Alcohol

Children

Whilst most people under the age of 15 don’t drink, the amount of alcohol consumed by children aged 11 to 15 years old has doubled since 1990.[1] Drinking alcohol at an earlier age is associated with adverse consequences including: 

• an increased likelihood of alcohol dependence during adulthood
• significant changes in brain structure of those drinking heavily which can affect brain functions including motivation and reasoning
• adverse effects on liver, bone, growth, and endocrine development
• increased alcohol-related injuries, road traffic accidents and involvement in violence
• increased suicidal thoughts and attempts
• increased sexual partners, incorrect/no use of condoms and higher pregnancy rates 

• increased risky behaviours including using drugs and risky driving behaviours[1]

   

Families with parental substance misuse and looked after children

Parental substance misuse has been noted to cause harm to children of all ages – right through from their initial conception into adulthood[2]. Misuse can lead to unpredictable parenting with knock on effects including the children having to care for their parents or siblings, impacts on their physical and mental health as well as educational attainment and engagement at school.[3],[4]

Some children become under kinship, i.e. looked after by extended family members as the child’s parent(s) misuse substances and cannot care for their children.[5]Over 50% of children living in kinship care are doing so because of parental substance misuse.[6] Almost 17% of children within the North East region who are recorded as ‘children in need’ are supported by social care due to parental alcohol use.

Carers

There is a significant impact on the loved ones of those who are misusing drugs and/or alcohol. YouGov results from 2019 suggest that almost 1 in 3 (15.7 million) adults in Great Britain have been negatively affected by someone else’s substance use at some point in their life and that 5.2 million people are currently affected.[6] The effects of substance misuse to the family/carers are broad including: isolation and impact on their own mental health, financial implications, and strained family relationships.[6]

Pregnancy

Alcohol consumption during pregnancy is associated with harmful effects on the foetus in addition to adverse outcomes for the mother. Foetal alcohol spectrum disorders (FASD) are the range of clinical syndromes which can occur to the developing infant of a mother who consumes alcohol. The harmful effects to the foetus vary depending on a number of factors including level of alcohol consumed and stage of pregnancy when alcohol is being consumed.

Older People and Housebound patients

Risk of alcohol-related harm is known to increase with older age where physiological changes mean older people often have lower tolerance to alcohol and therefore experience harm from lower levels of alcohol than what would be considered high risk for the normal population.[7] Adults of older age are at an increased risk of being housebound, meaning they are unable to leave their house, usually due to illness.[8] Such individuals may experience higher levels of social isolation and increased dependence on others which could potentially increase their risk of alcohol misuse and dependence.

Homelessness

Alcohol and/or drug addiction are a known cause and consequence of homelessness; two thirds of homeless people state that their drug or alcohol use is the reason they first became homeless.[9] Those who are homeless experience considerable emotional stress and there is a higher prevalence of mental health illness in this population. Many use alcohol and drugs as a coping mechanism, and the overlap of multiple disadvantages such as poor mental health and alcohol misuse worsens the inequalities this population experience.

People with mental health conditions

Research shows there are a large proportion of individuals with both alcohol misuse and poor mental health, and therefore engaging with both mental health and drug & alcohol services. It was estimated that 44% of community mental health patients reported to have problem drug or alcohol use in the prior year.[10]

There is also evidence of a strong association between suicide and alcohol misuse with a history of alcohol misuse being present in 45% of suicides between 2002 and 2011.[10] 

Prisoners and those involved in the criminal justice system

Some adults who engage with alcohol or drug treatment services have a criminal history. The most recent data on this is from 2012 and shows that of the individuals in treatment in 2011 or 2012 who had a criminal conviction in the two years prior to treatment, 22% of them were misusing alcohol in North Tyneside.

[1]GOV.UK. Alcohol consumption by children and young people. 17th December 2009. Available from: https://www.gov.uk/government/publications/alcohol-consumption-by-children-and-young-people
[2] Advisory Council on the Misuse of Drugs (ACMD). Hidden Harm – Responding to the needs of children of problem drug users. 2003. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/120620/hidden-harm-full.pdf
[3] Hedges, S. & Kenny, C. Parental Alcohol Misuse and Children. 9th February 2018. Parliamentary Office of Science and Technology. Available from: https://post.parliament.uk/research-briefings/post-pn-0570/
[4] Syed, S. & Gilbert, R. Parental alcohol misuse has major effects on children's health and development. BMJ (Clinical research ed.). 2019; 364:l912. doi: 10.1136/bmj.l912
[5] Kinship. What is kinship care?. Available from: https://kinship.org.uk/for-kinship-carers/what-is-kinship-care/
[6] Adfam. One in Three: Adfam’s Manifesto for 2020 and beyond. 2020. Available from: https://adfam.org.uk/files/one-in-three.pdf
[7] Bareham, B., Seddon, J. Alcohol Use: Its Meaning and Impact in Older Age. In: Thurnell-Read, T., Fenton, L. (eds) Alcohol, Age, Generation and the Life Course, Leisure Studies in a Global Era. Palgrave Macmillan, Cham. 2022. p.275-295. https://link.springer.com/chapter/10.1007/978-3-031-04017-7_12
[8] Musich S, Wang SS, Hawkins K, Yeh CS. Homebound older adults: Prevalence, characteristics, health care utilization and quality of care. Geriatric Nursing. 2015;36(6): 445-450. https://doi.org/10.1016/j.gerinurse.2015.06.013.
[9] Crisis UK. Drugs and alcohol. https://www.crisis.org.uk/ending-homelessness/health-and-wellbeing/drugs-and-alcohol/ [Accessed 21st December 2022]
[10] Public Health England. Health matters: harmful drinking and alcohol dependence. 21st January 2016. Available from: https://www.gov.uk/government/publications/health-matters-harmful-drinking-and-alcohol-dependence/health-matters-harmful-drinking-and-alcohol-dependence