Drug use in Ireland and Northern Ireland

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1 Drug use i Irelad ad Norther Irelad Bulleti 7 Alcohol Cosumptio ad Alcohol-Related Harm i Irelad This bulleti presets the mai fidigs o alcohol cosumptio ad alcohol-related harm amog adults i Irelad from 2010/11 Drug Prevalece Survey. The survey sampled a represetative umber of people aged betwee 15 ad 64 durig late 2010 ad early This is the first NACD Drug Prevalece Survey to iclude a comprehesive series of questios o both the rates ad patters of alcohol cosumptio i Irelad ad o alcohol-related harm. Key fidigs The rate of abstiece from alcohol amog year-olds i the 12 moths prior to the survey was 13%. Wome (15%) were more likely tha me (11%) to be o drikers ad respodets aged years (19%) were more likely to abstai compared with year-olds (7%). Eighty seve per cet of adults aged years cosumed alcohol i the previous 12 moths ad these were classified as curret drikers i this survey. Me were more likely to cosume alcohol at least twice weekly compared with wome (31% vs. 21%). Those aged years-old were the most likely to cosume alcohol at least twice weekly with 39% of males ad 22% of females i this age group drikig this ofte. Wome (31%) were more likely tha me (18%) to cosume 1 2 stadard driks per drikig occasio which is classified as beig withi low risk daily cosumptio limits. Drikers aged years drak the most alcohol o a typical drikig occasio with 73% cosumig at least five stadard driks ad 31% cosumig at least ie stadard driks per drikig occasio which equates with four ad a half pits of beer or oe ad oe quarter bottles of wie. The survey examied patters of harmful drikig usig the WHO s AUDIT-C screeig tool ad harmful drikers were idetified as those who had a score of five or more. Based o this screeig tool, 50% of the survey populatio aged years ad 58% of curret drikers were classified as cosumig alcohol i a harmful maer. Harmful drikig, usig AUDIT-C scores, was more commo amog me (63%) tha wome (37%) i the survey populatio. Whe this screeig tool was applied to curret drikers, more male drikers (71%) tha female drikers (44%) cosumed alcohol i a harmful maer. Harmful drikig was more commo amog year-olds i the survey populatio (70%) ad also amog year-olds i the curret drikers group (75%) tha amog their older adult couterparts. Risky sigle occasio drikig (RSOD), defied as cosumig at least 75g of alcohol o a sigle drikig occasio, oe or more times per moth is also cosidered a harmful patter of alcohol cosumptio; this is commoly described as bige drikig. I 2010/11, 45% of the survey populatio aged years ad 52% of curret drikers cosumed alcohol i this maer i the previous 12 moths. Male respodets (57%) were more likely tha female respodets (33%) to bige drik oe or more times per moth. Whe this parameter was calculated amog curret drikers, 64% of me ad 39% of wome reported bige drikig. Over two-thirds of survey respodets ad 72% of curret drikers, aged years, egaged i mothly bige drikig i the 12 moths prior to the survey. Oe i five drikers reported that they had experieced harm i the previous 12 moths as a result of their drikig, with me almost twice as likely as wome to report harm, such as harm to health, work ad friedship (26% vs. 14%). Harm to health was reported by 13% of drikers with 24% of year-olds reportig this harm. Over oe quarter of respodets (27%) reported that they had experieced harm i the previous year as a result of someoe else s drikig; these harms iclude family problems, beig assaulted ad beig a passeger with a druk driver. Natioal Advisory Committee o Drugs (NACD) (2012) 1

2 Cotets Key fidigs 1 List of tables 3 List of figures 3 Itroductio 4 Methodology 4 Alcohol survey questios 4 Uderstadig the results of this bulleti 5 Results 6 Frequecy ad quatity of alcohol cosumptio 6 Harmful drikig patters 7 Alcohol cosumptio by demographics 11 Polydrug use 14 Alcohol-related harm 15 Refereces 19 2 Natioal Advisory Committee o Drugs (NACD) (2012)

