Getting Serious About Addiction and Binge Drinking in the U.K.

Two public figures in the U.K. are showing inspiring leadership on reducing the country’s severe drug and alcohol problems. After the election, I wrote an extended series (here, here, here, here, here, here and here) about the substance use and policy situation in the U.K., in which many people came in for criticism. I am therefore happy that I have leaders now upon whom I can heap unambiguous praise:

(1) Kate Middleton. I tend not to follow the lives of the royal family, but I have just become a huge fan of HRH The Duchess of Cambridge. She has chosen to become the patron of Action on Addiction, a leading charity in the field. Much as Princess Diana adopted AIDS as a cause and thereby galvanized public sympathy for its victims, The Duchess is doing the same thing for people who struggle with addiction to alcohol and other drugs. Action on Addiction’s CEO, Nick Barton, tells me that the Duchess’ interest in helping addicted people was self-directed: She approached the charity rather than having to be wooed. Nothing anyone in government could have done matches the cultural impact of having a wildly popular member of the royal family regularly bring the realities of addiction and recovery into the public eye. With thanks, this non-Brit says, God Save Her Royal Highness!

(2) David Cameron. A number of us have been banging on for some time about setting a minimum price for alcohol in the UK (For a definition of the policy and a debate among expert commentators, see here. For an update on recent developments, see here). This policy proposal just got the best kind of lift: an endorsement from the Prime Minister.

A minimum price, which is not a tax, would eliminate the extremely low cost beverages that drive binge drinking and associated disorder. In contrast, the average pub goer would not even notice the policy was in place. The Canadian experience, as studied by Dr. Tim Stockwell, has been very positive and the policy team at Number 10 have wisely sought out Tim’s advice.

The economic and social benefit of curtailing binge drinking in the UK would be hard to over-estimate. It costs the NHS alone almost 3 billion quid per year; the total cost mounts up to about 500 pounds per taxpayer per year. Libertarians with integrity (i.e., the noble minority who are more than crypto-shills for corporate interests) point out another cost to Britain’s booze culture which is a countrywide loss of freedom. Many people no longer feel safe in their own communities. They would like to enjoy an evening’s stroll down high street, but have resigned themselves to the fact that the place is a war zone. Likewise, their quality of life is damaged by the vomit, broken bottles and property damage to which they awake on too many a Saturday and Sunday morning. Setting a minimum price for alcohol is an excellent and fair way to reduce binge drinking and also re-allocate its externalities more equitably across the society. This would reduce the suffering of binge drinkers, limit costs to the taxpayer, and maximize the freedom of people nationwide to live and work safely in their communities.

Author: Keith Humphreys

Keith Humphreys is a Professor of Psychiatry at Stanford University. His research, teaching and writing have focused on addictive disorders, self-help organizations (e.g., breast cancer support groups, Alcoholics Anonymous), evaluation research methods, and public policy related to health care, mental illness, veterans and drugs. He is the author or co-author of numerous books and scholarly articles, and has written for the New York Times, Wall Street Journal, Washington Post, The Guardian (UK), the San Francisco Chronicle and other media outlets. When he is not in the San Francisco Bay Area, he is usually in London, where he is an ad hoc policy adviser to the national and city government, an honorary professor of psychiatry at Kings College, a senior editorial adviser to the journal Addiction, and a member of The Athenaeum. When he is not in the San Francisco Bay Area or London, he is usually in Washington D.C., where he serves as a frequent science and policy advisor to federal agencies, and where he has served previously as an appointee to a White House commission and several Secretarial task forces. From July 2009-2010, he served as Senior Policy Advisor at the White House Office of National Drug Control Policy. When he is not in the San Francisco Bay Area or London or Washington D.C., he is usually in the Middle East, where since 2004 he has volunteered in the international humanitarian effort to rebuild Iraq’s mental health care system. This work has taken him to Turkey, Egypt, Iraq, Jordan and Lebanon to teach and consult with Iraqi health professionals and policy makers.

8 thoughts on “Getting Serious About Addiction and Binge Drinking in the U.K.”

  1. Are you serious? They are “getting serious”? I haven’t noticed. I’ve been following the headlines for weeks and it’s nothing but stand-up comedy material. First, you had the “two-drink” standard–if you have more than two drinks a day, you’re the target of anti-binge policy. Yeah, sure, someone who has three “drinks” a day is a bit of a lush, perhaps well on the way to becoming an alcoholic. But three drinks do not make a “binge”.

    Then you got the “two dry days a week” standard–if you can NOT drink two days a week, you’re not an alcoholic. I wish I were making these things up, but all this nonsense was coming from the the cabinet and from Parliament.

