By the numbers: Simple 10 step approach to reducing harms of alcohol

Scientists Jürgen Rehm from the Centre for Addiction and Mental Health (CAMH) in Toronto, Canada, and David Nutt, Neuropsychopharmacologist from Imperial College London and Vice President of the European Brain Council, have created an integrated set of evidence-based strategies focusing on what individuals and governments can do to reduce the personal and public costs of alcohol.

"Alcohol is one of the leading causes of disease and disability in the UK and Europe, says Jürgen Rehm. "And the harm attributable to alcohol could be easily reduced."

The first four points focus on personal health behavior. Nutt and Rehm suggest:

• Monitoring alcohol intake = know your number. In much the same way you would know your blood pressure, cholesterol level or calorie intake.
• Limiting consumption to 20 grams (about 2.5 drinks based on UK drink size, but less than 2 drinks in most other EU countries) per day for men and 15 (about 2 drinks in the UK and between 1 and 2 in other countries) grams per day for women.
• Less is more. As with lower blood pressure and cholesterol, lower amounts of alcohol consumption lead to greater health and longevity.
• Take a day off. Not drinking for one or two days a week can help the liver recover from the effects of alcohol and reduce the risk of liver complications.

The next six points focus on government intervention:

• Minimum pricing of alcohol would reduce consumption of cheap alcohol, especially in young people.
• Labeling the amount of alcohol grams, much like food labeling, would allow consumers to track the exact amount of alcohol they are consuming.
• Limiting the times and places alcohol can be purchased will make impulse buying, particularly when drunk, much harder and make it easier for people with alcohol-use problems to avoid contact with alcohol in shops and supermarkets.
• Providing treatment can provide significant health benefits to individuals and society and should be offered to all people with an alcohol dependence problem.
• Investing in research can develop new approaches to addiction. Techniques using genetics and neuroimaging will optimize and build on current research. Pharmaceutical investment in alcohol treatments is minimal and should be revitalized by government incentives.
• Developing alternatives to alcohol by investigating the possibility of new drugs that mimic the milder effects of alcohol. An alternative substance that could simulate relaxation without the negative side effects would reduce public health and social costs from alcohol-related damage.

"It is important to create a climate where the risks of alcohol are known, and where governments take their responsibility to reduce problems caused by alcohol," says Nutt. "But our method also involves education and self-monitoring approaches of individuals that have already proven effective in relation to cholesterol and blood pressure. The combination of individual and societal approaches would likely have major beneficial impact on health effect and social harms due to alcohol, and reduce alcohol-attributable mortality especially in younger ages. The proposed approach would also reduce the stigma currently associated with alcohol use disorders and thus enable earlier and more interventions."