Middle-aged drink and drug abusers put strain on NHS
Doctors say burden unsustainable as people in 40s lead surge in admissions, adding they risk cancer as result of drinking habits.
More than half a million people have been hospitalised in the past three years because of drink or drugs, with those in their 40s behind a surge in cases that is putting a strain on the NHS, official figures reveal.
A total of 533,302 people in England have been admitted to hospital as an emergency since 2010 with serious health problems related to their consumption of alcohol or illicit substances. The vast majority were admissions for conditions specifically related to alcohol abuse, such as liver problems. Of those, 60,738 were aged 40 to 44 and another 60,083 were 45 to 49 – together, more than a fifth of the total. Some were admitted a number of times between 2010 and 2013.
The growing numbers have prompted warnings that a generation of the early middle-aged are risking cancer and other potentially fatal health problems as a result of their drinking habits.
According to hospital admissions data published by health performance experts Dr Foster in their latest annual Hospital Guide, problems related to alcohol and drugs now cost the NHS £607m a year. The cost of treating those kept in for at least one night owing to long-term alcohol misuse dwarfs the £22m a year the NHS spends on those admitted after binge drinking.
The stark differential prompted one senior NHS executive to describe as a myth the popular notion that binge drinking, epitomised by teenagers and hen and stag party revellers, is the main problem for the NHS.
Doctors called for a renewed focus on drinking among the middle-aged and for ministers and the NHS to take tough action to tackle a significant cause of illness and pressure on hospital beds.
Almost one in five fortysomethings admitted to hospital for any reason in 2012-13 were classed by the NHS as “emergency admissions due to a known drug/alcohol issue”.
Matt Tee, chief operating officer of the NHS Confederation, which represents hospitals, said the less visible problem of middle-aged excessive drinking produced more harm than those who drink a lot at one time. “It’s all too easy to dupe ourselves that binge-drinking teenagers or stag and hen parties in their 20s are the cause of alcohol-related pressures on the health service. Today’s news puts this myth firmly back in its place and makes it even more important that as a society we seriously examine the impact our drinking habits have on our health – and on our health service.”
The figures also show high rates of admission for drink or drugs among 30 to 34-year-olds (15% of admissions were drink or drug-related), those aged 35 to 39 (18%) and 50 to 54-year-olds, where the rate was 16%. Among the total admissions for drink and drug-related problems over the three-year period, 24,101 were 15 to 19-year-olds and another 3,013 were as young as 10 to 14.
The figures show problem drinking across socioeconomic groups. Of the admissions, 45,957 (8.6%) were from the wealthiest 20% of the population and another 61,672 (11.6%) were from the next most well-off 20%. However, the poorest were disproportionately represented, with 192,014 (36%) from the most deprived income group.
There is no comparative data, as this is the first time the figures have been compiled in this way.
Doctors’ leaders and NHS bosses warned that alcohol’s burden on the NHS was unsustainable. “It is vital that we take more action to tackle the impact of excessive alcohol consumption on the UK’s population and the NHS,” said a spokesman for the British Medical Association. “As the Dr Foster research highlights, this is a problem that affects large numbers of people across all age groups and as a result places serious strain on a number of already overstretched NHS services.
“We cannot afford to keep spending millions of pounds in today’s economic climate on mopping up the after-effects of an alcohol problem that the government should tackle with a greater emphasis on preventive measures.”
The BMA urged ministers to embrace “a comprehensive system of minimum unit pricing for alcohol, that has already been taken forward in Scotland, and improved labelling on alcohol products so that consumers understand the damage that might result from excessive consumption”, as well as a crackdown on “irresponsible marketing practices”.
Dr Martin McShane, NHS England’s director for patients with long-term conditions, said the rate of admissions and high number of fortysomethings represented a “deeply worrying trend that we should all take heed of. Every day in the NHS we see the impact of excessive alcohol consumption. The figures clearly reflect what we see coming through the doors of our GP services and hospitals. It is so important people think about their alcohol intake – not just during the runup to Christmas but at all times of the year.
“We are the NHS. We are here to help anybody who comes through the door. But excessive consumption of alcohol does hit the public purse hard, there is no question about that.”
As with many health problems, the figures show a sharp north-south divide in the proportion of patients admitted because drink or drugs. The areas with the lowest rates were Essex (10%), Thames Valley (11%) and Hertfordshire and the South Midlands (also 11%), while those with the highest rates were Merseyside (21%), Greater Manchester (18%) and Durham, Darlington and Tees (also 18%).
A Department of Health spokesman said: “We are helping the NHS target harmful drinkers with measures such as increasing the use of interventions by health professionals, and introducing alcohol liaison nurses in A&E. However, there must also be more focus on prevention, not just treatment, for those with existing problems. That is why alcohol is addressed by GPs as part of the NHS health check.”
He added: “We are also working to both reduce harmful drug and alcohol use and to increase the numbers recovering from their dependence. Our focus is on combining health and social policies to help people affected access services, rebuild their lives and play a full part in society.”