Chanelle Ashman, Esirigho Okagbare, Ibijoke
Adeyemi, Eguaogie Gregory Obaseki and
Aderemi Adejumola
Alcohol
Misuse-
Drinkaware
What is alcohol misuse?
• Alcohol misuse is a significant public health issue. It is defined as the alcohol use that
places people at risk of alcohol abuse and alcohol dependency (WHO, 2011).
• Studies show that 24% of adults in the UK regularly drink over the low-risk guidelines
(Scottish Government, 2020).
• 10.8 million adults in England are drinking at levels that pose risk to their health
(Public Health England, 2016) .
• There are an estimated 1.6 million adults in England who may have some level of
alcohol dependence (Public Health England, 2016).
Association between alcohol misuse
and mental health
• Alcohol misuse is associated with a range of mental health illnesses, including depression, anxiety, personality
disorders and schizophrenia (Mental Health Foundation, 2016).
• People with mental health illnesses are three times more likely to be alcohol-dependent than those without mental
health illnesses. People with alcohol problems are also at increased risk of developing a mental health illness (Mental
Health Foundation, 2016).
• There is a high prevalence of co-mo
idity in those attending both mental health services and alcohol treatment
services (Public Health England, 2016).
• 44% of community mental health patients in England have reported harmful alcohol use in the previous year (Public
Health England, 2016).
• There is a strong association between alcohol misuse and suicide. 45% of suicide cases had a history of alcohol
misuse (Public Health England, 2016).
Introduction to chosen initiative –
Drinkaware Drink Free Days
• Drinkaware is a charity that works to prevent and reduce
alcohol-related harm in the UK by changing peoples drinking
habits.
• They have a range of campaigns, one being “Drink Free Days”.
• Drink Free Days targets midlife drinkers aged 45-64 who drink
outinely in the home and over the low risk drinking
guidelines.
• Drink Free Days is a collaboration between Drinkaware and
Public Health England (PHE).
• Their aim is to change peoples drinking habits, in turn
preventing and reducing alcohol-related harm.
(Drinkaware, 2021)
Biological effect of alcohol misuse
Alcohol and liver function
The liver is the major site for alcohol metabolism; 80% of
alcohol is
oken down in the liver (NICE, 2011).
Enzymes
eakdown alcohol in the liver including ADH, ALDH
and catalase enzymes.
The reactions involved in the
eakdown of alcohol from
these enzymes are toxic and can cause damage to the liver,
such as liver disease (Rocco et al, 2014).
In England, liver disease is one of the leading causes of death
in 35 to 49 year olds. Around 90% of all cases of liver disease
is alcohol related (PHE, 2020).
Alcohol and liver function continued
Three stages of liver disease:
1. Fatty liver disease- where lipids build up in the liver causing a
uild up of liver fat. No symptoms usually present at this stage,
treatment for this is to stop alcohol consumption, damage at this
stage can be reversed.
2. Alcoholic hepatitis – liver is inflamed at this stage. Symptoms
include , jaundice, stomach aches, fever, nausea and vomiting,
fatigue and weight loss.
3. Ci
hosis – from continuous liver damage. At this stage the liver
is sca
ed (fi
osis) loosing its ability to function. The liver
eventually shrinks and can no longer process alcohol. Ci
hosis
cannot be reversed and is life-threatening . Treatment – liver
transplant. Ci
hosis can also increase risk of liver cancer (Rocco
et al, 2014).
Biological effect of alcohol misuse- the
central nervous system
• Alcohol is a depressant that causes the Central Nervous System to slow down, it can effect mood
and mental Health (John, 2011).
• Alcohol interferes with chemicals in the
ain and inhibits
ain activity.
• Alcohol increases the
ains neurotransmitters Gaba and decreases the neurotransmitters
Glutamate which makes neurons less able to respond to stimuli (John, 2011).
• This can cause difficultly in thinking, slow down reaction time, cause slu
ed speech and memory
loss (Stavro et al, 2012).
• Alcohol increases dopamine and serotonin which gives users the short-term pleasure of alcohol,
such as happiness and being relaxed, one of the reasons users can become dependant. However,
once alcohol wears off these levels are decreased and in the long-term can cause low mood, anxiety
and depression (John, 2011).
• Alcohol impacts sleep and sleep pattern; a lack of sleep is linked to depression and anxiety.
• Excessive alcohol consumption can also eventually lead to
ain damage and death of
ain cells,
increasing the risk of alcohol related dementia. Alcohol related dementia accounts for around 15%
of all dementia cases (Alcohol Change UK, 2020).
Biological effect of alcohol misuse
continued
Pancreatitis
Chronic and acute pancreatitis can be caused by heavy
drinking. This is because alcohol interferes with the cells of the
pancreas, stopping them working properly (Drinkaware, 2021).
