Alcohol misuse is an an important public health issues and is negatively affecting millions globally
Alcohol was described by Wills (2014) as depressant substance that concentrates in blood within an hour of consumption and interacts with the nerves and neurotransmitters, thereby sedating, reducing muscular control and impairing judgement. Hence, alcohol misuse according to NHS choices (2015) refers to the excessive consumption of alcohol above the lower-risk limits of consumption units. Alcohol misuse affects the ability to think clearly and Department of Health (DOH) (2011) described mental health as how one feels in their mind. It further described mental health problem as a state of mind which makes it difficult for someone to live a normal life, but suggested that people with mental health problem can live normal life with right support and treatment.
Mental health problems is one of the leading causes of diseases, injuries and death, while alcohol misuse is one of the core public health challenges, accounting for 1.6 million dependants in 2007 (DOH, 2011). Mental health problem is a risk factor for developing substance misuse problems, just as substance misuse problems could lead to mental health problems. Similarly, long-term use of substances can also result in mental and physical health problems (Royal College of Psychiatrists (RCPSYCH, 2002).
There is a broad estimated 3% increase in NHS admissions in England from 2013/2014 to 1.1 million admissions in 2014/2015 for alcohol-related disease, injury or conditions. Likewise, an estimated 6,831 deaths related to alcohol consumption was recorded in 2014 and represents a 4% increase from 2013. An estimated prescription cost to the NHS in 2015 was put at £3.93 million, representing a 15% increase from 2014 (NHS Digital, 2016). 15% of road accident death is attributable to drink driving with 44% of violent incidents perpetuated by alcohol abusers (Chaplin et al, 2011). These alarming statistics necessitates a rethink in the formulation and implementation of policies to ensure improved quality of care delivery for adults with dual diagnosis.
The rate of alcohol dependence is twice higher amongst people mental health conditions compared to the larger population. Consequently, there is a higher rate of affective and depressive problems amongst people who are alcohol dependent. The impact of alcohol use/misuse on people with mental health problem includes the likelihood to develop liver disease, cognitive problems, cancer, pancreatitis, ulcers and nutritional deficits including physical dependencies resulting in potential life threatening withdrawal symptoms such as seizures and delirium tremens. More so, alcohol use/misuse interacts with prescribed medication resulting in a combination of life-threatening central nervous system depressants. It also increases suicide rates (DOH, 2016).
Health promotion approaches by World Health Organisation (WHO) (1986) could be used in addressing alcohol misuse. These are advocacy (providing information and resources for supporting individuals and population group in understanding factors that affects health), enablement (empowering and motivating individuals and population group to achieve potentials), and mediations (representing and promoting the interest of different population groups). They involves helping patients develop personal skills, build confidence and competent for personal health risks assessment, understand social-economic and environmental factors influencing health, make informed health and lifestyle decisions, and to access and use health care system (Wills, 2007).
Therefore, training and re-training of professionals and enhancing multi-agency working should be encouraged. Adequate funding should be provided and access to information resources should be enhanced to meet the needs of people who misuse alcohol. Reviewing and streamlining of major public health policies and strategies will also be helpful and the use of alcohol misuse reduction champions and tailored services should be encouraged to drive health promotion and to influence practice.