When public policy is being shaped, it should be based on science and evidence rather that prejudice and distortion. So where is the evidence that Minimum Unit Pricing works?
No matter what the weather, once the clocks go back we’re in winter. Many love the long dark evenings, with their promise of festive fun, friendship and scares. But it’s not all great gas out there right now. Not in Ireland, nor indeed elsewhere.
In addition to the promise of good times, these months also see an upswing in Seasonal Affective Disorder (SAD) and depression. Not everyone is in the party mood. That’s no surprise, given the shit that’s been hitting the fan(s) recently: it is hard to feel upbeat in a world gone crazy.
Plus, some among us are inclined to push the boat out too far, on occasion at least taking things into uncharted waters. If we do not have a clear sense of what the boundaries are – or at least the capacity to learn from past mistakes – even good times can go very bad. It is a message we have been hearing loud and clear, over the past few weeks, in relation to bullying and sexual harassment.
So, there is something to be said for an advertisement that has started popping up on terrestrial radio, warning about using alcohol as a crutch in times of depression. It’s a bit preachy in its tone – but we have no problem with the message. Getting wasted is only going to make you feel worse – maybe even far worse – in the long run.
This message is certainly much more relevant, and to the point, than the Alcohol (Public Health) Bill that is still trundling around the alleys of legislation. To be very clear about it, in relation to the vast majority of the population, the issues that this self-serving piece of legislation is intended to address are largely of the past, both in terms of behaviours and communications patterns. More importantly, the proposed new law offers little to tackle the very real problems of a small minority of the population, albeit a very visible and troubled one, in relation to their use of alcohol.
This isn’t just the view from Hog Hill. It’s also widely held in Sweden, where a paper on that country’s alcohol consumption was published on Medscape in 2015. It explored the divergence in recent years between per capita alcohol consumption, which has decreased, and alcohol-related harmful effects, which have increased sharply among Stockholm youth over the past decade.
The Swedish researchers identified a clear difference between those who drink moderately and those who drink dangerously. They recommended focusing on the latter: “So that targeted interventions can be developed to reduce their current levels of drinking and associated harmful effects.” This clear-minded and non-moralistic thinking is diametrically opposite to the general population control measures in vogue here where, in the view of the Government’s advisors, we are all high-risk drinkers.
One of the key planks of the Irish legislation is the introduction of a minimum unit price (MUP), which is being imposed with little or no sound data to back it up – the only western market where it has been implemented is British Columbia, in Canada.
Crucially, here in Hot Press, we can find no research into whether MUP causes the target groups to switch to homemade liquor; to steal more; to shop across the border; or, more pertinently in the Irish context, to move to drugs for their highs. Since those who will be principally affected by minimum unit pricing are economically disadvantaged, or young, or both, and these groups are most familiar with the drugs market, it seems irresponsible – and potentially very risky – to create such a push factor towards illegality. We wrote recently on hotpress.com that Valium is now available at €1 a pill on the streets. But, of course, that is just one of many uppers, downers and inside-outers that can be bought from drug dealers. They will be rubbing their hands, if and when the effect of the legislation kicks in…
There is a very disquieting aspect to all of this. Those shaping public policy seem incapable of being clear and truthful about what has actually been happening here – so we will tell you.
You would never realise it from the headlines, but alcohol consumption in Ireland has fallen by 25% since 2005; over the same period, the country dropped from 9th to 18th in a World Health Organisation survey of 28 countries. The European Schools Study on Alcohol and Other Drugs (ESPAD, 2016) showed not only a significant decline in underage use, but that Ireland had fallen from 8th to 28th out of 33 countries participating in ESPAD.
There’s more. The Health Promotion Research Centre in UCG has gathered data from 50,000 10-17 years olds since 1998. They found that young people in Ireland are starting to drink later in life and that fewer are smoking tobacco and cannabis. The number who said they drank so much alcohol at some point in their lives that they were “really drunk” fell from 33% in 1998 to 21% in 2014.
So the truth is that things are moderating in the general population.
VOCAL LOBBY GROUP
It is a different picture with the minority who are involved in consumption of drugs and alcohol, in a way that threatens to become problematic in the long run. For example, a recently published small (but significant) study of young cannabis users in Ballymun found them spending over €100 a week on cannabis. But those not in employment, education or training spent an average of €152 a week, even though they only get €100 a week in jobseeker’s assistance.
That €52 gap begs a question. It also emphasises our point about the possibility of unintentionally diverting individuals within this minority group away from legal and regulated substances towards an illegal, and far riskier, type of behaviour.
It is imperative that policy-makers take a rounded, holistic view in relation to these issues. Right now, they seem incapable of that in Ireland, preferring instead the thoroughly simplistic Alcohol Is Bad line of thinking.
For the most vulnerable, potentially problematic cohort, the really serious risks start when there is contact with, and sometimes immersion in, the criminal underworld. But the risks also include the drugs themselves which, as Forensic Science Ireland (the State laboratory) has pointed out, are riddled with impurities, which can themselves be killers. In addition, crack cocaine is widely available in Ballymun, where the survey referred to took place. We also have to watch for fentanyl, the very powerful opioid implicated in the death of Prince, which can be up to 500 times stronger than heroin.
Even before fentanyl breaks out here, Ireland has the third highest rate of overdose deaths in the EU. In 2016, Forensic Science Ireland detected 27 new types of synthetic drugs here; some, like N-Bomb, can kill you. And then there’s Spice, and other synthetic cannabinoids…
The Bill also proposes some controls on advertising and sponsorship. In an opinion column in The Irish Times last July, Professor Frank Murray, chair of the Alcohol Health Action Alliance lobby group, argued that “evidence demonstrates that exposure to alcohol advertising, whether on TV, in cinema, in public places or alcohol-branded sponsorships, predicts future youth drinking.” He added that “France has achieved a 25% reduction in alcohol consumption since introducing advertising restrictions via the ‘Loi Evin’”…
Well, if that’s supposed to be the evidence for a policy change, we have a real problem, as is clear from The ‘Loi Evin’: a French exception by Drs Alain Regaud and Michel Craplet – a study that was published in 2004, by the Institute of Alcohol Studies (IAS) in the UK. Again, to be clear about it, the IAS is an offshoot of the Alliance House Foundation, a long-established UK temperance organisation. At the time of writing the paper, Regaud was Président of the Association Nationale de Prévention en Alcoologie et Addictologie (ANPAA) in France and Craplet was its medical adviser. So, these authors were not apologists for the alcoholic beverages industry; rather, they were very much in favour of the French law and on the same side as the Irish anti-alcohol lobby. But here’s what they actually said about that law:
“The effect of the Loi Evin has been swamped by the general trend towards reduced alcohol consumption in France. This is a powerful and long running diminution of the average consumption of 1 per cent per year, making it decline dramatically from 30 to 13 litres of pure alcohol per capita per year between 1960 and 2004.”
In other words, and entirely contrary to claims by Irish anti-alcohol lobbyists, the French law had no tangible quantitative effect! So why are we trying to replicate it here?
It is to placate a vocal lobby group. And it is also to be seen climbing onto the high moral ground. But the truth is that distorting the evidence and shaping public policy on the basis of an ideological hatred of alcohol rather than on the evidence available is not a moral position at all.
That’s why we prefer the advert. Simple, to the point, and likely to connect with young men in particular. And it uses the media, instead of trying to undermine them.
Much smarter thinking…
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