Measures to tackle alcohol misuse

Scotland Substance abuse

Richard Simpson MSP argues that we need more than just minimum pricing to tackle alcohol misuse.

Alcohol misuse and its consequence for health and community safety remains a significant challenge throughout the UK. The Sheffield model on which the debate around minimum unit price (MUP) has been based predicated a reduction in consumption of 3.8% from a ban on discounting. In practice there was a reduction of only 1%. It is worrying for MUP that the model has been found flawed at the first test.

Increases in duty and VAT have led to an increase in price and will have contributed to the reduction in the UK consumption over recent years. Many other measurements are improving including deaths particularly in men down 15%, self reported hazardous drinking down by a quarter, and reductions in admissions and discharges from hospital. Scotland remains the nation with the greatest problem in the UK. It was clear at the time of the debate on MUP that whatever the merits of MUP many stakeholders were of the opinion that other measures were needed.

With the support of Labour colleagues I have consulted on fourteen measures which may form part of a private members bill. The responses have been generally positive or very positive. There are two strands to the bill. One is concerned with those whose pattern of alcohol consumption is getting them into difficulty. Many of them build on pilot work already undertaken.

Areas where there were diverse views many supportive but with some suggesting the need for further evidence and evaluation included:

  • Restrictions on pre-mixed caffeinated alcohol products;
  • Licensing Boards having the power to make bottle-tagging schemes a licensing condition;
  • Fine Diversion being made available on a statutory basis;
  • Arrest Referral Schemes for alcohol (as well as drugs) being a statutory requirement in each Community Justice Authority;
  • Drink Banning Orders;
  • Extending Drug Treatment and Testing Orders (DTTOs) to become Alcohol Drug Treatment and Testing Orders (ADTTOs).

The evidence on the risks of premixed caffeine alcohol drinks has strengthened since this was last proposed. The USA has now banned premixed drinks completely.

The use of Bottle Tagging to gather intelligence on the source of purchases involved in both underage drinking and proxy purchasing could help tackle underage drinking. There are some objections on the ground of cost to the licensee. However, this would not be a requirement on all licensees rather a power to make it part of the license if requested by the police.

Fine diversion into educational programmes has proved worthwhile in a Fife pilot.

Currently a very substantial proportion of offenders in short term custody have an alcohol element in their offence. Short term custody does not allow the Scottish Prison service to undertake work with prisoners so more diversion which does address their problem should be valuable. Arrest referral is only currently available in two sherrifdoms though some five do have such a referral mechanism for drug misuse. The bill would extend this to all eight sheriffdoms.

Drink Banning Orders in England show some benefit both in the individual behaviour and in community safety. Some of the new Police Commissioners are committed to extending their use. ACPOS support for this measure is particularly welcomed.

Increase diversion from custodial sentences into treatment, building on the Drug Testing and Treatment orders (DTTO) and Community Orders, is proposed with a specific order for Alcohol (ATTO).

One reference was made in the consultation response to the application of breathalyser locks being required by some US states following an offence. Drivers have to demonstrate that they meet the drink driving limits before a vehicle will start. This is not in the bill at present but may be worth considering
There are a number of general measures including clarification on the licensing conditions on the public health interest and protecting children; re-establishing the national licensing forum; strengthening the discount ban and restricting advertising. The full response to the consultation on the bill will be published as soon as we have the government’s view.

Dr Richard Simpson MSP is Scottish Labour’s Public Health spokesman.

From Healthier Scotland: the Journal