3 List of tables Table 1: Frequecy of drikig ad umber of driks cosumed per drikig occasio i the previous 12 moths, by geder ad age group Table 2: Table 3: Table 4: Table 5: Table 6: Table 7: Table 8: Table 9: Table 10: Table 11: Table 12: Table 13: Table 14: Frequecy of drikig ad umber of driks cosumed per drikig occasio i the previous 12 moths, geder by age group Frequecy of RSOD ad rate of harmful drikig amog drikers i the previous 12 moths, by geder ad age group Frequecy of RSOD ad rate of harmful drikig amog drikers i the previous 12 moths, geder by age group Proportio of drikers who scored positive for each RAPS questios by geder ad age group Proportio of drikers who scored positive for each RAPS questios, geder by age group Frequecy ad volume of drikig ad harmful drikig patters i the previous 12 moths, social class by geder ad age Frequecy ad volume of drikig ad harmful drikig patters i the previous 12 moths, by highest level of educatio completed Frequecy ad volume of drikig ad harmful drikig patters i the previous 12 moths, by marital status ad age group Percetage of drikers who reported that they cosumed both alcohol ad ay other substace i the previous moth, by geder ad age Percetage of drikers who reported egative cosequeces i the previous 12 moths as a result of their drikig, by geder ad age group Percetage of drikers who reported egative cosequeces i the previous 12 moths as a result of their drikig, geder by age group Percetage of respodets (adults years) who reported egative cosequeces i the previous 12 moths as a result of someoe else s drikig, by geder ad age group Percetage of respodets (adults years) who reported egative cosequeces i the previous 12 moths as a result of someoe else s drikig, geder by age group List of figures Figure 1: Percetage of o-drikers by geder ad age group Figure 2: Figure 3: Figure 4: Figure 5: Figure 6: Figure 7: Figure 8: Percetage of drikers who egaged i weekly RSOD i the previous 12 moths, by geder ad age group Percetage of drikers with a positive AUDIT-C score, by geder ad age group Percetage of drikers who had two positive scores o the RAPS screeig tool, by geder ad age group Harmful drikig patters amog drikers by social class ad age Percetage of drikers who reported egative cosequeces i the previous 12 moths as a result of their ow drikig, by drikig patter Percetage of respodets (adults yrs) who beig assaulted, beig a passeger with a druk driver or havig property vadalised i the previous 12 moths as a result of someoe else s drikig, by drikig patter Percetage of respodets (adults yrs) who reported family or moey problems i the previous 12 moths as a result of someoe else s drikig, by drikig patter Natioal Advisory Committee o Drugs (NACD) (2012) 3

4 Itroductio This bulleti presets the mai fidigs o alcohol cosumptio ad alcohol-related harm amog adults i Irelad from the. The survey was commissioed by the Natioal Advisory Committee o Drugs (NACD) i Irelad ad the Public Health Iformatio & Research Brach (PHIRB) withi the Departmet of Health, Social Services ad Public Safety (DHSSPS) i Norther Irelad. It also cotaied questios o illegal drugs, such as caabis, ecstasy, cocaie ad heroi; other legal drugs such as traquilisers ad ati-depressats; ad tobacco. The prevalece rates for these substaces have already bee preseted i a previous NACD bulleti. 1 Methodology The questioaire (excludig the alcohol sectio) ad methodology for this geeral populatio survey were based o best practice guidelies draw up by the Europea Moitorig Cetre for Drugs ad Drug Addictio (EMCDDA). The questioaires were admiistered through face-to-face iterviews with respodets aged betwee 15 ad 64 years ad who are ormally residet i households i Irelad. Thus persos outside these age rages, or who do ot ormally live i private households, have ot bee icluded i the survey (for example prisos, ursig homes etc.). Fieldwork for the survey was carried out betwee October 2010 ad May 2011 ad the fial achieved sample comprised 5,134 respodets. The respose rate for the survey was 60%. Areas based samplig was applied i Irelad. The first stage ivolved stratifyig by Health Board i Irelad **. The achieved sample was weighted by geder, age, regio *** to maximise its represetativeess of the geeral populatio. The effects of stratificatio, clusterig ad weighig have bee icorporated i the iterval estimates (i.e. itervals are desig effect adjusted). Iterviews were coducted usig computer-assisted persoal iterviewig (CAPI). These techiques allow iterviews to be coducted more efficietly ad more accurately tha other techiques such as pe-ad-paper completio. Details of the methodology have bee summarised i a paper published o the website of the NACD ad a comprehesive techical report cotaiig a copy of the complete questioaire used is published separately ( survey_drug_prevalece.html). As this survey was coducted primarily to measure the prevalece of illegal drug use, i commo with other Europea drug surveys people over the age of 64 were excluded, as they grew up i a era whe both the use ad availability of illegal drugs were very limited. Alcohol survey questios This is the first NACD Drug Prevalece Survey to iclude a comprehesive series of questios o both the rates ad patters of alcohol cosumptio i Irelad ad o alcohol-related harm. Respodets were asked questios about the frequecy ad quatity of alcohol cosumed i the previous 12 moths (Tables 1 2). Quatity was measured by askig how may stadard driks were cosumed o a typical drikig occasio. I Irelad a stadard drik cotais 10g of pure alcohol ad is equivalet to half a pit of beer or cider, a sigle pub measure of spirits, a small (100ml) glass of wie, or a bottle of alcopops. Harmful drikig patters were assessed by measurig the proportio of drikers who egaged i risky sigle occasio drikig (RSOD) at least oce a moth i the previous year (Tables 3 4), had a positive AUDIT-C score (Tables 3 4) or scored positive o the RAPS screeig tool (Tables 5 6). Risky Sigle Occasio Drikig (RSOD) RSOD may also be referred to as bige drikig ad was defied as cosumig 75g of pure alcohol o a sigle drikig occasio. This correspods to four pits of beer or seve pub measures of spirits or oe 750ml bottle of wie. There is o defiitive guidelies o what costitutes RSOD; for this survey 75g was used to deote RSOD as this is the defiitio which was used by the Europea Comparative Alcohol Study 2 ad has bee used i a umber of Irish drikig surveys. Accordig to the Europea Commissio, RSOD at least oce a moth i the previous year ca be cosidered a harmful drikig patter. 3 AUDIT-C screeig tool A umber of istrumets have bee developed to measure alcohol abuse ad depedece. The AUDIT-C is a short versio of the Alcohol Use Disorders Idetificatio Test (AUDIT), which was developed by the World Health Orgaizatio to scree for excessive drikig ad to idetify persos with harmful drikig ** Sice Jauary 2005 the Health Boards i Irelad have bee restructured ad merged uder oe authority, the Health Service Executive. For the purpose of facilitatig comparisos betwee the 2002/3, 2006/7 ad the curret survey, it was decided to cotiue to weigh the data by the former Health Board areas as these correspod with the Regioal Drug Task Force structures. *** The compositio of the populatio i Irelad has chaged substatially sice Cesus Give that Cesus 2011 iformatio was ot available whe weights were calculated, it was decided to weight the data usig 2010 populatio estimates. For the purpose of costructig post-stratificatio weights, Regioal Authority areas were used to defie regios istead of Health Board/RDTF. 4 Natioal Advisory Committee o Drugs (NACD) (2012)

