Table of Contents
Rationale
Epidemiological Statistics
Health Inequalities and Alcohol Dependence
Population Experiencing Severe Disadvantages
Assessment, Plan and Commission of Intervention
Role of Nursing
References
Substance Misuse: Alcohol
The term “health promotion” can be defined as the way to develop objectives that address the association of biology, health status, health services, individual behaviour and social factors. It requires careful assessment of the patients with respect to their strengths, weaknesses and past experiences that they have already had in order to improve wellbeing. In this case, the goal is to improve the wellbeing of the consumers of alcohol and helping them to reduce its consumption. Steps to decrease and prevent the use of alcohol and similar drugs can have a magnificent effect on the health and safety in the community (Whiteford, et al. 2013). It is not necessary that all the approaches will work equally. It is shown by the researchers that education on the own can only impact to a small extent against the problems and norms raising due to drinking. To strengthen the impact of education, the culture of the organisation that supports the wellbeing of the consumers of alcohol and the public around that along with the practices and policies that are comprehensive, well-established, well-promoted and clear. An effective policy helps the people to get a clearer idea of what is unacceptable and acceptable. A framework is provided by it for the prevention and early intervention to tackle the potential problems experienced by the public (Williams, et al. 2014). A path is established by it eventually in order to make sure that objectives associated with the public relationships, productivity and safety are achieved. By only having the policies cannot make sure the safety and wellbeing of the population (Williams, et al. 2014).
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The resistance can also be created by the process from the top to bottom for establishing the policies. The rights of the citizens are also infringed by the policies sometimes and sometimes these are implemented unevenly and dishonourably but not all the times. The suggestions and highlight of the keys issues encountered in the developments and implementation of the alcohol policies are given in this rationale. It is determined that the implementation of alcohol policies includes several stakeholders (Whiteford, et al. 2013). Therefore, essential information regarding the use of health promotion, preventions of abuse and limitation to the misuse of substance are covered and the role of health nurses and health and safety coalitions in the UK is elaborated. The responsibility of PHE (Public Health England) is to make sure the harms triggered by the consumption are prevented and reduced as much as possible. The awareness on the effect of dependency on alcohol is provided by PHE. The delivery and commissioning of the intervention that is evidence-based are supported by it in order to address the hazardous impact of alcohol dependency among adults (Williams, et al. 2014).
Epidemiological Statistics
There exist approximately 1.5 million adults in the UK who are having the same level of dependency on alcohol. However, all of those do not require interventions. Some of them will get better with a short intervention. It is defined by the NICE (National Institute for Health and Care Excellence) that consumption of drugs is a pattern that can potentially cause problems like physical illness, depression and road accidents (Williams, et al. 2014). Heavy drinkers can become dependent on the drug usage which is characterised by tolerance, continuous drinking and craving despite the consequences according to NICE (Whiteford, et al. 2013). A report of public by CMO (Chief Medical Officer) states that drinking can be associated with a threat to health independent of the level of consumption. Adults are suggested to keep their drinking within 14 pegs a week in order to prevent liver diseases or even cancer. It was found in an assessment in which 67 factors of disability and death were included that alcohol ranks third on the table to cause disability and death just below obesity and smoking (Whiteford, et al. 2013).
The evaluation of CMO indicated that all alcohols can possibly cause cancer. The risk of cancers like breast, mouth, liver, stomach and bowel can be increased by drinking regardless of the level of consumption. A recent review of CoC (Committee on Carcinogenicity) supported this evaluation on the risk of cancer by alcohol. In addition to that, it is also demonstrated by the epidemiological surveys that there exist strong relation of the attendees to get mental health services with the use of alcohol. It has been reported by a community of mental health patients that over 40% of the problems were related to the alcohol usage last year (Williams, et al. 2014). There exist a strong relation of the suicide with the misuse of alcohol. It was found by the inquiry of National confidential into suicide by the people suffering from mental issues that there was a strong relation of alcohol misuse with 45% of the suicides among them between 2002 and 2011 (Abuse and Administration, 2016).
Health Inequalities and Alcohol Dependence
Even though the potential threat to wellbeing is indicated by the volume of alcohol consumption, the relationship is affected by other factors.
The dependency of alcohol in the UK is more common in men than women with 6% to 2% respectively (Inchley and Currie, 2013. This differences in gender can be same globally and it is one of the key dissimilarities based on gender in social behaviour. The effect of excessive drinking is greater for the ones with lower income and the ones suffering from the deprivations. The reason for this is not easily understandable because people with lower income do not appear to consume alcohol as much as compared to people with higher incomes. The higher risk can be related to the impact of other threats impacting lower socio-economic people (Rehm, et al. 2013). The areas with the highest rate of mortality are situated in North West mostly while the lowest rates are situated in the south of England. The mortalities associated with the alcohol were found to be 53% inclined from the year of 2013 (Rehm, et al. 2013). In Blackpool during the year of 2013, mare 80 death was found to be related with the alcohol per 100,000 population while in Wokingham, Berkshire the figures were 33 per 100,000 (Abuse and Administration, 2016).
