EU alcohol strategy must address alcohol-related health inequalities affecting homeless population

Homelessness and problematic alcohol use are complex issues that need to be addressed in an integrated manner. A multi-sector approach is needed to allow for partnerships among different health and social care providers so that they can coordinate support better. While it is important to develop a variety of treatments targeting homeless people with problematic alcohol use, there is also a pressing need to provide them with other support services. Evidence shows that stable housing both during and after treatment is key to recovery and can reduce the risk of relapse.

More evidence of effective policies to combat the harmful effects of problematic alcohol use has become available since the last EU Alcohol Strategy. The new strategy should build on this evidence and ensure, through adequate funding instruments, that alcohol-related harm is addressed comprehensively. When developing action, consideration should be given to population groups experiencing severe vulnerability and that are at risk of problematic alcohol consumption.

The EU Health Strategy and the European Commission Staff Working Document, ‘Investing in Health’, recognize the importance of reducing health inequalities. The new Alcohol strategy should contribute to this by recognizing that problematic alcohol use exacerbates health inequalities, particularly among vulnerable groups such as homeless people.The European Commission should take this strong request from the European Parliament, also expressed on various occasions by member states and civil society, on board and propose a new and ambitious EU strategy to prevent and reduce problematic alcohol use and alcohol-related harm in Europe.

European Parliament Resolution calls for new EU Alcohol Strategy

On 29 April, the European Parliament (EP) adopted a Resolution calling on the European Commission to present a new EU Alcohol Strategy to tackle health harm for 2016-2022. The clear message from MEPs comes just a week after EU Health Ministers meeting in Riga called on the Commission (1) to take action on the health impacts of alcohol. Both MEPs and Ministers have criticized the Commission for failing to update the previous EU Alcohol Strategy which expired in 2012.

Today’s European Parliament Resolution calls for a new Strategy, emphasising the importance of better labeling of alcoholic drinks including ingredients and nutritional information with special focus on calories, and the need to raise awareness across the EU of the dangers of drinking during pregnancy and drink driving.

A coalition of public health organisations (2) welcomes the EP’s decision as a step towards reducing harm from alcohol in Europe. Today’s resolution – coupled with the strong view of EU Health Ministers - is a wake-up call to the European Commission to move ahead urgently with a new EU Alcohol Strategy and measures to urgently reduce the severity, scope and huge cost imposed by alcohol-related diseases across Europe, which claim 120,000 lives every year in the EU.

Alcohol-abuse is the leading risk factor for ill-health and premature death for the working age population (25-59 years) in Europe(3). The societal costs of alcohol use in Europe are in excess of €155 billion per year across the EU (4).

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Alcohol-related harm costs Europe at least 2-3% of GDP, mostly from lost productivity and massive healthcare costs.“Prevention of alcohol-related harm is a smart investment for the economy, it cuts long-term healthcare expenditures and at the same time raises workforce productivity,” said Eurocare Secretary General Mariann Skar. “The Commission needs to respond to Ministers and the Parliament with a decisive new Alcohol Strategy.  The lack of a Strategy is currently undermining Europe’s efforts for jobs and growth,“ went on to say Mrs Skar.

Addressing alcohol-related harm is also crucial to reduce health inequalities, as the burden of disease and deaths related to alcohol disproportionately affect the most deprived. One of the most cost-effective ways for society to minimise the damage from alcohol consumption is a MUP, such as that proposed by the Scottish Government. This resolution also includes a reference to Minimum Unit Price (MUP) (5).

Alcohol abuse is a major public health issue in every EU country that requires coordinated action. “The Parliament vote, coupled with the call from EU Health Ministers should shame the Commission into action on alcohol. Years of EU inaction have allowed the alcohol industry to hide the harm – and even the calories – in their drinks. The Commission is currently fixated on 'Better Regulation', but what’s better about the Commission failing in its duty to protect public health?" concluded EPHA Secretary General Nina Renshaw.

Six facts on alcohol related harm

• Alcohol is the 3^rd risk factor in Europe for ill health and non-communicable diseases including some cancers and cardiovascular disease.
• Alcohol is a toxic substance in terms of its direct and indirect effects on a wide range of body organs and a cause of some 60 diseases. Taking all diseases and injuries at global level into account, the negative health impact of alcohol consumption outweighs the benefit by 32:1.
• 12 million people in the EU are dependent on alcohol.
• Around 9 million children in the EU are living with one or both parents addicted to alcohol.
• 1 in 4 road fatalities in the EU are due to alcohol. In 2010 nearly 31,000 Europeans were killed on the roads of which 25% were related to alcohol.
• Alcohol is responsible 1 in 7 male deaths and 1 in 13 female deaths in the group aged 15–64 years, resulting in approximately 120 000 premature deaths.

(1) Health Ministers in Riga agree on the need for common EU nutrition and alcohol policies

(2)European Alcohol Policy Alliance(Eurocare), the European Public Health Alliance(EPHA), the European Association for the Study of the Liver(EASL), the European Liver Patients Association(ELPA), United European Gastroenterology(UEG) the Association of European Cancer Leagues(ECL) Standing Committee of European Doctors(CPME), Royal College of Physicians, and the British Medical Association(both from the UK).

(3)Scientific Opinion of the Science Group of the European Alcohol and Health Forum (2011)  Alcohol, Work and Productivity

(4)Rehm, J. et al (2012) Interventions for alcohol dependence in Europe: A missed opportunity to improve public health.

(5)[Joint press release] Doctors take battle to implement “Scotland the brave’s” alcohol minimum unit price policy to Brussel

Spirits sector comments on parliament resolution on EU alcohol strategy

spiritsEUROPE noted the adoption of the European Parliament Resolution on the Future EU Alcohol Strategy.  In particular, the Parliament’s focus on tackling alcohol harm rather than on alcohol consumption per se is correct, and MEPs’ emphasis on the contexts and patterns of alcohol consumption are also very welcome.

“We welcome the Parliament’s interest and we welcome the majority of the proposals they make,” said Paul Skehan, Director General of spiritsEUROPE.  “We support the MEPs’ calls for better research, for better collection of data and for sharing evidence.  In particular, the spirits sector applauds the Parliamentarians’ call for appropriate strategies to tackle the problem of alcohol counterfeiting as well as illegal and black market sales of alcohol.”

The spirits sector has contributed to 374 initiatives aimed at tackling harmful use of alcohol across the EU since the inception of the European Alcohol and Health Forum in 2007.  Working to address harm at local level, in partnerships with local police, licensing authorities, ministries for health and others, is producing results.

Skehan concluded: “We are pleased the European Parliament invites the Commission to build on the good work achieved over the past eight years and we will continue to play our part to foster a culture of responsible drinking in Europe”.