• alcohol abuse
• mental health, alcohol abuse
• epidemiology
• accident prevention

The EMJ publication on the cohort study of alcohol related attendances in Newcastle (UK)1 is a timely reminder of the impact and burden of alcohol on emergency departments. Almost 1 in 6 emergency department attenders in this study presented following significant alcohol consumption. This in itself is a cause for concern. However, the prevalence rises to almost 3 in 4 four attendances during the late evening and early hours of weekends.

This study, in an inner city emergency department, best reflects the case load and case mix of other metropolitan and urban centres, but the key messages are relevant to all emergency departments in countries where alcohol is readily available.

Current national and international data describing the financial burden of alcohol are dramatic, yet the response of governments has been woefully inadequate.

In England alone, the National Health Service (NHS) estimates that there are 1 million hospital admissions annually as a direct result of acute or chronic alcohol ingestion. The financial cost to the NHS is £3.5 billion.2 The cost to individuals is even greater—over 21 000 deaths per year in England are recorded as alcohol related, although even this is the tip of an iceberg in relation to the blighted lives, lost opportunities, failed relationships and physical injuries consequent on the misuse of alcohol. Globally, the WHO reports 3.3 million deaths per year from alcohol—a staggering 6% of all deaths worldwide.

The commonest reasons for alcohol related attendances are physical injury and mental health related …