5 patters. It has bee show to be effective i screeig for harmful drikig patters i healthcare settigs ad i populatio surveys. 4 7 I lie with iteratioal research a cut-off score of five was used to deote harmful drikig. It should be oted that the AUDIT-C defies RSOD as cosumig 60g of pure alcohol o a sigle drikig occasio, while 75g is defied as RSOD i this aalysis. Therefore, it is possible that this survey has uderestimated the proportio of people who score positive o the AUDIT-C. Prevalece estimates for risky occasio drikig ad AUDIT-C are reported i the survey populatio (18 64 yrs) ad curret drikers. Followig iteratioal practice 13 a AUDIT-C, score of zero was allocated to respodets who aswered the questio How ofte have you drak alcohol i the last year with ever ad who have ot bee asked subsequet questios. RAPS screeig tool The Rapid Alcohol Problem Scree (RAPS) is a screeig istrumet which is used to scree for alcohol depedece it is suggested that two positive scores may be idicative of depedece. 8 It cotais four questios ad was asked of curret drikers (defied as those who had cosumed alcohol i the previous 12 moths): Durig the past 12 moths have you 1) had feeligs of guilt or remorse after drikig? 2) Had a fried or family member tell you about thigs you said or did while drikig that you did ot remember? 3) Failed to do what was ormally expected from you because of drikig? 4) Needed a first drik i the morig to get yourself goig after a heavy drikig sessio? Harm as a result of drikig Six questios o harms were asked of curret drikers (defied as those who had cosumed alcohol i the previous 12 moths): Durig the last 12 moths have you 1) got ito a fight whe you had bee drikig? 2) bee i a accidet whe you had bee drikig? 3) felt that your drikig harmed your friedships? 4) felt that your drikig harmed your home life? 5) felt that your drikig harmed your work or studies? 6) felt that your drikig harmed your health? (Tables 11 12). Five measures were used to assess the egative cosequeces experieced by people as a result of someoe else s drikig (harm to others). The harm to others questios were asked of all participats icludig drikers ad o-drikers: Durig the last 12 moths, have you experieced ay of the followig as a result of someoe else s drikig? 1) had family problems or relatioship difficulties? 2) bee a passeger with a driver who had too much to drik? 3) bee hit or assaulted by someoe who had bee drikig? 4) had fiacial trouble? 5) had property vadalised? (Tables 13 14). Uderstadig the results of this bulleti Oly those respodets aged years are icluded i this aalysis which results i a fial weighted sample of 4,843 respodets. Respodets aged years were excluded as it is illegal for this age group to cosume alcohol uless it is provided to them by a paret or legal guardia ad it was ot feasible to examie this group o their ow as there were oly 218 respodets. Ivalid resposes have bee excluded from all aalyses. All prevalece rates preseted i the accompayig tables are rouded to oe decimal place ad are rouded to whole umbers i the text. Percetages may ot always sum to 100 due to the effect of roudig. While may of the questios used i this survey were also used i the last SLÁN survey which was coducted i 2007, the age profile of the respodets i the two surveys differs. The SLÁN survey icluded all adults aged 18 years ad over while this aalysis oly icludes adults aged years. As adults aged 65 years ad over are less likely to drik tha those uder 65 years, egage i harmful drikig patters ad experiece alcohol-related harm, care should be take whe comparig the two surveys. Polydrug use I relatio to polydrug use the defiitio used i this bulleti is use of alcohol ad at least oe other drug i the last moth (for example, havig used both alcohol ad cocaie). Ay illegal drugs refers to amphetamies, caabis, cocaie powder, crack, ecstasy, heroi, LSD, magic mushrooms, poppers ad solvets. Alcohol cosumptio ad drikig patters are aalysed by social class usig the Stadard Occupatioal Classificatio (SOC2000). This classificatio is based o the employmet status, level of resposibility, ad qualificatios of the chief icome earer withi a household. Six social classes were idetified ad were categorised ito two groups ABC1 ad C2DE which are take to equate to middle class ad workig class respectively. SOC2000 Classificatio A B C1 C2 D Professioals, seior maagemet ad top civil servats Middle maagemet, seior civil servats, maagers ad owers of busiess Juior maagemet ad owers of small busiesses Skilled maual workers ad maual workers resposible for other workers Semi-skilled ad uskilled maual workers, traiees ad appretices E All those depedet o the State log-term Natioal Advisory Committee o Drugs (NACD) (2012) 5

