Thursday 22 June 2017

It wasn't about Eilish - it was about how we view alcohol

'Operation Transformation' panellist Dr Ciara Kelly responds to criticism of her treatment of Eilish on the TV show

Dr Ciara Kelly was not impressed with Eilish's one lb weight loss
Dr Ciara Kelly was not impressed with Eilish's one lb weight loss
Operation Transformation participant Eilish Kavanagh

Dr Ciara Kelly

If any good has come from last week, it's that we're at least discussing, if not truly debating, our national pastime - drinking. This week on Operation Transformation, RTE's health show, I came under sharp criticism for how I reacted to Eilish, one of our leaders, drinking at the races whilst on the programme. "Too harsh" said my critics. "Sure what's wrong with you - it's only a bit of craic." "Everyone's entitled to a drink. If anyone's a disgrace it's you", I was told.

Now, at the outset, I want to say I've huge respect for Eilish and indeed all our leaders. They put themselves out there - which isn't easy - and they let the country in, to watch their struggle to embrace a new healthy regime of diet and exercise. That's far more challenging than it looks from the outside. And they genuinely inspire people to follow them - so all over the country on drizzly January evenings, people, many of whom have never exercised before, are heading out in gangs, in high-viz jackets to walk or run.

It's my favourite bit of Operation Transformation, that huge community commitment and involvement that occurs.

But, as a doctor I've a huge problem with how we Irish view and use alcohol. And on our national broadcaster's flagship health show, I felt I had no option but to show my utter dismay at seeing one of our leaders go drinking. I felt that to not deal with the subject would've been irresponsible of me.

This was not about Eilish having a few drinks at the races. Yes I was speaking to Eilish, but I wasn't talking about Eilish. I was talking about all of us.

There's a collective denial about the fact that we Irish drink far in excess of other countries. That 1.3m of us have a harmful drinking pattern - that's about two-thirds of all Irish adults. And that three-quarters of all episodes of drinking here is binge- drinking. We don't drink here to socialise. Ireland drinks to get drunk.

Binge-drinking is defined as more than six units of alcohol - that's three pints. That's fact. It's considered a binge because more than six units causes adverse physical effects.

However, in Irish terms, we consider six units drinking in moderation. We think a binge is being comatose. Twenty or thirty units constitutes an Irish binge. Our perspective is so skewed that we don't even recognise that our drinking levels are abnormal - many of the two-thirds of adults here with harmful drinking patterns believe themselves to be light drinkers.

We constantly minimise our drinking - talking about going for 'a pint' or a 'couple of drinks' when in reality we mean multiples of that. And we extol nights out where we don't remember how we got home, where we were or what we did. But we know it was great craic.

It costs us though, our special relationship with drink. We spend about €6bn annually on buying it. And a further €4bn per year in cleaning up the messes it causes in terms of public order and healthcare. Those figures are staggering. To put them in context: the entire health budget is only €13bn.

Eight per cent of our total health spend goes on alcohol-related problems. We could fund several additional hospitals or indeed clear up the trolley crisis over night with that kind of money. But sure the craic is mighty - although not in our A&Es obviously, which are ugly, violent places at night. Dangerous for staff and other patients alike, many of whom are sober and fearful, huddled on trolleys under the fluorescent lights, watching the drunken fights. Public disorder inside our hospitals.

But for me that isn't the real cost. The real cost is in terms of lives ruined. The marriages destroyed. The careers ended. The children neglected by parents. The parents assaulted by children. We scratch our heads about the high suicide rate in our young men but never seem to connect the fact that excessive drinking makes you eight times more likely to commit suicide.

Almost 40pc of our young men who die by suicide had been drinking when it happened. And alcohol is - between suicides, assaults and accidents - the single biggest cause of deaths in men under thirty. I believe by not challenging our drink culture we're letting those young men down.

UCC, this week, published a survey which showed that two-thirds of our university students have harmful drinking patterns and that young women are now ahead of young men in the drinking stakes. Basically, we operate off the system here that two-thirds of our youth drink like alcoholics, while we just hope that most of them will grow out of it. Those that don't - the casualties along the way - are collateral damage.

So we talk out of both sides of our mouths when it comes to alcohol here. We say, "it's a disgrace" when we see people puking, urinating and fighting in the streets. But we continue to describe as "legend" our drunkest nights out. We wonder why our young people drink like fish, while we the older generation do the exact same.

We pay lip service to fixing it - but baulked only last week at banning alcohol sponsorship of sports because that might actually change something and I believe we don't want that. We don't actually want to stop drinking like this - we want to continue but we'd prefer if nobody noticed.

And that's why I reacted so strongly this week because, as a doctor, I'm long past denial. I see the other side of drink every day and this was a health promotion show.

Eilish got the brunt of that which was probably undeserved. But am I sorry for bringing it up? No. Let's have that debate. @ciarakellydoc

Read Karl Henry's Operation Transformation diary every Saturday in the Irish Independent

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