Alex White (Dublin South, Labour) | Oireachtas source

I am pleased to be back in the Seanad and welcome this opportunity to discuss the difficult and challenging issue of alcohol misuse in our country. The national substance misuse strategy steering group identified the following four key harms of alcohol. First, 88 people died every month in 2008 from alcohol. Second, in 2007 the total estimated cost of alcohol misuse to the health care and justice systems, the economy and from alcohol-related road accidents was ¤3.4 billion. Third, alcohol is a contributory factor in half of all suicides, which means it was a contributory factor in the suicides of 245 people in 2010. Fourth, the group noted that alcohol was consumed in four in every ten episodes of self-harm in Ireland in 2010 and was a factor in 4,764 episodes of deliberate self-harm in 2011.

In addition, the 2011 Annual Report of the National Registry of Deliberate Self Harm Ireland declared the following: "In line with previous years, misuse or abuse of alcohol is one of the factors associated with the higher rate of self-harm presentations on Sundays, Mondays and public holidays around the hours of midnight."

I am sure that these kinds of figures on deaths, self-harm and monetary costs register with every Member of this House and make us wonder about the reason we are letting alcohol do that and the reason our legal regime governing the direct and indirect sale of alcohol - in the form of advertising - is a factor in all of this harm. If those four harms were not enough there is another series of problems that alcohol is causing according to the National Substance Misuse Strategy Steering Group. One in four deaths in young men was estimated to be due to alcohol; alcohol increases the risk of more than 60 medical conditions, including many cancers; it is associated with 2,000 beds being occupied every night in Irish acute hospitals; it is associated with a quarter of injuries presenting to emergency departments; it is estimated to be associated with 16% of child abuse cases; it has been reported that alcohol was a trigger in one third of domestic abuse cases in 2005; and it is associated with harms to infants as a result of mothers drinking during pregnancy, and a range of disorders known as foetal alcohol spectrum disorders are caused by mothers drinking alcohol in pregnancy. This series of harm patterns for alcohol would therefore seem to represent an insurmountable wall of harm, as it were, for a huge number of Irish people.

We cannot deny that alcohol is associated with many aspects of our social and cultural life; that is self-evident. It is part of our custom for sociability, relaxation and enjoyment. The pub often plays an important role in community life and it is also an attraction for tourists. The paradox of alcohol, however, is that its consumption for pleasure and hospitality, along with its economic benefits, is overshadowed by the harm and health problems it causes when it is misused or consumed in a harmful and hazardous way.

Worryingly, Irish adults binge drink more than any other European country; 25% of Irish adults have reported that they binge drink every week. Irish children are also drinking from a younger age, and drinking more than ever before. Over half of Irish 16 year old children have been drunk, and one in five is a weekly drinker according to studies that have been prepared. Ultimately, 1.5 million Irish adults drink in a harmful pattern according to the steering group.

Senators will be aware that there has been a proliferation of outlets and stores that sell alcohol, and not just in urban areas. Supermarkets, convenience stores and petrol stations now sell alcohol. I suggest it is not unreasonable to link elevated levels of alcohol consumption by the Irish population with this proliferation of availability. We must do something about that because if we do not, we risk ignoring the body of evidence that is plain for all to see.

The normalisation of alcohol in Irish society has been achieved partly at least by the manner in which it is promoted through various media. It is almost as if alcohol has become a basic everyday grocery product to be purchased with everyday consumables such as bread, milk and butter. On the contrary, alcohol is no ordinary commodity, to borrow the title of the World Health Organisation-sponsored study by Babor and others some years ago. It has major public health implications, and the State has a responsibility to preserve and protect public health and the general well-being of society. Furthermore, alcohol is a psychoactive substance that can impair motor skills and judgment, and its effects on the individual can occur at various points across a spectrum. It is a drug of dependence and can act as a gateway to the use of illicit drugs for some people.

