Transcript ALCOHOL SEX AND YOUNG PEOPLE, CAN HEALTH ADVISERS HELP

YOUNG PEOPLE , SEX AND
ALCOHOL, CAN HEALTH
ADVISERS HELP WITH THE
HANGOVER?
RICHARD BETOURNAY
DIONYSUS
 GREEK GOD OF WINE AND ECSTACY
 RITUAL GATHERINGS KNOWN AS ORGIES
Sex and Alcohol .....
is there a link?
 Little Evidence
 British Youth Council Survey, 68% believe link
between drinking and unprotected or regretted
sex
 50% report sex later regretted, half of these think
drinking before hand a factor.

British Youth Council 2009
 No interlinking between UK Sexual Health
Strategy and UK Alcohol Harm Reduction
Strategy
Government Strategy
 In 2007 launched “Safe sensible and
sociable” next steps in national
strategy targeting:
 Under 18 year olds
 18-24 binge drinkers
 Higher risk drinkers
Youth Drinking in the UK
Children’s Attitudes
 43% Think older people drink alcohol to look
cool
 30% think wine drinkers have 5 or more glasses
per night
 30% think binge drinking is normal.
 3 in 5 think people drink to forget problems

Life Education UK Survey of attitudes of 9-11 year olds 2008
Why do young people drink?
 The same reasons as every one else does-to
have fun, to relax, to socialise and feel more
outgoing
Quotes from Rochdale
Study
 “ if someone says why did you do such a
thing then you can say because i was pissed,
and yes you have got a reason (female).
 “You don’t know if they really want it when
your drunk”(male)
 “helps you feel good about yourself” (female).
Rochdale Study
 Alcohol seen as playing both positive and
negative roles in relation to sex.
 To have a laugh emerges as most common
reason for drinking.
 Negotiating consent is seen as very difficult
by effects of alcohol.
 A third of respondents cite confidence as a
benefit of drinking alcohol before having sex

Redgrave and Limmer 2006
Economics for young people
Trends of Alcohol
Consumption in Young People
Summary of Southampton Study
 520 GU attendees questioned
 86% 0f GU attendees exceed government limits, 54%in GHS
 Clinic attendees binged alcohol, average of 13 units on usual
night and 26 on a heavy night
 32% thought alcohol played part in clinic visit
 77% had been drinking before sex with a new partner
 In women reporting pregnancy - 55% said unwanted pregnancy
and 28% of those reported drinking before UPSI

Standerwick et al 2006.
Where are we at now?
and ...
Who said what?
 ‘Alcohol is a problem for society, quite simply England has an
alcohol problem’.
 ‘Deeply ingrained drinking culture costs NHS £2.7 Billion a year’.
 ‘We don’t want the responsible drinkers to have to pay more or
suffer as a result of the excesses of a minority’.
 ‘Increased alcohol duty would be unpopular as many were
struggling with their finances as result of the recession’.
Where do sexual health services fit in?
TIER 1
alcohol-related information
and advice; screening;
simple brief interventions;
and referral
(Primary Care, General
Health Care settings, Social
Care settings and Criminal
Justice Settings)
TIER 2
open access; noncare-planned;
alcoholspecific
interventions
(Drop in Centres,
Counselling
Services)
TIER 3
community-based;
structured; careplanned alcohol
treatment
(counselling
services, outpatient
detox services)
TIER 4
alcohol specialist
inpatient treatment
and residential
rehabilitation
(inpatient detox
services, residential
rehab services)
Opportunities to influence risk behaviour
 STI clinics are well placed to identify
substance use and offer onward referral if
necessary.

Patten et al 2008
 Young people must be able to access advice
on how to make choices to avoid
unprotected, unsafe or regrettable sexual
experiences, this advice must include
information on how to avoid drinking leading
to unprotected, unsafe or regrettable sex.

British youth council report 2009.
Making the most of “The teachable Moment.”
 A time when a person is
most receptive to learning
something or particularly
responsive to being made
aware.
 Can not be created, may be
combined with different
emotions.
 Has a “half life” delay
between identification and
intervention must be kept to
a minimum.

Williams et al 2004.
Screening for hazardous and harmful drinking
SASQ
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Single Alcohol Screening Question.
When was the last time you had
more than x units in one day
Never/ More than 12 months ago, 312 months ago, within past 3
months
Within past 3 months = positive
response.
Sensitivity and specificity =86% for
detecting hazardous drinking in past
3 months or alcohol disorder in last
year.
What is brief alcohol intervention?
 “The giving of information, advice and
encouragement to the patient to consider the
positives and negatives of their drinking behaviour,
plus support and help to the patient if they decide
they want to cut down on their drinking
 “Brief interventions are usually “opportunistic”- that is
they are administered to patients who have not
attended a consultation to discuss their drinking.
 Make use of “Teachable moments”

Alcohol Harm reduction strategy for England
Features of Brief interventions
 A family of interventions
ranging from a few
minutes simple but
structured advice to 20
minutes counselling.
Style of brief advice
 Similar to motivational interviewing
 Stages of change, help think about initiating and
maintaining new patterns of healthy behaviour
 Empathic and non judgemental
 Work with ambivalence, patient may not have been
expecting discussion about alcohol issues.
Rationale for screening and
brief interventions
 Early intervention and secondary prevention
of medical and social harm.
 Public health improvements.
 Reduce costs to health service.
 Evidence of effectiveness 56 trials of
effectiveness, mainly in primary care.
 Number Needed to treat (NNT) rate of 8-12
Training and Information
 www.alcohollearningcentre.org.uk
 Alcohol Identification and Brief advice
 Online E learning
 DOH approved package
 Supported by RCN, RCP, RCGP.
Conclusions
 Health advisers have transferable skills to
provide effective brief interventions.
 Intervention possible at “teachable moments”
 Need multi faceted approach, Government,
drinks industry, health care providers.
 Break the sexy-alcohol link, helping young
people to explore costs and benefits.
 Address sexual health and alcohol issues
together.
If only I had listened to my Health Adviser !!!!!!!!!!!!!!!!!