6 Results Frequecy ad quatity of alcohol cosumptio Tables 1 ad 2 preset the frequecy of alcohol cosumptio ad the average umber of driks that alcohol drikers cosume o a typical drikig occasio. These are preseted by geder ad age group (Table 1) ad geder by age group (Table 2). Table 1: Frequecy of drikig ad umber of driks cosumed per drikig occasio i the previous 12 moths, by geder ad age group (=4,843) Geder Age group All Male Female Frequecy of drikig % % % Never Less tha mothly times/mothly Oce a week times/week times per week Driker but frequecy ukow No. of driks/occasio Table 2: Frequecy of drikig ad umber of driks cosumed per drikig occasio i the previous 12 moths, geder by age group (=4,843) Male Female Frequecy of drikig % % Never Less tha mothly times/mothly Oce a week times/week times per week Driker but frequecy ukow No. of driks/occasio Natioal Advisory Committee o Drugs (NACD) (2012)

7 No-drikers The rate of abstiece, defied as cosumig o alcohol i the previous 12 moths, was 13% amog year-olds. This is lower tha the rate reported i the last SLÁN survey (19%) ad may be explaied by the exclusio from this survey of older adults (65 years ad over) who are more likely tha youger adults to be o-drikers. I the SLÁN survey 41% of adults aged 65 ad over did ot cosume alcohol. I this survey wome (15%) were more likely to be o-drikers tha me (11%), ad older adults aged (19%) were more likely to abstai from alcohol compared with year-olds (6%). Across all age groups, with the exceptio of year-olds, wome were more likely tha me to abstai from alcohol (Figure 1, Table 2). Figure 1: Percetage of o-drikers by geder ad age group 25% 20% % 10% % % All ages All Males Females Age group Frequecy of drikig Just over oe quarter (26%) of all respodets reported that they cosumed alcohol at least twice weekly i the previous 12 moths. Me cosumed alcohol more frequetly tha wome with 31% of me reportig that they drak alcohol at least twice weekly (21% for wome). Those aged years were also more likely to cosume alcohol at least twice a week (31%) compared to the youger age groups (Table 1). These treds are similar to those reported i the 2007 SLÁN survey. Quatity of alcohol cosumed per drikig occasio Almost oe quarter (24%) of drikers reported cosumig 1 2 stadard driks per drikig occasio. This amouts to 10 20g of pure alcohol ad is withi low-risk daily alcohol cosumptio limits. Older adults cosumed less per drikig occasio compared with youger adults, for example, 34% of respodets aged years reported cosumig 1 2 stadard driks per drikig occasio compared to 10% of year-olds (Table 1). Previous research has show that while Irish drikers cosume alcohol less frequetly tha drikers across the rest of Europe they cosume greater volumes of alcohol per drikig occasio. 9 A similar patter was observed i this survey particularly amog youger adults; 23% of drikers aged years drak alcohol at least twice weekly but 73% cosumed at least five stadard driks o a typical drikig occasio with 31% cosumig at least ie stadard driks per drikig occasio. Harmful drikig patters Accordig to the World Health Orgaizatio, the cocept of harmful use of alcohol is broad ad ecompasses both the drikig that causes detrimetal health ad social cosequeces for the driker, the people aroud the driker ad society at large, ad the patters of drikig that are associated with icreased risk of detrimetal health outcomes. Harmful use of alcohol compromises both idividual ad social developmet. It ca rui the lives of idividuals, devastate families, ad damage the fabric of commuities. 10 Natioal Advisory Committee o Drugs (NACD) (2012) 7

8 Both a perso s overall volume of alcohol cosumptio ad their patter of drikig are importat determiats of alcohol-related harm. I geeral, icreases i overall cosumptio are accompaied by a greater icidece of health ad social problems. Volume of cosumptio as well as patters of drikig, especially risky sigle-occasio drikig (RSOD), determie the burde of disease caused by alcohol. For example, all-cause mortality i male drikers cosumig less tha two driks per day is about twice as high if they also have occasioal heavy drikig episodes. 11 Tables 3 ad 4 preset the frequecy of RSOD ad the proportios of respodets who scored positive for harmful use of alcohol o the AUDIT-C screeig tool. The harmful use of alcohol is reported i these tables i two forms. It is reported as the prevalece amog the populatio aged years ad as the prevalece amog curret drikers i the populatio aged years. These are preseted by geder ad age group (Table 3) ad geder by age group (Table 4). Table 3: Frequecy of RSOD ad rates of harmful drikig i the previous 12 moths, by geder ad age group Geder Age group All Male Female Frequecy of RSOD amog drikers % % % Never Less tha mothly times/mothly times a week Harmful drikig amog drikers Mothly RSOD * Positive AUDIT-C Harmful drikig i the populatio Mothly RSOD * Positive AUDIT-C * Defied as cosumig at least 75g of alcohol o a sigle drikig occasio Defied as scorig 5 or more o the AUDIT-C screeig tool Table 4: Frequecy of RSOD ad rate of harmful drikig i the previous 12 moths, geder by age group Male Female Frequecy of RSOD amog drikers % % Never Less tha mothly times/mothly times a week Harmful drikig amog drikers Mothly RSOD * Positive AUDIT-C Harmful drikig i the populatio Mothly RSOD * Positive AUDIT-C * Defied as cosumig at least 75g of alcohol o a sigle drikig occasio Defied as scorig 5 or more o the AUDIT-C screeig tool 8 Natioal Advisory Committee o Drugs (NACD) (2012)