It is imperative that we reduce the overall level of alcohol consumed in our society and tackle the problems of alcohol misuse. As Senators are aware, the report of the National Substance Misuse Strategy Steering Group was published last February. The steering group's objective was to set out an evidence-based framework which identifies effective policies and actions to tackle the harm caused to individuals and society by alcohol use and misuse.

The report made a range of recommendations that focused on key issues in the area of the misuse of alcohol. These issues include the supply, pricing, availability and marketing of alcohol along with preventive strategies including treatment, rehabilitation, alcohol and substance dependency research and information.

Some of the key recommendations within the report include the following - increase the price of alcohol so that it becomes less affordable; introduce a legislative basis for minimum pricing, along with a social responsibility levy on the drinks industry; commence section 9 of the Intoxicating Liquor Act 2008, which deals with structural separation of alcohol from other products in supermarkets and other outlets; introduce legislation and statutory codes to provide for a 9 p.m. watershed for alcohol advertising on television and radio; there could not be that type of advertising prior to 9 p.m.; alcohol advertising in cinemas to be associated with films classified as being suitable for those over 18 only; prohibition of all outdoor advertising of alcohol; all alcohol advertising in the print media to be subject to stringent codes, enshrined in legislation and independently monitored; phase out drinks industry sponsorship of sport and other large public events by 2016; develop a system to monitor the enforcement of the provisions of intoxicating liquor legislation; establish a clinical directorate to develop the clinical and organisational governance framework in order to underpin treatment and rehabilitation services; and develop early intervention guidelines for alcohol and substance use across all relevant sectors of the health and social care system. This will include a national screening and brief intervention protocol for early identification of problem alcohol use.

As stated earlier, the steering group noted that children are drinking sooner and drinking more than ever before. The group was wholly cognisant of children when framing its recommendations, as Senators will see from the document. These recommendations are generic and apply to all cohorts of the population, including children.

Members will see from the recommendations that there was a strong public health dimension to the steering group's work in dealing with alcohol misuse. Our agenda now is to protect and improve the health of Irish people on foot of the recommendations that have been made. The steering group's report was stark as to public health and protection given that it reported that potentially 1.5 million people in Ireland are drinking in a harmful way.

The burden of alcohol on our society and systems is overwhelming. This is an evidence-based statement based on what the National Substance Misuse Strategy Steering Group found and reported. These problems are patently obvious - the burden of hazards and pain that alcohol misuse causes; the trauma it is responsible for; the waste it provokes in the case of lost economic output, absenteeism and more; the adverse effects it has on families and children as a result of a family member misusing alcohol. It has been estimated that adult alcohol problems are associated with 16% of child abuse and neglect cases, and alcohol has been found to be a trigger in one third of domestic abuse cases.

The steering group covered issues pertinent to children and families where it addressed the treatment and rehabilitation of people due to the misuse of alcohol. These include addressing gaps in child and adolescent service provision, and developing multi-disciplinary child and adolescent teams, along with developing an approach to addressing the needs of children and families experiencing alcohol dependency problems.

The extent of alcohol misuse warrants strong and effective policies that can address this pervasive threat to Irish public health. One such policy recommended by the steering group is a regime of minimum pricing. Minimum pricing is ultimately a mechanism of imposing a statutory floor in price levels for alcohol products that must be legally observed by retailers. The primary function of this measure is to reduce at risk levels of alcohol consumption, especially by those who drink in a harmful and hazardous way.

It also would have a greater impact on discouraging children to drink. In turn, this could then diminish the effect the misuse of alcohol and over-consumption would have on a range of social areas, including public services, crimes and public health, together of course with productivity in the economy. One cannot be ambivalent when it comes to the pattern of alcohol consumption and the harms for which alcohol is responsible. Ambivalence on alcohol is now inexcusable and the report of the steering group has made sure of that. The national substance misuse strategy points the way for the future direction of policy to deal with the use and misuse of alcohol. There are challenges with some of these recommendations and this is both clear and perhaps inevitable. Nonetheless, my Department is preparing a concrete set of proposals on the basis of the national substance misuse strategy report to which I have alluded. The intention is to submit these proposals to the Government for consideration and approval as soon as possible.