Alcohol in Ireland: A sobering report

Last month, as the UK called time on the EU, the Health Research Board (HRB) released a sobering report on the harm and cost of alcohol consumption in Ireland. Using data from the hospital in-patient reporting system, the authors examine the patterns and effects of alcohol consumption and the impact on Irish society.

The report is extensive and thorough, with headline figures, such as:

  • In 2014 Irish drinkers consumed on average 11 litres of pure alcohol, with 50% of drinkers consuming alcohol in a harmful manner. Among 36 OECD countries, Ireland has the fourth highest alcohol consumption.
  • The number of people discharged from hospital whose condition was totally attributable to alcohol rose by 82% between 1995 and 2013. Three people died each day in 2013 as a result of drinking alcohol and in 2014 one-in-three self-harm presentations were alcohol-related.
  •  In 2013, alcohol-related discharges accounted for 160,211 bed days in public hospitals – 3.6% of all bed days that year. €1.5 billion is the cost to the tax-payer for alcohol-related discharges from hospital. That is equal to €1 for every €10 spent on public health in 2012 (This excludes the cost of emergency cases, GP visits, psychiatric admissions and alcohol treatment services).The estimated cost of alcohol-related absenteeism was €41,290,805 in 2013.

The full report is here, with a summary of findings in graphical form here.

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13 thoughts on “Alcohol in Ireland: A sobering report”

  1. 3 people per day die due to alcoholism. Drink sensibly is fluff given the national genes.

      1. Ernie, certain physical features are made more prominent by selection. Why not alcoholism?

  2. Its a good report, but the figures in the report don’t match the alarmist headline, which is itself a rather sober headline compared to most media treatment of the matter. Health fascism has grown alarmingly in Ireland in recent years and this is behind much sensationalist media coverage of the problem (I’m not suggesting this report is an example of health fascism, but one can be sure it will be used by the media to promote health fascism).

    (1) The WHO has published several tables for alcohol consumption in recent years. Three are included in this link:

    https://en.wikipedia.org/wiki/List_of_countries_by_alcohol_consumption_per_capita

    The one used in this report is the third of the three, showing Ireland 4th-ranked. The other two show Ireland 12th-ranked and 22nd-ranked respectively. The differences between them appear to relate to (a) the year chosen (b) whether or not an estimate is included for unrecorded consumption (c) whether or not the figures are adjusted for the age-distribution of the population, I agree with adjusting the figures (as done in this report) to show alcohol consumption per person aged 15+ (rather than just per person) – however, they should be further adjusted to take account of the fact that the proportion of the population aged 70+ is much lower in Ireland than in other countries. Generally, those aged 70+ can’t consume nearly as much alcohol as 25-year-old rugby players after a match.

    When all these factors are taken into account, contrary to all the sensationalist media headlines and racist stereotyping (as exemplified by Seafoid’s post), the level of alcohol consumption in Ireland is very close to that in other northern European countries, a little bit lower on some measures and a little bit higher on other measures. These countries all have fairly similar climates and living standards and so comparison is valid. Comparing them with the OECD average is of little value, since the OECD has many countries with large populations (e.g. Mexico, Turkey) that have very low living standards compared with northern Europe, so these distort the average.

    (2) The CSO figures given in the report show alcohol consumption rising from 10.3 units per person aged 15+ in 1985 to 11.0 units per person aged 15+ in 2015. Given that living standards and real incomes more than doubled in this period, its not much of an increase and hardly the epidemic the media refer to.

    (3) During the period covered in the report, overall mortality rates fell dramatically in Ireland. They fell by 35%-40% for all age groups between 1995 and 2015. And life expectancy increased by almost 6 years in that period, the largest increase in western Europe. So, if there was an increase in alcohol-related deaths, this was dwarfed by a much larger decrease in non-alcohol-related deaths. Has any research been done into the part played by moderate alcohol consumption in the healthier lifestyle that led to this fall?

    (4) All the medical statistics contained in the report clearly indicate that the problem peaked in the early 2000s and has declined sharply since. For example, the number of admissions to hospitals for alcoholism treatments was lower in 2014 than in 2002, despite a 20 per cent increase in the population aged 15+ in that period.

    (5) As the figures in the report make clear, social problems, usually attributed to alcohol, such as suicides, road deaths and public order offences, have all shown sharp falls since the early 2000s.

    (6) Taxes on alcohol in Ireland are by far the highest in the EU. Alcohol prices in Ireland are 75% higher than the EU average and the highest in the EU. Alcohol is virtually the only consumer item that is more expensive in Ireland than in the high-cost Nordic countries. And still there is a clamour for more. This is the result of health fascism gone mad and has been very damaging to the tourist industry and to the retail trade in border areas.

    I myself drink a negligible amount (my last drink was a single glass of wine when Tyrone won the All-Ireland in 2008 and I’m hoping to repeat that this year) and would be happy for alcohol consumption to be zero. My parents were both Pioneers. So was I until it became too dangerous to wear the badge in Belfast in the 1970s. The Pioneer movement was by far the most successful movement in Ireland’s history in reducing alcohol consumption. Its success was mirrored by the Salvation Army in other countries. Such organisations are out of fashion in modern secular liberal societies, the chief characteristic of which is the need for instant gratification and lack of self-restraint in every sphere, with the only weapon to curb the resultant excesses being penal taxation that punishes those who don’t have a problem as much as it does those who do have a problem. It would be much better if alcohol consumption was curbed by strong social movements such as these rather than by economically-damaging penal taxation.