9 Risky sigle-occasio drikig (RSOD) RSOD was defied as cosumig 75g of pure alcohol o a sigle drikig occasio which correspods to four pits of beer or seve pub measures of spirits or oe 750ml bottle of wie. RSOD, apart from ay log-term effects, ca icrease impulsivity, reduce ihibitios ad distort behaviour, ad is associated with adverse health ad social cosequeces, icludig accidets, suicide, violece ad loss of productivity or abseteeism, which affect both the idividuals who egage i it ad those aroud them. Accordig to the Europea Commissio, RSOD at least oce a moth i the previous year ca be cosidered a harmful drikig patter. 3 Prevalece of RSOD amog adults The data i Table 3 show that 45% of the survey populatio egaged i RSOD at least oce per moth i the year precedig the survey. This patter of high-risk drikig was more commo i me (57%) tha wome (33%). The prevalece of RSOD at least oce per moth i the year precedig the survey decreased with icreasig age (Table 4). For example, 67% of those aged years egaged i RSOD while oly 32% of those aged years egaged i this patter of drikig. The data also reveal that RSOD was particularly commo amog me less tha 35 years ad wome less tha 25 years. Prevalece of RSOD amog curret drikers Over half (52%) of curret drikers reported RSOD at least oce a moth (Figure 2) with 30% reportig weekly RSOD. Mothly RSOD was most commo amog year-olds (72%) ad decreased with icreasig age (Figure 2); me were more likely tha wome to cosume alcohol i this maer (64% vs. 39%). Figure 2: Percetage of drikers who egaged i mothly RSOD i the previous 12 moths, by geder ad age group 90% 80% 70% 60% 50% 40% 30% % 10% 0% All Males Females Age group AUDIT-C screeig tool Harmful drikers were idetified as those who had a score of five or more o the AUDIT-C screeig tool; usig these criteria, 58% of year-old drikers may be cosidered harmful drikers (Table 3 Figure 3). These results are similar to those i SLÁN 2007, where 56% of all adult drikers icludig those aged 65 ad over had a positive AUDIT-C score. 12 Harmful drikig was more commo amog male drikers (71%) tha female drikers (44%) ad more commo amog year-old drikers (75%) tha their older couterparts. Natioal Advisory Committee o Drugs (NACD) (2012) 9

10 Figure 3: Percetage of drikers with a positive AUDIT-C score, by geder ad age group 90% 80% 70% 60% 50% 40% 30% % 10% 0% All Males Females Age group RAPS screeig tool The 10th Revisio of the Iteratioal Classificatio of Diseases ad Health Problems (ICD-10) defies [alcohol] depedece as a cluster of physiological, behavioural, ad cogitive pheomea i which the use of alcohol takes o a much higher priority for a give idividual tha other behaviours that oce had greater value. The RAPS screeig tool has bee used to scree for alcohol depedece ad it has bee suggested that two positive scores may be idicative of depedece. Tables 5 ad 6 preset the proportio of respodets who scored positive for each of the RAPS questios. These are preseted by geder ad age group (Table 5) ad geder by age group (Table 6). Amog curret drikers, 18% scored positive for two questios ad 7% scored positive for three questios o the RAPS screeig tool (Table 5). Males were more likely tha females to have either two or three positive scores. Those aged years were most likely to score positive for two questios (43%) while those aged year-olds were least likely (7%). Similar to the treds for RSOD ad harmful drikig, the year age group showed the least geder differece (47% of males ad 40% of females had two positive scores) whe compared with other age groups (Table 6, Figure 4). Table 5: Percetage of drikers who scored positive for each of the RAPS questios by geder ad age group Geder Age group All Male Female Feeligs of guilt or remorse Fried/family told you about thigs you said/ did that you did ot remember Failed to do what was ormally expected Needed a first drik i the morig positive scores positive scores Natioal Advisory Committee o Drugs (NACD) (2012)