Hospital admission rates due to alcohol also vary regionally. For the least deprived docile, the rate of admissions to the hospital are almost 70% lesser in 2013 to 2014. The North West saw the highest number of admissions to hostel caused by alcohol with 551 per 100,000 population while the lowest rate was witnessed in the south-east with 383 (Abuse and Administration, 2016).
Population Experiencing Severe Disadvantages
There is visible incline in the overlap of population experience severe disadvantages such as homelessness, offending behaviours, alcohol and drug misuse and poor mental health (Inchley and Currie, 2013. Alcohol abuse is a more common cause of death among the homeless people makes around 35% of all deaths (Barry, et al. 2013). It was found by a study that life quality in England was even worse than reported by the people with low salaries particularly in terms of mental health (Barry, et al. 2013). Factors related to the alcohol in England are found over several domains in PHOF (Public Health Outcomes Framework) such as improvement in determinants of health, prevention of premature mortality, improvement and protection of health (Barry, et al. 2013).
Assessment, Plan and Commission of Intervention
Wellbeing boards and local councils and health are responsible for planning an intervention to misuse of alcohol.
Environmental health
Social care
Public health
Licensing standards
Clinical treatment services
Housing strategy
Consumers are placed at the heart of intervention by this. Treatment is a crucial way in which the council will plan and deliver interventions (McGorry, Bates and Birchwood, 2013). This comes after the conditions of public health grant. Boards of wellbeing and health will take into account the ways in which services in the hospital are integrated with the standardised systems and will arrange joint funding for the public health (McGorry, Bates and Birchwood, 2013). JSNA (Joint Strategic Needs Assessment): Local data on alcohol harm is provided by the JSNA in order to plan and commission the intervention. It includes commissioning community alcohol treatment services as well as hospital services (McGorry, Bates and Birchwood, 2013. Quality governance guidance for council commissioners of alcohol and drug services: Councils are required to provide quality arrangements during services according to the public health grant. NDTMS: A little or restricted access to the confidential data is provided to the commissioners in order to help planning and improving services. Reports are provided in an annual and monthly basis. Detailed information is provided by them on the clients in drug treatment and structured alcohol from the National Drug Treatment Monitoring System (NDTMS) (McGorry, Bates and Birchwood, 2013.
Role of Nursing
The nurses are required to comply with the guidance provided by NICE on alcohol use. The nurses have to support the people dependent on alcohol in order to sustain fast recovery. The service users need to be engaged in a stable accommodation by the nurses. There might be alcohol dependents who do not seem to be ready for the intervention, nurses should work with the cooperation of other services in order to address the requirements of drinkers resistant to change. Nurses should provide information to the family members as well regarding the treatment. Nurses are entitled to comply with the Care Act 2014 and are required to comply with the guidance provided by the government if there exist safeguarding issues against treatment.
Nurses are required to see their role as health promoters at the time of treatment. The drinking habits of the patients should be assessed by the nurse when it same appropriate at the time of admission. This cannot be done thoroughly enough to make the nurses able to bring effectiveness in the treatments in case the sufferer seems to be excessively addicted to alcohol. The treatment out of the specialist units includes clomethiazole and multivitamins in order to tackle withdrawal by reducing the role of nursing to only dispensing. Serious consequences will trigger if these issues are not addressed properly in the future. The alcohol consumers these days are most likely to be the patients in coming days and the number of them will surely be remarkable.
Abuse, S. and Administration, M.H.S., 2016. 2015 National Survey on Drug Use and Health.
Barry, M.M., Clarke, A.M., Jenkins, R. and Patel, V., 2013. A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries. BMC public health, 13(1), p.835.
Chesney, E., Goodwin, G.M. and Fazel, S., 2014. Risks of all‐cause and suicide mortality in mental disorders: a meta‐review. World Psychiatry, 13(2), pp.153-160.
Inchley, J. and Currie, D., 2013. Growing up unequal: gender and socioeconomic differences in young people’s health and well-being. Health Behaviour in School-aged Children (HBSC) study: international report from the, 2014.
McGorry, P., Bates, T. and Birchwood, M., 2013. Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. The British Journal of Psychiatry, 202(s54), pp.s30-s35.
Rehm, J., Shield, K.D., Gmel, G., Rehm, M.X. and Frick, U., 2013. Modeling the impact of alcohol dependence on mortality burden and the effect of available treatment interventions in the European Union. European Neuropsychopharmacology, 23(2), pp.89-97.
Whiteford, H.A., Degenhardt, L., Rehm, J., Baxter, A.J., Ferrari, A.J., Erskine, H.E., Charlson, F.J., Norman, R.E., Flaxman, A.D., Johns, N. and Burstein, R., 2013. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. The Lancet, 382(9904), pp.1575-1586.
Williams, R., Aspinall, R., Bellis, M., Camps-Walsh, G., Cramp, M., Dhawan, A., Ferguson, J., Forton, D., Foster, G., Gilmore, I. and Hickman, M., 2014. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. The Lancet, 384(9958), pp.1953-1997.
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