  3. Health costs rise faster than GDP across the EU. It may not be possible for much longer for drinks companies to take all the profit from alcohol sales while avoiding the costs of mitigating the damage done via chronic alcohol consumption. The days of the taxpayer picking up the tab are probably numbered.
    The same goes for sugar.

  4. I’ve always been a bit sceptical when medics branch out from their primary function to (a) preach and (b) dabble in economics/econometrics.

    I was really impressed at the estimate quoted for the cost of alcohol-related absenteeism: €41,290,805. I never realised that empirical work in Economics had attained the level of precision we normally associate with Newtonian Physics.

    More seriously, the research seems to regard the social costs of alcohol as simply what it costs the health service – again with amazing precision. I am sure the social costs are large, leaving aside the heretical thought that alcohol might have benefits when taken in moderation. However in the long-run even if the “costs” were eliminated due to a total cessation of alcohol consumption, then other costs would arise: people with healthy livers would have to die of something else which would impose costs on the health system; increased longevity would cost the Exchequer even more in pensions, care of the very elderly and so on.

    While it is true that increasing the price of alcohol would have health benefits, there are some problems with this. For a start increased alcohol taxes are likely to highly regressive – I suppose that’s OK when one is on a moral crusade, and anyhow the effects on the pockets of highly-paid medics are likely to be small. A further consideration is that when one looks at southern Europe where alcohol is relatively cheap, consumption habits seem to be relatively benign. Maybe much more intensive health education and a really tough crackdown on the anti-social behaviour associated with excessive and under-age drinking might achieve a fair amount without annoying those whose incomes and drinking habits are modest.

    1. I’ve always been a bit sceptical when economiats branch out from their primary function to (a) preach and (b) dabble in medical policy

  5. So what? So long as the externality of harm from alcohol is covered there’s no issue. Also some classic remedies for recovering that cost, are blunt instruments that merely subsidize and even encourage risk taking.

    Also the claimed absenteeism cost is so methodologically sloppy as being difficult to forgive, whatever the loss is, it’s unlikely to be the paycost. Often team members make up the slack within resources…other times sales may be missed.

    Lastly I’m not reviewing the purported health system costs, as I’ve no reason to expect any better quality there, as alone one would have to account for co-morbidities etc

  6. Well done to the researchers, and to Ms Bourke for posting report.

    If anything, the costs to society and the economy, are probably understated in the report. One of the more serious costs of alcohol consumption is the forfeiture of personal confidence and ambition by people who consume excessive amounts of alcohol, and such costs, while very real, do not lend themselves to quantification.

    “Survey data from 2013 indicate that drinkers in Ireland consume alcohol in an unhealthy pattern; 37.3% of drinkers engaged in monthly risky single-occasion drinking (RSOD), more commonly known as binge drinking, in the previous year; 54.3% of drinkers had a positive score on the AUDIT-C screening tool; 6.9% scored positive for dependence, which indicates that there were somewhere between 149,300 and 203,897 dependent drinkers in Ireland in 2013. At least three-quarters of the alcohol consumed was done so as part of a risky single-occasion or binge drinking session.”

    The above excerpt indicates that the pattern of alcohol consumption in Ireland is a serious health issue and should be treated as such, with taxation policy in relation to product, manufacturers, and retailers being used to address the issue.

    Whether the alcohol consumption patterns are close to other northern European is not the point (as argued by JTO above), Saying that we no worse than the worst of English football fans abroad is cold comfort. Can we set better ambitions of our own volition for once!

    @Seafóid

    “The days of the taxpayer picking up the tab are probably numbered.
    The same goes for sugar.”

    I hope you are right, but would not count on Ireland taking a strong stand on anything (except corporate tax reductions)!

    1. I agree with you that alcohol consumption in excess is bad. Even alcohol consumption in moderation is (in my opinion) a total waste of money. Its for both those reasons that I don’t drink. However, the question is whether the problem is so uniquely bad in Ireland that taxes on alcohol need to be uniquely high.

      I say it isn’t. No one has come back since my first post to show otherwise. And there is nothing in this report that shows otherwise.

      Although high taxes on alcohol don’t affect me in the slightest, I fail to see why honest family men, who may be moderate consumers of alcohol, should be subject to penal taxation in some vain attempt to influence the behaviour of those who drink alcohol to excess.

      The reason Ireland has gone down this road (taxing alcohol so much that its twice the price of countries like France, Germany and Mediterranean countries – all tourist rivals) is because of sensationalist media coverage that purports to show (a) the problem is worse in Ireland than other countries (b) its getting worse. The statistics don’t bear this out. They show (a) its on a par with other countries (b) is getting better (consumption stable or falling despite much greater incomes, road deaths, suicides, public disorder, hospital admissions for alcohol treatment, overall mortality all falling).

      I totally agree that drinking to excess is both unhealthy and morally bad. Some men spend their wage packets on their wives and children. Others on drink. The difference between them is moral. We need to stop propagating the idea that alcoholism is a disease that comes out of the blue. It may become a disease, but in the early days of excessive drinking (which may eventually bring on the disease) its not a disease but bad moral behaviour. However, I have little faith in the ability of governments, economists, social engineers to influence people’s moral behaviour. Strong (usually faith-based) social movements like the Pioneer movement of the Salvation Army temperance movement have a much better record in this respect,

    2. ” …with taxation policy in relation to product, manufacturers, and retailers being used to address the issue.”

      Nope. Never works. Merely creates an additional economic opportunity for illegal business. Aversion Therapy (gory stuff) might persuade some. Persistant, public persuasion will create an acceptable level of abuse. That’s it.

  7. Denial .. Not just a river in Egypt.
    “Yerrah divil a bit of harm , t’aul drink”

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