11 Table 6: Percetage of drikers who scored positive for each of the RAPS questios, geder by age group Male Female Feeligs of guilt or remorse Fried/family told you about thigs you said/did that you did ot remember Failed to do what was ormally expected Needed a first drik i the morig positive scores positive scores Figure 4: Percetage of drikers who had two positive scores o the RAPS screeig tool, by geder ad age group 50% 40% % 20% 10% % All Males Females Age group Alcohol cosumptio by demographics I the populatio aged ad amog curret drikers social class is a much weaker predictor of harmful drikig tha either geder or age. Prevalece of drikig patters by social class The prevalece of harmful drikig as measured by RSOD, was margially higher amog youger professioals tha youger service/ maual workers (Table 7). This applied to both youger (18 34 years) me ad wome. Prevalece of drikig patters amog curret drikers by social class Amog the youger age group (18 34-year-olds) there was little differece by social class i the frequecy of drikig, volume of drikig or i the frequecy of RSOD. Amog year-olds, those i the C2DE social class were more likely to be o-drikers tha those i ABC1 social class; this was observed both amog males (17% vs. 10%) ad females (21% vs. 14%) (Table 7). Natioal Advisory Committee o Drugs (NACD) (2012) 11

12 Table 7: Frequecy ad volume of drikig ad harmful drikig patters i the previous 12 moths, by social class, geder ad age Males Females ABC1 C2DE ABC1 C2DE ABC1 C2DE ABC1 C2DE Frequecy of drikig % % Never Less tha mothly times/mothly Oce a week times/week times per week Frequecy ukow No. of driks/occasio Harmful drikig amog drikers Mothly RSOD* Positive AUDIT-C Harmful drikig i the populatio Mothly RSOD* Positive AUDIT-C * Defied as cosumig at least 75g of alcohol o a sigle drikig occasio Defied as scorig 5 or more o the AUDIT-C screeig tool There were margial differeces betwee the two social class groupigs i relatio to harmful drikig patters (Figure 5). Figure 5: Harmful drikig patters amog drikers by social class ad age 80% 70% 60% 50% 40% % 20% 10% 0% ABC1 C2DE ABC1 C2DE Mothly RSOD AUDIT-C 12 Natioal Advisory Committee o Drugs (NACD) (2012)

13 Prevalece of harmful drikig by educatio Table 8 presets alcohol cosumptio by highest level of educatio completed for all adults (18 64 yrs). Those who had oly completed primary level were most likely to abstai from alcohol i the last year (24%). The prevalece of mothly RSOD was lowest for those with primary level educatio (42%) ad there was little differece betwee those with third level (44%), Juior Certificate (45%) ad Leavig Certificate (47%) (Table 8). The proportio of the year-old populatio with a harmful AUDIT-C score was slightly lower for those whose highest level of educatio completed was primary (49%) compared to Juior Certificate (51%), Leavig Certificate or Third level (both 50%). These results may be due to statistical variatio rather tha beig a true differece. Prevalece of harmful drikig amog curret drikers by educatio While curret drikers who had completed third level educatio had the lowest level of harmful drikig, there were mior differeces betwee each of the educatio groupigs (Table 8). Due to the low umber of respodets with oly a primary level of educatio, who were aged 34 years ad uder, aalysis by age was ot udertake. Table 8: Frequecy ad volume of drikig ad harmful drikig patters i the previous 12 moths, by highest level of educatio completed Primary^ (=286) Juior (=892) Leavig (=1,372) Third (=2,283) Frequecy of drikig % % % % Never Less tha mothly times/mothly Oce a week times/week times per week Driker but frequecy ukow No. of driks/occasio Harmful drikig amog drikers Mothly RSOD* Positive AUDIT-C Harmful drikig i the populatio Mothly RSOD* Positive AUDIT-C * Defied as cosumig at least 75g of alcohol o a sigle drikig occasio Defied as scorig 5 or more o the AUDIT-C screeig tool ^ This icludes respodets with o formal educatio Natioal Advisory Committee o Drugs (NACD) (2012) 13

14 Alcohol cosumptio ad marital status Table 9 presets alcohol cosumptio ad harmful patters of drikig by marital status ad age. I Irelad the average age of first marriage is 34 years for me ad 32 years for wome; marital status is iflueced by age. Marriage appears to be protective for youg people; 47% of married year-olds had a positive AUDIT-C score compared to 70% of sigle people i the same age group. Sigle drikers were more likely to cosume alcohol i a harmful maer compared to married or separated drikers ad this was evidet i both age groups. Three quarters of sigle drikers aged years had a positive AUDIT-C score compared to 54% of married youg drikers. It should be oted that there were oly 15 respodets i the separated/divorced/widowed category that were aged years old. Table 9: Frequecy ad volume of drikig ad harmful drikig patters i the previous 12 moths, by marital status ad age group Sigle (=1,447) Married/Cohabitig (=3,132) Sep/div/wid^ (m=258) Frequecy of drikig % % % Never Less tha mothly times/mothly Oce a week times/week times per week Driker but frequecy ukow No. of driks/occasio Harmful drikig amog drikers Mothly RSOD* Positive AUDIT-C Harmful drikig i the populatio Mothly RSOD* Positive AUDIT-C * Defied as cosumig at least 75g of alcohol o a sigle drikig occasio Defied as scorig 5 or more o the AUDIT-C screeig tool ^ Separated/widowed/divorced Polydrug use Polydrug use, defied i this bulleti as the use of alcohol ad at least oe other drug i the last moth, is associated with a umber of egative cosequeces icludig metal ad physical ill-health, violece, aggressio ad a rage of social problems. It is more likely to result i accidets ad death (icludig death from overdose) tha whe a sigle drug is cosumed. A total of 3,542 respodets (73%) reported that they had used alcohol i the moth prior to the survey. Table 10 presets the percetage of drikers who used alcohol ad ay other drug i the previous moth. Tobacco was the drug most commoly used i additio to alcohol with 32% of respodets usig both tobacco ad alcohol i the previous moth. The use of ay illegal drug ad alcohol was reported by 4% ad was more commo amog me tha wome (6% vs. 2%) ad amog year-olds tha i year-olds (7% vs 2%). Wome were more likely tha me to report havig used alcohol ad either ati-depressats or sedatives ad these combiatios of drug use were more commo i year-olds tha i year-olds. 14 Natioal Advisory Committee o Drugs (NACD) (2012)

