The harm from alcohol costs society in England £27.44 billion a year, according to a new analysis by the Institute of Alcohol Studies.
The cost of alcohol to society has risen 37% in just over 20 years since 2003, which was when the last comparable research was carried out by The Cabinet Office, which then estimated the costs at between £18.5bn and £20bn.
By far the major cost is in crime and disorder at £14.58bn, but the cost to the NHS and healthcare is a staggering £4.91bn, including just over £2bn due to alcohol-related hospital admissions, just over £1bn due to A&E visits, and £857mn due to ambulance call-outs.
The wider economic cost (lost working days, low productivity and unemployment) costs £5.06bn and social services cost £2.89bn.
There is an increasing death toll associated with alcohol use, with the most recent official figures for 2022 released in April showing that 10,048 people died from alcohol-specific causes. This is the highest level since records began in 2001.
Drinking has been linked to over 100 illnesses, including seven types of cancer, cardiovascular disease, cirrhosis, stroke and digestive problems, and can drive mental disorder, self-harm and suicide.
Responding to the report, Alice Wiseman, Vice President of the Association of Directors of Public Health, said:
“We have known for a long time that alcohol consumption places an avoidable burden on society…Half of police workload is alcohol related, 40% of ambulance time is spent responding to alcohol-related incidents and around 17 million working days are lost every year because of alcohol-related sickness – these are staggering statistics.”
“The evidence is all there – alcohol is harmful. It harms individuals and, if that isn’t motive enough, it harms our country’s economy. What’s needed now is for the Government to take action and develop a new alcohol strategy so that we can drive down the increasing, and unacceptable, cost of alcohol harm.”
Cuts to services
Despite the massive harm alcohol causes to society and the economy, which has been known about for many years, funding for alcohol services, usually lumped in with drug services, has been a target for cuts as the public health grant given to local authorities by government has failed to keep up with inflation or demand since 2015/16.
The Health Foundation estimates that since 2015/16 the public health grant has been cut by 28% on a real-terms per person basis. Some of the largest reductions in spending have been on drug and alcohol services for young people (down 31%).
A 2023 report from the National Audit Office found that in 2021/22, local authorities reported spending £637 million on alcohol and drug services, a real term fall in spending of 27% compared with 2014/15. The NAO also found that there is considerable local variation in reported spending on, and outcomes from, alcohol treatment. In 2021/22, the amount local authorities reported spending on alcohol treatment varied from £4,000 per 100,000 people to over £1 million, with median spending of £313,000. And the number of adults in England receiving treatment for alcohol dependency fell by 16% from 2013/14 to 2020/21, despite a rise in people needing help.
In 2021, the government allocated extra funding for substance misuse services of £533 million, but this is time-limited at just three years, with the last allocation of £267 million now made for 2024/25.
Evidence of the harm alcohol does to the nation’s health was heard by the House of Commons health and social care select committee, as part of its inquiry into preventing ill health from drinking, smoking, drugs and gambling, but the announcement of the election has stopped this work.
But, the current government had already been told of the increasing harm and cost to the economy and society of alcohol. Not only was there the NAO report in February 2023, but soon after in May 2023 a House of Commons Public Accounts Committee report into alcohol treatment services concluded that the government was “not taking alcohol harm sufficiently seriously.”
The committee noted that “despite the increase in harm there has been no alcohol-focused strategy since 2012 and the latest plans to publish one were abandoned in 2020.”
It acknowledged that the government had published a 10-year drugs strategy in 2022, but the committee felt that the government still needed “to take seriously the impact of alcohol and not just drugs.”
The committee heard evidence that the reduction in public health grant had had major consequences for funding for drug and alcohol treatment services, leaving services “on their knees” according to Dame Carol Black (author of the government’s independent review of drugs in 2020).
Funding cuts and frequent retendering of treatment services has led to a high turnover of staff and depletion of skills. There has been a fall in the number of addiction psychiatrists, psychologists, nurses and social workers. The Royal College of Psychiatrists (RCPsych) told the committee that there has been a 58% fall in the number of trainee places for addiction psychiatrists from 64 in 2011 to 27 in 2019, adding that chronic staff shortages and a disconnect between services mean many patients were not getting the care they need.
The increase in availability of treatment services for alcohol addiction, however, is only one part of the solution to the harm that alcohol causes individuals, society and the economy. Strategies to reduce the use of alcohol in the first place are badly needed, including targeting the widespread availability and low cost of alcohol, as Alice Wiseman notes:
“The alcohol industry’s huge marketing machine needs to be regulated much more rigorously so that we are no longer bombarded with the message that alcohol is a safe, attractive product. We also need to reduce the availability and affordability of alcohol by introducing minimum unit pricing.”
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