The issue of alcohol, and more specifically binge drinking, particularly among young people has been highlighted several times in the past week, by Government-backed reports and Ministers. Hélène Hofmanreports
The Taoiseach says the problem is "over-exaggerated", most health professionals argue it's a cause for concern, and addiction services and youth groups want it to be tackled immediately.
It's impossible to know the exact extent of binge-drinking, or drinking to get drunk, in Ireland, but a report published by the European Commission last June found that we spend more on alcohol than any other European country, and estimates we go on drinking binges an average of 32 times a year.
Last Wednesday, the State of the Nation's Children report compiled by the Department of Health and Children referred to figures from 2003, which found Irish 15-year-olds had the third-highest level of binge drinking in Europe.
Fifty-seven per cent of the teenagers surveyed had taken five or more alcoholic drinks in the past 30 days. Then on Friday, another study unveiled at the Coombe Women's Hospital found that 60 per cent of women continue to drink while pregnant, with Irish and UK-born women more likely than other nationalities to exceed the recommended maximum of six units of alcohol.
Mary Cunningham, director of the National Youth Council of Ireland (NYCI), was a member of the Strategic Taskforce for Alcohol and the Department of an Taoiseach Special Initiative on Alcohol. She says that there is confusion over the exact definition of binge drinking.
"We prefer to think of binge drinking as harmful drinking, which is more easily understood. Significant numbers of people are drinking harmful levels of alcohol but aren't aware of it," she says.
"Anecdotally you think of binge drinking as people being out of their heads, but from a medical point of view, it takes a much smaller amount to do harm," says Cunningham. "Someone might have a drink before dinner, wine during dinner and a drink after dinner and without realising they've gone over the limit."
The Department of Health and Children says that anything up to 14 standard drinks a week for women and up to 21 standard drinks a week for men is low risk, provided the drinks are spread out over a week that includes some alcohol-free days.
In most cases drinking more than six standard drinks in one sitting, which is equal to six shots, six glasses of wine or three pints, is considered binge drinking.
"Another problem is we have a very high level of tolerance and perhaps ambivalence to public drunkenness," she says.
"There is no embarrassment attached to being seen like that in the street, in many cases it's even seen as a badge of honour," she says.
The NYCI has issued a number of recommendations regarding alcohol, including an increase in alcohol taxes. Although Cunningham acknowledges that alcohol prices in Ireland are among the highest in Europe, she argues that people also have higher levels of disposable income so alcohol is still affordable and increasingly available. She is also concerned that we no longer have a National Adviser on Alcohol, after the post was terminated at the end of 2005.
However, according to Cunningham, one of the major issues is the absence of a mandatory code of practice for alcohol advertising. Currently, the drinks industry abides by a voluntary code under the Advertising Standards Authority of Ireland and all adverts are required to carry central copy clearance.
"We fully recognise the problems related to alcohol misuse in Ireland and we've been involved in several initiatives to try to tackle that," says Rosemary Garth, director of the Drinks Manufacturers of Ireland (DMI) branch of Ibec.
DMI recently announced its intention to invest an additional €20 million, over time , in the Mature Enjoyment of Alcohol in Society (MEAS) group, which is funded by the drinks industry and promotes responsible drinking. Recent campaigns include the designated driver campaign and drinkaware.ie.
"Contrary to what some people say we don't want people to drink as much as possible," says Garth. "It's not good for business. It devalues the brand and it's bad for the reputation. Having sensible customers who enjoy the product is far more profitable in the long term.
"We've established a working group to look at labelling to educate customers on the appropriate consumption," she says.
"The Department of Health has a weekly recommendation and we're okay with that but it seems some people don't understand and we're looking at giving them that information, for example, this product contains two units of alcohol.
"That, supported by an awareness campaign, could be useful but there's a lot of information on labels already and we need to know that it will change people's behaviour before we go ahead with it," says Garth.
"As regards advertising, making an alcohol ad is very difficult. They have to be strictly vetted by an independent body to ensure they're responsible, and there are codes about where ads can be placed. A lot of advertising now is more about brand selection - choosing one beer over another - than increasing consumption anyway," says Garth.
Despite the calls for alcohol advertising and sponsorship to be regulated, Dr Caroline Smyth who worked on Trinity College Dublin's Binge Drinking and Youth Culture report in 2004, says resolving the problem is more complex.
"We've found that banning advertising and increasing taxes only increases consumption. Banning advertising just makes drinking more seductive. It's the classic thing of doing what you think people don't want you to. Also people have more money now and the cost implications of increasing taxes aren't significant enough to matter," she says.
"There are a number of reasons people drink like that. Irish culture is part of it. Drinking goes with most celebrations - St Patrick's Day is coming up and then graduations, weddings - there are very few celebrations that are isolated from drink," she says.
"What we need is an effective peer education system in schools and at community level. A family support system can also help. One thing they say is they do it to deal with stress - so by giving them problem-solving skills they can use that through life.
"Giving them those broad social values will be more effective than simply banning ads or pushing up alcohol prices."
Regardless of how the problem is solved, Dr Rolande Anderson, national alcohol project director with the Irish College of General Practitioners and alcohol addiction counsellor, says it is an urgent issue.
"Binge drinking is linked to absenteeism, and what's known as presenteeism - where you're there without really being there," he says.
"It's also linked to violence and people who continue binge drinking may find they suffer from long-term problems with their physical health and wellbeing.
"It's important to point out that a significant number of people do not keep binge drinking. But we feel that the more people who drink, then the more people will end up getting into trouble," says Anderson.
"Drinking and heavy drinking has been normalised in this country so when we see the figures from international studies we think they're exaggerated but it's too serious a problem to ignore. People are being killed walking home drunk, people are being killed drink driving, and binge drinking is very strongly linked to suicide and depression. We know that STIs are on the increase and it might also be contributing to martial breakdown," he says.
"All my colleagues say the problem is getting worse. As an alcohol counsellor I see lots of people in their 20s and 30s with major alcohol-dependency problems, and the danger is we'll see more of this in future.
"Maybe we will get hold of the problem but someone in Government needs to get behind the cause and huge money needs to be pumped into it first," he says.