15 Table 10: Percetage of drikers reported that they cosumed both alcohol ad ay other substace i the previous moth, by geder ad age Geder Age group All Males Females Tobacco Ati-depressats Sedatives, traquillisers Ay illegal drugs Caabis Cocaie* * This also icludes crack cocaie Alcohol-related harm The likelihood of a perso experiecig alcohol-related harm depeds o both their overall volume of alcohol cosumptio ad the patter i which they drik. Alcohol-related harm is ot cofied to the miority of heaviest drikers i the populatio; i reality, it is the much greater umber of low- to medium-volume drikers i a populatio who egage i RSOD that accouts for much of the acute alcohol-related problems, such as aggressio, violece, ijuries, ad poor work performace. Alcohol-related harm is ot restricted to the idividual driker but has egative cosequeces for families, frieds, ad iocet bystaders. Such egative cosequeces iclude family problems, public disturbaces, violece, ad reduced work-related performace. There are idicatios that alcohol s harm to others may be of the same order of magitude as alcohol s harm to the driker. Negative cosequeces experieced by the driker Tables 11 ad 12 preset the proportio of curret drikers who reported that they had experieced egative cosequeces as a result of their ow drikig i the previous 12 moths. These are preseted by geder ad age group (Table 11) ad geder by age group (Table 12). The overall prevalece of experiecig at least oe of the six harms as a result of their ow alcohol use was 20%, with me almost twice as likely as wome to report harms (me 26%, wome 14%). Male drikers were more likely tha female drikers to experiece each idividual harm, while the year age group were more likely tha older adults to experiece each harm. While me were more likely to experiece harms tha wome, there was less of a geder differece amog year-olds; oe i five of both me ad wome i this age group reported that they experieced harm to their work or study i the previous year, ad oe i four me ad oe i five wome i this age group experieced harm to their health. Youg males aged years were the group most likely to experiece acute cosequeces such as beig ivolved i fights (24%) ad beig i a accidet (11%). Table 11 Percetage of drikers who reported egative cosequeces i the previous 12 moths as a result of their drikig, by geder ad age group Geder Age group All Male Female Cosequeces from ow drikig % % % Fights Bee i accidet Harm to friedship Harm to home life Harm to work/study Harm to health Natioal Advisory Committee o Drugs (NACD) (2012) 15

16 Table 12: Percetage of drikers who reported egative cosequeces i the previous 12 moths as a result of their drikig, geder by age group Male Female Cosequeces from ow drikig % % Fights Bee i accidet Harm to friedship Harm to home life Harm to work/study Harm to health Drikers who egaged i frequet RSOD were more likely to report experiecig egative cosequeces as a result of their ow drikig (Figure 6). For example, 23% of weekly RSOD drikers reported that their drikig had harmed their health, while the figure for ifrequet RSOD drikers was 12% ad was just 3% for those who did ot drik i a risky way. Figure 6: Percetage of drikers who reported egative cosequeces i the previous 12 moths as a result of their ow drikig, by drikig patter 25% 20% 15% 10% 5% 0% No RSOD Less tha weekly RSOD Weekly RSOD Fights Accidet Frieds Home life Work/study Health Negative cosequeces experieced by others besides the driker Tables 13 ad 14 preset the proportio of respodets (icludig o-drikers) who experieced egative cosequeces as a result of someoe else s drikig i the previous 12 moths. These are preseted by geder ad age group (Table 13) ad geder by age group (Table 14). Family problems were the most frequetly reported egative cosequece as a result of someoe else s drikig (14%). The overall prevalece of experiecig at least oe of the five harms as a result of someoe else s alcohol use was 27% (males 31%, females 22%). Males were more likely to experiece acute cosequeces such as beig assaulted, havig property vadalised ad beig a passeger with a druk driver. Females were more likely to experiece family problems arisig from someoe else s drikig (Table 14). 16 Natioal Advisory Committee o Drugs (NACD) (2012)

