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Extent of hospital patient alcohol misuse 'much bigger' than assumed

A new review of evidence from the UK has found high levels of alcohol dependence among hospital inpatients. The researchers estimate one in five patients in the UK hospital system uses alcohol harmfully, and one in 10 is alcohol dependent.

Currently little is being done to screen routinely for alcohol dependence in hospitals, and services for patients with alcohol dependence are limited. The researchers call for universal screening in hospitals for alcohol-related problems and improved training for hospital staff around alcohol-related conditions.

This new systematic review and meta-analysis, published in the scientific journal Addiction (link), provides the first robust estimates of alcohol-related conditions among UK hospital inpatients by pooling the results of 124 earlier studies covering a total of 1,657,614 participants.

The prevalence of alcohol-related conditions was already thought to be higher in hospital inpatients compared with the general population, but until now we have not had reliable estimates of the true overall prevalence of these conditions in the inpatient population. The review suggests harmful alcohol use is 10 times higher in hospital inpatients, and alcohol dependence is eight times higher, compared with the UK general population.

The review also found that harmful use of alcohol is most prevalent in mental health inpatient units and alcohol dependence is found most commonly in patients attending accident and emergency departments.

Alcohol-related conditions are estimated to cost the National Health Service (NHS) approximately £3.5 billion per year. Alcohol can cause a large number of medical conditions and without in-hospital screening many alcohol-related conditions may be missed and not receive appropriate treatment. Accurate prevalence estimates are vital to inform policy makers of the scale of the problem and are particularly timely given the UK government’s development of a new alcohol strategy and the NHS 10-year plan, which includes funding allocations to combat alcohol-related conditions.  

Lead researcher Dr Emmert Roberts, from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London, says: ‘Many doctors are aware that alcohol-related conditions are common among hospital inpatients, but our results suggest the problem is much bigger than anecdotally assumed. Dedicated inpatient alcohol care teams are needed to ensure this widespread problem is being addressed, particularly in the context of diminishing numbers of specialist community alcohol services in the UK.’