Drink kills as many people as drugs in Scotland. Here's what we need to do
Drink-related harms should be given parity with Scotland’s drug-death crisis, with a serious examination of alcohol advertising
It’s Alcohol Awareness Week, and as a GP of over 25 years, I’ve been reflecting on the devastating impact alcohol misuse can have on a person, their family, and society. Whether it’s losing a patient to cirrhosis, seeing babies born with foetal alcohol syndrome, or family and friends struggling to support their loved ones —alcohol dependence and misuse damages too many lives in Scotland.
Scotland has a deeply problematic relationship with alcohol. We consistently rank among the highest in Europe for alcohol consumption, and data published last month showed that more than half of Scots continue to drink above the safe limit of 14 units per week.
While the occasional few drinks can be enjoyable and carry minimal health risks, we need to be honest and accept that too many of us are drinking beyond what can be considered safe.
Covid’s effect on drinking habits
Alcohol-specific deaths in Scotland have reached a 15-year high, with 1,277 people dying prematurely in 2023 – nearly 25 per cent higher than in 2019, the last full year before the Covid hit. There is no doubt that the pandemic led to an increase in unhealthy drinking patterns, the effects of which are still being realised.
Some have argued that these statistics show minimum unit pricing (MUP) has failed as an intervention. I firmly believe the opposite is true: without MUP, the number of Scots dying from alcohol misuse would be significantly higher.
When MUP was introduced, the aim was to reduce alcohol consumption among those drinking at harmful levels, and to lower overall population consumption. On both counts, MUP has had a discernible positive impact.
Research published in The Lancet demonstrates that MUP was associated with a 13.4 per cent reduction in deaths wholly attributable to alcohol. The greatest improvements were seen in the most socioeconomically deprived deciles and among men – groups disproportionately affected by alcohol misuse. At a population level, alcohol sales fell by 3 per cent.
Put simply, an average of 156 alcohol-related deaths have been prevented each year since MUP came into force. Hospitalisations decreased by 4.1 per cent – a figure not to be lightly dismissed given the pressures facing my colleagues in hospitals.
Deaths of despair
Wales and the Republic of Ireland have since followed Scotland’s lead and introduced their own MUP regimes, and it is disappointing that Wes Streeting has opted not to follow suit in England. No one ever claimed MUP would be a panacea, but we must now build on its success and address alcohol-related harms in a broader context.
Tackling alcohol-related harms should be given parity with Scotland’s drug death crisis. Given that alcohol kills around the same number of Scots as drugs, there should be additional resources, political attention, and public messaging to reduce alcohol-related harm. This must include a serious examination of alcohol advertising.
Ultimately, deaths caused by alcohol in Scotland are intrinsically linked to poverty, deprivation, and despair. Alcohol-related deaths in the most deprived areas are 4.5 times higher than in the least deprived. If we are to make serious progress in reducing Scotland’s shameful alcohol death figures, then tackling poverty and giving people hope is non-negotiable.
Dr Chris Provan is chair of the Royal College of GPs in Scotland
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