17 Table 13: Percetage of respodets (adults yrs) who reported egative cosequeces i the previous 12 moths as a result of someoe else s drikig, by geder ad age group Geder Age group All Male Female Cosequeces from others drikig % % % Family problems Passeger with druk driver Assaulted Moey problems Property vadalised Twety ie per cet of males aged years were assaulted i the previous 12 moths as a result of someoe else s drikig. Males aged years were also the group most likely to have bee a passeger with a druk driver (16%) have had their property vadalised (15%) ad have had moey problems (5%). Females aged years were most likely to have experieced family problems (19%) (Table 14). Table 14: Percetage of respodets (adults yrs) who reported egative cosequeces i the previous 12 moths as a result of someoe else s drikig, geder by age group Male Female Cosequeces from others drikig % % Family problems Passeger with druk driver Assaulted Moey problems Property vadalised Drikers who egaged i frequet RSOD were more likely to experiece each idividual harm with the exceptio of moey problems, as a result of someoe else s drikig ad this tred was most obvious for the followig harms beig a passeger with a druk driver, beig assaulted ad havig property vadalised (Figure 7). The likelihood of experiecig family problems ad moey problems was similar for o-drikers ad o-risky drikers (Figure 8). Natioal Advisory Committee o Drugs (NACD) (2012) 17

18 Figure 7: Percetage of respodets (adults yrs) who reported beig assaulted, beig a passeger with a druk driver or havig property vadalised i the previous 12 moths as a result of someoe else s drikig, by drikig patter 14% 12% 10% 8% 6% 4% 2% 0% No driker No RSOD Less tha weekly RSOD Weekly RSOD Assaulted Passeger druk driver Property vadalised Figure 8: Percetage of respodets (adults yrs) who reported family or moey problems i the previous 12 moths as a result of someoe else s drikig, by drikig patter 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% No driker No RSOD Less tha weekly RSOD Weekly RSOD Family problems Moey problems Natioal Advisory Committee o Drugs (NACD) (2012)

19 Refereces 1. Natioal Advisory Committee o Drugs ad Public Health Iformatio ad Research Brach (2011) Drug use i Irelad ad Norther Irelad. First results from the. Dubli & Belfast: NACD & PHIRB. 2. Norstrom T (2002) Alcohol i postwar Europe. Cosumptio, drikig patters, cosequeces ad policy resposes i 15 Europea coutries. Stockholm: Natioal Istitute of Public Health. 3. Europea Commissio: Health Cosumers Directorate Geeral (2010) Report o the work of the Committee o Alcohol Data, Idicators ad Defiitios. Brussels: Europea Commissio. 4. Bush K, Kivlaha D, McDoell M, Fih S ad Bradley K (1998) The AUDIT alcohol cosumptio questios (AUDIT-C). Archives of Iteral Medicie. 158: Aalto M, Alho H, Halme JT ad Seppä K (2009) AUDIT ad its abbreviated versios i detectig heavy ad bige drikig i a geeral populatio survey. Drug ad Alcohol Depedece. 103: Bradley KA, DeBeedetti AF, Volk RJ, Williams EC, Frak D ad Kivlaha DR (2007) AUDIT-C as a brief scree for alcohol misuse i primary care. Alcoholism: Cliical ad Experimetal Research. 31: Reiert DF ad Alle JP (2007) The alcohol use disorders idetificatio test: a update of research fidigs. Alcoholism: Cliical ad Experimetal Research. 31: Moskalewicz J ad Sieroslawski J (2010) Drikig populatio surveys guidace documet for stadardized approach. Warsaw: Istitute of Psychiatry ad Neurology. 9. TNS Opiio ad Social (2010) EU citizes attitudes towards alcohol. Special Eurobarometer 331. Brussels: Europea Commissio. ec.europa.eu/public_opiio/archives/ebs/ebs_331_e.pdf 10. World Health Orgaizatio (2009) Workig documet for developig a draft global strategy to reduce harmful use of alcohol. Geeva: WHO. 11. Rehm J, Greefield TK ad Rogers JD (2001) Average volume of alcohol cosumptio, patters of drikig, ad all-cause mortality: results from the US Natioal Alcohol Survey. America Joural of Epidemiology. 153: Morga K, McGee H, Dicker P, Brugha R, Ward M, Shelley E, et al. (2009) SLAN 2007: Survey of lifestyle, attitudes ad utritio i Irelad. Alcohol use i Irelad: a profile of drikig patters ad alcohol-related harm from SLAN Dubli: Departmet of Health ad Childre. 13 Aalto M, Seppa K, Kiiamaa K ad Sillaaukee P (1999), Drikig habits ad prevalece of heavy drikig amog primary health care outpatiets ad geeral populatio. Addictio. 94: Rosta J (2008) Hazardous alcohol use amog hospital doctors. Alcohol ad Alcoholism. 43: Natioal Advisory Committee o Drugs (NACD) (2012) 19

20 The Natioal Advisory Committee o Drugs wish to exted sicere gratitude to Dr. Deirdre Moga Health Research Board (HRB), author of this report ad to all those who have cotributed to the developmet ad implemetatio of the Drug Prevalece Survey i Irelad ad Norther Irelad 2010/11. Research Advisory Group Ms. Joa O Fly (NACD util February 2012), Dr. Des Corriga (NACD util December 2011), Dr. Justie Horga, Dr. Deirdre Moga, Dr. Jea Log (HRB), Ms. Mario Rackard (HSE), Ms. Dairearca Ni Neill, Drugs Policy Uit, Departmet of Health, Ms. Susa Scally (NACD util December 2010). ISSN: August Natioal Advisory Committee o Drugs (NACD) (2012)