    Plus there is a whole bunch of columns that say things like, “Eskimos have a hundred words for snow and Englishmen have the same number of words for getting drunk”. Ha-ha!

    It’s all just a way to raise taxes without saying that they are raising taxes–because, as you know, conservatives just don’t do that sort of thing. They hike taxes on wine and wonder why no one drinks it but they keep the taxes down on beer or there would be a revolt. The case went up before the ECJ, but the judges must all have been drunk and let them get away with it.

    Remember the brilliant idea that Gorbachev had when he instituted the Fight on Drunkenness? They did not just ban the sales of vodka for most hours, but they physically rooted out a bunch of ancient vinyards in Ukraine, Moldova and Georgia. It’s even painful to think about the damage. For a couple of years, Russians could not buy hard candy and cologne in stores–they were all bought out in bulk and re-distilled into crappy moonshine that went to the black market. If Cameron thinks he can legislate out drunkenness, he’s an even bigger fool than I figured him for.

  2. Only £3 million in NHS costs? Surely you mean £3 billion.

    BTW, good for HRH Kate. As I and many others have said before, William is a lucky man. But they should have scrapped the fusty Duke and Duchess bit. “Duke of Cambridge”? Wasn’t he fed to lampreys or something in Act I of Richard III? William’s a prince; she can be a Princess.

    1. James: Good catch thanks.
      ShadowFox: Minimum pricing simply isn’t a tax, it doesn’t bring a penny into the Treasury. Minimum pricing policies come out of anti-competitive business practice regulation, such as is used to stop product dumping. When the state stops a supplier from dumping a product below cost for the purpose of bankrupting the supplier’s competitors, that isn’t “taxation” unless one changes that word to the point that it is meaningless.

      1. I know you were talking about minimum pricing, but I never mentioned it. My point is that they are looking for a way to squeeze revenue out of this and minimum pricing will not be the only measure–precisely because it doesn’t accomplish that. Perhaps I am wrong, but from what I’ve heard and know of UK alcohol pricing, it certainly does not qualify as “dumping below cost”–that’s something you will find in US college towns (e.g., Columbus or Miami or Athens, OH, Madison, WI, Amherst, MA, etc.). If anything, there is an inflation of beer prices because the market will bear it and an inflation of other alcohol prices because of taxes. British prices are much higher than continental–and it’s not like UK is an isolated island with limited resources, like Hawaii. The problem is cultural, not economic. There are economic measures that do affect cultural shifts (e.g., slapping a 600-1000% tax on tobacco products is likely to curb smoking, but it wont eliminate it and it won’t prevent new users from getting into the market–the economic factor here is the sudden increase in price, not the price itself). For the most part, minimum pricing in the UK will have little effect on consumption although it might affect how it is purchased. But, of course, the government will trumpet the great measures they are taking that will end alcoholism as we know it. Except, of course, that they will do nothing of the sort.

        1. ShadowFox: I forget if you live in the UK or not. If so, walk down to Tesco and compare the price of hard cider to bottled water — it’s often lower. It’s a conscious strategy by supermarkets to use alcohol as a loss leader (That’s why the pubs are losing business in the UK).

          In terms of your assertion that the pricing will not affect UK consumption — where is your evidence for that? Stockwell’s work shows a drop in consumption, focused among the heaviest drinkers (Who, don’t forget, pay about 80% less per drink than the rest of the population). Where is the evidence that UK heavy drinkers would be less price sensitive than Canadian heavy drinkers?

  3. Don’t VAT, etc. taxes go up with the cost of the product?

    When I was last in London a couple of years ago I heard a lot about the need for the minimum price to cut down on “beer louts,” which, the upper class types I heard this from seemed to mean the lower classes.

    Just how cheap is this “lout” beer I was paying around five pounds for a pint in London pubs, although I did note a few with signboards out front promoting pints for three to four pounds. I did stop at an all night convenience store in Chelsea Harbor area and remembers some display for 99 Pence for what looked to be a pretty big can of beer. How much would a below cost price be? And wouldn’t it be mostly taxes?

    I do recall being on the tube many years ago following a soccer match with Scotland and seeing some soccer fans smashing the florescent tubes on the train.

    1. H: There are a range of minimum price proposals on the table, but under say a 50p per unit price, the 99 pence 24 ounce of lager in the supermarket would rise to 1.50 pounds, but the pint in the pub would be precisely the same price.

      You would pay more VAT on the pint (about 10 pence), but because minimum price lowers consumption, the Treasury would probably not make anything on the venture.

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