Cardiovascular system
Alcohol can increase heart rate and blood pressure. If not controlled ,it may lead to complications,
such as heart failure, heart disease and cardiovascular disease. This increases the risk of heart attack
and strokes (Piano, 2017).
Gastrointestinal System
Heavy alcohol consumption may cause various cancer related complications , such as mouth, throat
and stomach cancer etc (Public Health England, 2016).
Strengths of Drinkaware Drink Free Days
Drinkaware’s campaign evaluation XXXXXXXXXXstates that many people who
took part in the campaign:
• Took steps to cut down on their drinking.
• Reduced the units of alcohol consumed weekly.
• Changed their drinking habits.
• Drinkers were also more likely to take four or more drink free days
weekly than just one.
These positive finding suggests that because people are changing their
ad drinking habits, the risk of all complications of alcohol misuse that
we have discussed are therefore reduced, leading to better physical
and mental health of the public which is a major strength.
(Drinkaware, 2019)
Strength - Drink Free Days raised
awareness and provided education
• Drinkaware Drink Free Days aimed to raise awareness through educating drinkers on health risks as
many people in the UK are unaware of the consequences of drinking alcohol (Drinkaware, 2021).
• PHE XXXXXXXXXXmention that users who engaged in the Drink Free Days campaign are now more aware
of how having drink free days can reduce health risks.
• A survey found that 84% showed a good level of understanding of what health conditions alcohol
consumption can be linked to after engaging in the campaign. There was raised awareness
of alcohol harm amongst drinkers, with more people being able to identify the co
elation between
alcohol consumption and heart problems, pancreatitis, cancer and mental health illnesses (PHE,
2019).
• This is a major strength as raising awareness provides people on education which in turn
ings
change to people's behaviours, minismising and preventing alcohol related health risks.
Strength - Active Drink Free Days
As part of drink aware drink free days campaign it is
ecommended for users to have ‘active drink free days’ by
eplacing drinking with being active, such as going for a jog or a
swim (Drinkaware, 2021)
Strengths:
• Keeps users busy and active which distracts people from
drinking, in turn reduces ones alcohol intake and reduces the
isk of alcohol related health risks (Drinkaware, 2021).
• Exercise has a positive impact on physical health such as,
educing risk of long-term conditions (PHE, 2020).
• Exercise has a positive impact on mental health. It has been
found to increase mood, manage anxiety and stress and
educes the risk of depression (Mind, 2019).
Limitation - Mental Health related
challenges of Active Drink Free Days
It may be challenging for people with existing mental health illnesses to be active
as people with depression may have low mood and decreased energy levels (WHO,
2021).
People with mental health illnesses may also struggle to exercise due to
medications they are on, for example a common side effect of some
antidepressants is drowsiness and fatigue (BNF, 2021).
Encouraging exercise can be problematic for those with certain mental health
illnesses, such as anorexia and other eating disorders.
We must be very careful when encouraging exercise for those with certain eating
disorders as many people with eating disorders have a complex relationship with
exercise; they may have compulsive and addictive feelings about exercise and
overtraining could become an unhealthy part of their condition (Mind, 2019).
Drink aware have not considered the challenges of being active for those with
mental health conditions which is a major limitation.
Strength – Easily accessible
The campaign uses a lot of online tools, such as digital advertising, social
media, online tools and apps for smartphones (Drinkaware, 2021)
The NHS Long Term Plan XXXXXXXXXXhighlights the importance of E-Health and
mobile-health; it is important for individuals to be able to seek health
information and support online from ones own home.
The importance of this can be highlighted from how difficult it was for the
public to maintain face-to-face services during Coivd-19 lockdowns. It was
found that this difficulty in gaining access to services resulted in peoples
mental health decreasing and alcohol intake increasing which highlights the
importance of having other ways to access services and support (PHE, 2021).
Attwood et al XXXXXXXXXXconducted a study to evaluate the effectiveness of the
mobile health aspects of Drinkaware. It was found that overtime people that
used the mobile health aspects of drink aware had a decrease in alcohol intake,
therefore the app is a good tool for behaviour change (Attwood et al., 2017).
The ability to easily access the campaign is a huge strength.
Limitations of Mobile Health in relation
to mental health
Attwood et al XXXXXXXXXXalso found that the app was only useful for those who
had high levels of self-motivation and determination.
This suggests that those with mental health illnesses, such as depression
may not find these apps effective as those with depression may have low
mood, decreased energy levels, decrease in concentration and lack of
interest which all impact ones ability to be motivated (WHO, 2021).
Also medications can impact self-motivation, for example common side
effects of some antidepressants is drowsiness and fatigue (BNF, 2021).
This is a major limitation of the campaign as it may not be suited for those
that do not have high self-motivation levels, such as those with mental
health illnesses