Key topics

The Academy aims to identify and develop responses to key isssues or challenges facing the delivery of alcohol harm reduction. Below are a number of briefing papers and other areas the Academy is working on to promote development and understanding in the field.

Academy briefing papers


Alcohol and the workplace

It has been calcualted that the impact of alcohol misuse to the workplace costs the UK economy £6.4 billion per year - twice the cost to the NHS. These costs are largely attributed to alcohol-related sickness and absenteeism in addition to accidents and injuries. Many organisations may recognise employee health and wellbeing but few will consider how to prevent and reduce the impact of alcohol misuse specifically.


The Academy has been working with a number of organisations to research and develop the most effective ways to prevent and reduce alcohol misuse at work. Employers have the opportunity to promote lower risk drinking and deliver routine brief interventions. Robust alcohol policies should support preventative strategies whilst ensuring proper procodures to manage and support those with alcohol dependency.


Alcohol and older people


Alcohol use amongst older people is a topic many local alcohol leads raise as needing further attention.  There is a more limited understanding about alcohol use and impacts amongst the elderly than the general population, and there is a need for further research and guidance in this area. Evidence suggests that alcohol misuse is often overlooked or attributed to other conditions associated with the old. For instance the risks of combining alcohol with prescribed medication or not considering alcohol as a contributory factor in a fall are some examples of how further awareness and skills are needed. With the continuing growth of the older people’s population, the Academy feels this is an area that must be better addressed.

The Academy aims to support alcohol leads by promoting current research and practice, whilst developing and supporting further work and approaches. We are currently working to draw together the existing evidence base and practice examples through medical and treatment experts working with this group. We will be delivering focused workshops sessions at forthcoming regional events to engage local alcohol leads in discussions about what we know and how we can progress this important agenda.

See here for presentations from the
Academy alcohol and older people event in the South West. Stay posted for our forthcoming briefing.

Home drinking


Whilst levels of ‘binge drinking’ in the UK are amongst the highest in Europe, this issue has received significant attention through the media, awareness campaigns and local crime and disorder responses. A significant amount of new legislation has been passed over recent years specifically with the intention of addressing alcohol-related crime and disorder commonly attributed to binge drinking.


However some alcohol leads suggest further attention may be needed on harmful home drinkers since they drink behind closed doors and are less likely to draw attention through issues such as anti-social behaviour. However home drinkers may be more likely to drink on a daily basis, which increases a number of health-risk factors including dependency. Alcohol-related hospital inpatient and day visits are estimated to cost the NHS £1,190 million each year in addition to the £646 million A&E costs. Home consumption has risen significantly as a trend over recent years with a reported 1.8 million more people drinking at home than in 2004. 


The Academy will further explore how local alcohol harm reduction approaches are able to address issues that may be relevant to home drinking and whether further attention is needed. One such issue is that current alcohol treatment provision is focused on later-stage depandant drinkers who require time and cost intentsive interventions and support. A strong cost-savings argument suggests that focusing alcohol treatment for drinkers with early or moderate stage dependancies would be more beneficial as a longer-term preventative approach. A briefing will shortly be available summarising currently available information and what approaches may be effective in further addressing such issues.


See an Academy presentation on

'Harmful drinking in the home: an unacknowledged issue?'

Alcohol and cocaine poly-use: Cocaethylene

When alcohol and cocaine are combined a new substance is produced called cocaethylene. This unique compound produces a unique ‘euphoric’ effect which stays longer in the blood stream. However evidence indicates that cocaethylene significantly increases a number of health risks such as heart conditions or liver failure, and may increase violent tendencies in the user.


See here for the Academy's briefing paper: 'Cocaethylene: responding to combined alcohol and cocaine use'

Awareness of cocaethylene is reportedly low amongst the general public and even amongst some drug and alcohol practitioners. However it is acknowledged that the research and evidence base for the effects of cocaethylene is particularly limited. There also appear to have been no trials or guidance released on the best ways to respond to or treat cocaethylene use.
With continued increases in levels of cocaine use and reported poly-use of alcohol and cocaine, the Academy wishes to promote awareness of cocaethylene and the case for further research and understanding into the effects. From this there should be recognition of alcohol and cocaine poly-use in drug and alcohol policy and supporting guidance on how practitioners should respond to its use.

Skills for commissioning alcohol treatment

Health bodies and charities have long called for further investment and improvements in the provision of alcohol treatment, especially where the funding of drug treatments have been financially prioritised. This year the Department of Health produced ‘Signs for improvement’ as guidance for commissioning alcohol services and are due to release a further document on developing effective alcohol treatment pathways.

The Academy strongly welcomes this guidance but also recognises that alcohol leads require a wide range of knowledge and skills to deliver and influence commissioning; skills that are not likely to be reflected in their job descriptions or experienced in previous roles. The Academy therefore aims to develop and provide training on the most effective skills, learning and approaches required for the effective commissioning and development of alcohol treatment.