Raise a glass, yes, but at what cost do we celebrate everything with a few bevvies?

IT’S the national stereotype that we all love a drink, especially at New Year – summed up by those nostalgic pictures of people queuing outside off licences in the 50s and 60s for their cases of McEwan’s and Tennent’s Lager adorned with Lager Lovelies. How times change.

More than a few of us will remember guzzling down double rounds before the pubs shut at 9pm on Hogmanay and then the desperate search for a decent party. Scotland’s relationship with booze is historic and complex.

It’s the time to be merry and partake of the falling-down water, and I am fairly certain I may accept a libation or two out of politeness. The challenge is trying to understand those for whom it goes way beyond this and becomes a one-way ticket to oblivion.

Trauma

‘Big man, you seem to be under the misapprehension that my addiction was a terrible time for me,’ one chap at an addiction meeting in Kilmarnock told me. ‘Let me tell you, I was steaming for three years – it was brilliant!’

But then came the sting in the tail. ‘I lost my job, my house and my family. It was only at that point I realised how blinded to the destructive reality my addiction had made me.’

At the Addaction meeting with what are euphemistically called ‘service users’ – alcoholics to the rest of us – I sat facing a horseshoe of people with similar stories to tell and tried to establish the fork in the road where they had gone down that path, and what alternatives were available.

I listened to stories of childhood trauma, mental health problems, stress, broken relationships and loneliness. If you take the time to listen to those who are in that black hole where drink or drugs mask deep-seated issues they will soon put you right on any of your misconceptions.

The trick we have yet to crack is how to identify the problem before it becomes a crisis, and I have long argued that lessons learned in sport, art, drama and music can play a significant part, but there is a gulf between deprived communities and affluent areas which needs to be bridged.

It’s not that the better-off don’t have problems too, or that their addictions are not as damaging, it’s just that the support networks tend to be there to help people function. In fact, more abstain from alcohol in deprived areas than in more affluent ones, but the effects are much more acute.

Scotland tops the tables in far too many poor healthrelated statistics, such as drug and alcohol deaths, where we have the highest per capita rates in the world and the toll continues to rise at an alarming rate.

If we are to shed this reputation, then we must fundamentally change our approach. As Einstein said: ‘The definition of insanity is doing the same thing over and over and expecting different results.’

Alcohol addiction is a health problem which too often ends up in the courts and there is no doubt the Scottish Government decision to slash the Drug and Alcohol Partnerships budgets was wrong; so wrong that the money had to be reinstated, by which time many talented and experienced workers had moved on.

The Scottish Government’s minimum unit pricing (MUP) for alcohol might help, but I am never too comfortable trying to price already poor people out of bad health choices.

That is why in accepting the Bill, the Scottish Conservatives insisted on a five-year sunset clause when it would be assessed for unintended consequences and, if necessary, be revoked.

There is anecdotal evidence that some addicts may have replaced booze with street drugs because they are cheaper, and any measurement of MUP’s impact must include understanding whether the problem has just been transferred.

Addiction

There is no single solution. There is a higher density of alcohol retailers in poorer areas, not to mention the difference in quality, so that brings licensing into the equation. Obviously education has a huge part to play, but we must also understand that not all sufferers are confident enough to seek medical help.

Recovery cafes and organisations such as Addaction are better placed to be the first point of contact, so taking services out to the community is better than hoping people will come to them.

But alcohol addiction is just one entry on Scotland’s overall poor health report card and a full review of how health is viewed is long overdue.

Scotland is the most obese nation in the UK and one of the most obese of the 36 OECD countries, because despite gyms seemingly on every high street, physical activity for young people as a whole is in decline.

Universal access to physical activity crashed after the 198586 teachers’ strike decimated extra-curricular activity and this has never been replaced. Now, children often have to come home and head somewhere else to participate, which hits those without access to transport. Sport is therefore becoming the bastion of the middle classes.

Data is sketchy at best but, anecdotally, fast food is increasingly a primary source of nutrition. Physical Health England’s chief nutritionist Dr Alison Tedstone recently wrote that over a fifth of adults and children eat takeaway meals more than once a week and there’s no reason to think Scotland is any different.

Despite the ban, more than a third in the lowest fifth of earners still smoke.

And putting it all together produces the perfect storm for an unhealthy nation. No wonder 10 per cent of the NHS budget is spent on Type 2 diabetes and its complications.

There are only three elements required for a healthy lifestyle: a good diet, being physically active, and easy access to a support network like a club with instructors, facilities and information. There is nothing else, but the Scottish Government has never recognised this.

Yet the solutions are in our backyard; our schools have fantastic sports facilities that as a kid I could only have dreamed about, with betterinformed teachers and coaches to deliver the knowledge to reverse the trends. And our farmers produce world-class food.

Preventable problems continue to rise and unless we look at a culture shift across government and society as a whole we are simply managing the decline of the NHS.

While there is no question that health care should always be free at the point of delivery, the current system is unsustainable.

Identifying and treating those addicted to alcohol earlier – before the social and financial costs spiral – is just one example of the changes we need to see in our approach to health. It’s a challenge we can no longer afford to ignore.

Brian Whittle MSP is Scottish Tory spokesman for wellbeing and sport