Hugh MacDonald: It’s time to talk openly and honestly about the bevvy and the damage done

ONCE, in what seems like another lifetime, I told my doctor I was going to give up smoking. Knowing my addictive tendencies and past, he sent me to the smoking cessation nurse.

“Do you drink?”


“Not even a wee sherry at Christmas?”

“Not even a wine gum at Michaelmas.”

“Do you gamble?”


“Not even a lottery ticket?”

“Not even a shot in the work’s football card.”

There was pause when the nurse considered the implications of the above. She then added: “And you want to give up smoking too?”

READ MORE: Making sense of Scotland’s alcohol deaths and suicides

This spoke to the deeply-held Caledonian conviction that pleasures are only authentic when they invite death or, at least, psychic darkness.

The meeting with the nurse occurred in the last century but my blessings are counted daily, no more so when figures are released on the toll that addiction takes on my fellow Scots.

This week it was announced that there were 1190 alcohol-specific deaths in Scotland. Figures released last month showed there were 1339 deaths from drugs misuse in Scotland in 2020.

In December of last year, the rising drugs toll forced the departure of a government minister. The First Minister also described the situation as “indefensible”. The opposition cried “Scotland’s shame”. Any sentient person was appalled and deeply saddened.

The alcohol figures produce no similar storm. They are, too, almost certainly an under-reporting of the problem. First, alcohol is present in many drugs deaths. Second, alcohol-specific is a restrictive term. Alcohol-specific deaths only include those health conditions where each death is a direct consequence of alcohol misuse (that is, wholly attributable causes such as alcoholic liver disease).

Yet an international team, led by Imperial College London, published a report earlier this month that showed consuming alcohol increases the risk of getting more cancers than previously thought. These include cancers of the head and neck – mouth, pharynx and larynx – oesophageal and bowel, along with the more widely known connection with breast and liver. Victims of these diseases – save liver cancer – are unlikely to be included in the alcohol-specific category.

READ MORE: Alcohol campaigners call for mandatory labelling on bottled drinks

Further, three years ago a study conducted by the Global Burden of Disease study confirmed previous research that there is no safe level of drinking. Yup, that’s right. No. Safe. Level.

But what about the 14 units or whatever it is? Damage limitation.

What about that one glass of wine a day that protects one against heart disease?

Researchers said moderate drinking may protect against heart disease but they found that the risk of cancer and other diseases outweighs these protections.

The reaction to all of this has been instructive. Even small measures such as minimum pricing have been opposed.

There is, it seems, no political, social or economic will to face a problem that inflicts mayhem on accident and emergency units, makes the NHS creak, kills innocent bystanders through violence or drink driving and robs us of friends, fathers, mothers, brothers and sisters, husbands, wives or lovers.

The lack of an economic initiative is simply explained. Alcohol makes money for many. It allows industry to employ groups and spokesmen who spout banalities in the face of tragedy.

There is, too, little political capital on launching a crackdown or even the prohibition of a commodity that is, in some cases, synonymous with Scotland.

The social aspect is the most intriguing. It can be seen clearly in the difference in the level of the reaction to death by drugs misuse or alcohol-specific fatality.

The first category can be seen by policy makers or middle-class commentators as “death of the other”, that is, those outside a social or economic bubble of well-being. This is rubbish, of course. The triumph and tragedy of drugs is that they are seductive across all classes.

The reluctance to view alcohol critically, to scrutinise its use and effects, is born of its ubiquity and its acceptance by polite and impolite society. It seems almost rude to point out that one drink can have health effects. It appears mean-spirited to refer to the studies mentioned in this article.

It risks the accusation that one is howling at the bottle because one had to give it up. Believe me, I have no mission against alcohol, save my personal imperative not to take it. I sat with my son and his mates in a very congenial pub this week watching our German football team. I was so ridiculously sober I paid the bar bill.

But I wonder at the myopia over alcohol. I have seen its traces in drug abuse. I have witnessed it as a precursor to suicide.

The evidence of its damage is stark. It is told in the testimony of the casualty nurse. It is reflected in the figures that only hint at its fatal impact. The carriers of this message, including me, are dismissed as kill-joys.

Yet the irrefutable truth is that alcohol, most likely, has taken somebody close to you to a premature death. Society meets this with a shrug or a huff when minimum, restrictive measures are introduced.

The affronted cry freedom. We must be able to choose our poison, they say. Fair enough. But at least three people will die today in Scotland of alcohol-specific causes. It seems a waste, a scandal and a national and personal tragedy.

We must talk openly and honestly about how a favoured drug is allowed to kill. Once I was a candidate for this fate but escaped. I say this from the depths of gratitude not from the moral high ground. I say it in the hope others might survive, too.

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The Herald Scotland

The Herald is a Scottish broadsheet newspaper founded in 1783. The Herald is the longest running national newspaper in the world and is the eighth oldest daily paper in the world. The title was simplified from The Glasgow Herald in 1992