GUEST COLUMN: Co Mayo has the lowest number of alcohol-treatment cases per capita

Treatment for alcohol problems has been in the news recently with the release of data from the Health Research Board (HRB) on numbers accessing services. Of the 8,163 cases reported in 2023, just 114 were in Mayo. Other HRB reports finds that Co Mayo has the lowest number of alcohol treatment cases per capita compared with all other counties – just a fifth of the treatment level in Donegal which has the highest county rate. It is likely that this is a marker of access to services rather than a difference in problem levels.
There are real positives to note including a 10 percent rise in numbers accessing treatment compared with 2022. Another important trend is that in 2023 more of these cases involved people whose problems had not reached dependency levels. This is significant as the earlier people seek help, the more successful outcomes are likely to be. However, while these are welcome indicators, taking a wider look exposes another story.
HRB surveys have established that 15 percent of the population in Ireland has an Alcohol Use Disorder (AUD) – that’s 600,000 with a problem; 90,000 at a severe level. It is in this context that the chasm is really apparent. Just over 8,000 treatment cases last year is a drop in the ocean of alcohol harm that swamps Ireland.
Some of that damage reveals itself in illness, both physical and mental but there is much more which is hidden. We know that at least one in six children are living with the trauma of parental problem alcohol use which can have a lifelong legacy.
We need greatly expanded services for those with an AUD and their family members. Alcohol Action Ireland is calling on the government to set a target of increasing treatment levels by 20 percent each year for five years. This would go some way to guaranteeing timely access to services which we know can make all the difference.
There is of course a cost to this and indeed to all aspects of alcohol harm – a staggering €12 billion annually, yet excise duties only raise a tenth of that amount. It is time for government to consider a ‘polluter pays’ approach to this industry which is responsible for a multitude of harms from the home to the workplace to pressure on our health, justice and social care services. In this regard we can learn from the Gambling Regulation Bill, which provides for a Social Impact Fund via a levy on gambling licensees.
But all of this is downstream stuff; it’s about pulling people out of the alcohol river and trying to repair the damage already done. What’s most needed are upstream, preventative measures to reduce numbers falling into alcohol harm in the first place. The good news is that there are simple, proven, low-cost solutions – the WHO’s ‘best buys’ of controls on pricing, marketing and availability of alcohol.
In 2018 the Oireachtas passed the Public Health (Alcohol) Act which included Minimum Unit Pricing and curbs on alcohol marketing. The alcohol industry fiercely resisted these modest measures and an enormous effort across multiple public health organisations was required to ensure their passage and subsequent implementation – a job that six years later is still not completed. Among the advocates for this Act are Ballina residents, Ann and John Higgins, who have courageously highlighted the terrible loss of their son, David, by alcohol-related suicide, as a reason to introduce this legislation.
These measures have brought about a 10 percent drop in alcohol consumption since 2019. However, much more remains to be done. If Ireland was using alcohol at HSE lower-risk drinking guidelines, our consumption would be reduced by 40 percent. One approach would be to increase alcohol excise duties which have not changed in a decade. Supermarket alcohol prices are actually the same today as they were twenty years ago. A 15 percent increase in excise duties would go some way to redress this.
Will it work? Over 1,500 people die every year in Ireland because of alcohol. Many of these are young lives cut short leaving untold heartbreak. Looking to one remarkable country, Lithuania, which had the unenviable record of the highest alcohol-attributable years of life lost in the EU, a combination of increased taxation, reduction in licensing hours and a complete ban on advertising led to a 20 percent reduction of this rate between 2010 and 2016.
Similar action in Ireland would ensure that more of our young people would grow old in peace with their families.

Dr Sheila Gilheany, CEO Alcohol Action Ireland, alcoholireland.ie. If you have been affected by any of the issues in this article, you can contact HSE Drug and Alcohol Helpline on 1800 459 459.