Sexual health and drugs and alcohol are inextricably linked in terms of promotion, prevention, screening and treatment and therefore the service delivery comes under the remit of the wider sexual health and harm reduction team. The benefits of this are enabling comprehensive and consistent sexual health and harm reduction programmes of work to be delivered city wide; increasing the skill base within an already established and respected team; and ensuring that work is appropriately targeted in line with relevant sexual health, alcohol and drug strategies nationally and locally.

For the purpose of this website both alcohol and drugs and harm reduction have their own sections for more targeted and specific information.

Alcohol is a depressant drug. This means it temporarily switches off the centres of the brain controlling our physical, mental, emotional and behavioural state. Alcohol is classed as a drug because it alters the physical, mental, emotional and behavioural state of the drinker. For example, alcohol as a drug switches off our natural feelings of fear and caution.

It is the strength (% abv) of pure alcohol in a drink that makes it "alcoholic". Take a look at these different categories of drinks products:

Alcohol can be harmful in a variety of different ways. Harmful consequences can vary depending how much and how often a person is drinking as well as where and when they are drinking. A report by the Cabinet Office (2004) categorised alcohol related harm using four categories:

• Harm to the health of the individual
• Crime, anti-social behaviour, domestic violence, drink-driving and its impact on victims
• Loss of productivity
• Social harms, including problems within families

There are three types of alcohol misuse:

Hazardous alcohol misuse

Regularly drinking above safe daily limits with no current health or social harm. Continuing at these levels will increase the likelihood of future harm to self or others. This pattern of drinking is also referred to as “increasing risk” (men drinking between 21-50 units in one week and women drinking between 14-35 units).

Harmful alcohol misuse

Regularly drinking above safe daily limits and already experiencing direct or indirect health or social harm (to self or others) but in the absence of alcohol dependence. This pattern of drinking is also referred to as “higher risk” (men drinking above 50 units in one week and women drinking above 35 units in one week).

Dependent alcohol misuse

Experiencing signs and symptoms of alcohol dependency syndrome; this can be psychological and/or physical dependence. Signs and symptoms include increased tolerance to alcohol, physiological withdrawal and relief drinking, constant urges or cravings to drink and continued drinking despite harmful consequences.

What is the role of the PCT?

Models of care for alcohol misusers (MoCAM) provides best practice guidance for local health organisations and their partners in delivering a planned and integrated local treatment system for adult alcohol misusers. Pdf The following outcomes will be measured in the following areas:

• reduction of alcohol consumption  
• reduction in alcohol dependence
• amelioration of alcohol-related health problems
• amelioration of alcohol-related social problems
• general improvement in health and social functioning

Here are some examples of how alcohol misuse has an impact ill health, reducing life expectancy and quality of life.

Heart disease 1200 deaths a year caused by alcohol related stroke and 10% of deaths are due to hypertension caused by alcohol misuse.
Obesity Alcohol is high in empty calories (of no nutritional value) and also contributes to low energy levels and nerve ending damage (peripheral neuropathy).
Diabetes Alcohol damages the pancreas and alongside its high sugar content contributes to rising rates of diabetes.
Cancer Nearly 5000 cancer deaths are alcohol related (mouth, larynx, pharynx, oesophagus, liver).
Suicide 65% of suicide attempts are related to alcohol misuse
Child death Every day, an average of 13 children are hospitalised as a result of drinking too much (Figure based on written answer from Caroline Flint MP to Parliamentary Question from Sarah Teather MP, July 2005).

Alcohol related liver disease may overtake coronary heart disease as the biggest killer if we don’t change our drinking habits.

Reduce the under age conception rates A survey of 13-14 year olds found that 40% were drunk or stoned when they first had intercourse. One in seven 16-24 year olds have had unsafe sex and one in ten have been unable to remember whether they had sex the night before.
Domestic violence Alcohol is a drug that may aggravate violence, aggression and abuse. 360,000 cases of domestic violence are alcohol related. A woman coping with domestic violence is 15 times more likely to use alcohol.
Improve the quality of life and independence of older people Older adults are least likely to know about units of alcohol. A study of patients admitted acutely to an elderly care ward identified 8% as alcohol misusers.
Reducing waiting times in A&E Up to 70% of A&E attendance is alcohol related at peak times. Alcohol related diseases account for 1 in 8 NHS bed days every year.
Healthy prisons A snapshot of new inmates of HMP Manchester in June 2004 showed 64% had problems with alcohol prior to custodial sentences