can do surprsingly well if the chemistry is sorted out in early childhood. The outlook is bad if they leave it until later.
You are promoting quackery – there’s no evidence that autism can be somehow reversed through “nutrition therapy”.
As for depression, sadly the best proven method we have of treating this affliction is through the use of medications such as SSRIs. You seem to think otherwise, do you have any published academic literature to support your claim(s)?
Interesting Ted Talk here https://www.youtube.com/watch?v=nyrqBAICOXE
@Aoife Murphy: thanks for that Aoife. The pere nial question as to whether we are seeing dramatic increases in the incidence of childhood mental illness or an increase in their diagnosis aside, your speaker makes compelling arguments for improvements in nutrition leading to better outcomes.
I always say Home Economics should be as compulsory as Irish English and Maths for all students regardless of gender throughout primary and secondary education. No child should leave school without knowing how to select, prepare, and cook, wholesome and nutritious food.
Our Western diet has changed dramatically since WW2 and not to our good, but rather to the good of the corporates that provide processed sludge. We are sowing the wind and must reap the whirlwind. Diabetic storm incoming and worse besides.
Actually the NICE guidelines recommend psychosocial interventions or CBT first before considering medications for depression
@Tom the Bomb: In this country and others, CBT is ongoing whilst the medication is also being prescribed, not one before the other.
@Edmond OFlaherty: I am replying here as the voting was 4 to 1 against my point of view.I am doing this work since 1999 but went to Sydney in 2006 to get more knowledge. There was about 20 GPs attending the conference and the 2016 meeting was twice as large and also had several consultant psychiatrists attending. You can read about it at http://www.biobalance.org.au. I gave a lecture on this topic to the European GP meeting in Vienna later.Another useful website is http://www.walshinstitute.org. A good book is Nutrient Power by Dr William Walsh PhD. A London University psychiatist phoned me recently and told me that this is the way forwards.
Hey Nicola, So proud of you girl well done! I have bipolar disorder been off medication since 2011 and lead a normal life now with psychological treatment! People who have never suffered with a mental health problem have no right to an opinion on how somebody lives with mental health disorder and even commenting is pathetic because they have no understanding of what its like. Your inspiration girl, people with mental health issues have been hiding for far to long in this country due to stigma and discrimination. Don’t be listening to trolls on this! People are always afraid of what they don’t understand!!
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