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This is Victoria. She's 35 and has been drinking a bottle of brandy a
day. It's not sore. It's tender. Matthew's 45. 20 pints a day left
him needing a liver transplant. When Mr Richardson said, "Matthew
you're dying", I cried my eyes out. And Brian's 32. He drank so much
cheap cider, he ended up living in a cave. Grim place, isn't it?
This just looked like a normal home to me when I was drinking.
They're part of a new younger generation of problem drinkers.
are seeing people as young as those in their 20s dying of alcoholic
liver disease. Tonight Panorama gets rare access
to a hospital that's seeing the impact of drink on every ward.
Worse case scenario, it will kill you.
And we ask, are the Government doing enough to stop us drinking
ourselves to death? Saw you awhile back, didn't I? I can't remember.
Must get that done today. It's Friday morning at Liverpool's
biggest hospital, the Royal. OK. Who do we have in here?
Liver specialist Paul Richardson is on his ward round. One of his
patients is worrying him. Is she still tearful? She is.
Her name is Victoria White. Morning. Hi,.
Victoria's only 35. She's got two children. But she's been drinking
heavily since she was a teenager. And this is her today.
Some people go their separate ways from alcohol. I didn't. I just
carried on with it. You're just selfish through drink.
As long as you're all right, you just don't care. You really don't
care. Don't get me wrong. The kids were clean and, you know, clothed
and stuff like that, but that's besides the point. They need a
mother, not a drunk. Her eyes are yellow because her
liver's failing, and Victoria's been here before. She nearly died
five years ago and was told to stop drinking.
I was okay at first. I'd just have a couple and leave it, and then as
the days went to weeks, I just started drinking again. And here I
am today. Just ruined by this substance that
I pour into my body. And her mother Debbie has watched
drink slowly take over her daughter's life.
When she was about 16, she started lying, saying she hadn't had a
drink, but, you know, you could smell it on her. You could tell.
We'd start finding, like, cans of cider, bottles of vodka in her
bedroom. She'd hide them under her bed. It wasn't like a few glasses
of lager. It was like bottles of vodka, bottles and bottles of cider.
And all that vodka and cider has left Victoria very ill. The doctor
has serious concerns. He decides to take Victoria's mum away for a chat.
What Debbie hears now is every parent's nightmare. Off camera
she's told her daughter is getting I'd have expected to see
improvement by this sort of stage of her hospital stay, and
unfortunately, I've not seen the sort of progress that I'd like to.
Alcoholic liver failure is what used to kill old men. Now it also
kills young women. Paul Richardson says about two-thirds of his cases
are alcohol-related, but it is the trend that is most disturbing.
Cases of alcoholic liver disease in the under 30s have risen by half in
the last ten years. Both locally and nationally, people
who work in the field of hepatology have noticed an increase in
alcoholic liver disease - and particularly alcoholic liver
disease in a younger generation or a younger population, should I say.
We are seeing people as young as those in their 20s dying of
alcoholic liver disease, end-stage liver damage from alcohol. Now,
that was just not seen 30 years ago. So how did it come to this - with
alcoholic liver disease rising so dramatically and affecting younger
and younger people? Experts say it's down to our national addiction
- drink. It's everywhere. It's cheap, and
millions of people are drinking too much. From happy hours to
supermarket deals, alcohol is hurting the nation's health.
It's costing the health service about �2.7 billion a year, and in
fact about nine million people are affected by the harms that alcohol
causes. So it's a big problem. It's not just words and statistics.
This is what we saw one Friday night in the Royal's A&E. We're in
Liverpool, but this could be anywhere.
He's been out tonight, and he's had at least half a bottle of vodka.
He's been found sleeping on the floor, and his friends have gone
home and left him. This young lady that's just come in
was found lying in the street by police totally by herself. No-one
with her, and she's been drinking a lot tonight - said at least a
bottle of vodka. It is only 1.00am, so you never
know what's going to come in. The young in here have grown up in
a new drinking culture - a generation that's only known cheap,
readily available alcohol. What happened to you?
Have you been drinking tonight? She's been out tonight. She's had
quite a lot to drink, and she says a lot of vodka. And she's ended up
in Sefton Park and doesn't know how she's got there. Have you been out
tonight? Basically, my brother Paul had a
fall this evening after a few drinks. One too many.
Hit the wrong kerb and went over. It can look comical, but the scale
is terrifying. A quarter of the adult population drinks too much.
It was my birthday. I had about four or five pints for my birthday.
We've got the problem if we have a lot of people intoxicated by
alcohol in the cubicles, we've got nowhere then to see patients that
need to be assessed and things like that. It's very difficult to know
why our culture has changed so radically, but all the
international evidence suggests that the big drivers for the amount
people drink, the amount populations drink, are the price,
the availability and the marketing, and that's what we've been trying
to push governments to - to look at their policies.
But how much influence can politicians have on our national
drink problem? Well, our Prime Minister has strong views on cheap
alcohol and the consequences of drinking too much.
And this is the stuff that you're talking about - Frosty Jacks. That
is three litres, 5.28 pints, 7.5%. And what would that cost me?
can get that for �1.99. �1.99. You drink that lot, �1.99. You'll be
completely smashed. In opposition, the Conservatives
were clear that price was an issue. Their manifesto said: Ban off-
licences and supermarkets from selling alcohol below cost price.
Before coming to power, the Conservatives set up a Health
Commission to find a new way of dealing with public health problems.
Invited onto the panel were those who make and sell alcohol sitting
alongside health professionals. One of those invited was Simon Capewell,
a professor of public health at Liverpool University. He joined
because he thought everything was up for discussion. But he says
that's not how it really worked out. Every time effective interventions
were discussed - legislation, regulation, taxation, subsidies for
healthy options - there was a polite nod, and then we moved on to
the next item, and of course, when we got to drafting and finalising
the report, all of these - the most effective interventions - were
notable by their absence. But in power, the coalition
government clearly thought this more consensual approach was a good
idea. They called in the drinks industry and the health lobby.
So in theory, this would bring all of the interested parties together
- the drinks industry and the health lobby with the Government
listening and brokering a way forward. All sounds good.
The companies that make and market alcohol were represented, as were
the supermarkets. A number of health and pressure groups were
there too. But once again the allegation is real change was not
on the agenda. We put forward the suggestion that
the supermarkets should not stack huge mountains of alcohol in the
front of their stores. We put forward the suggestion that we
should have health warnings on alcohol adverts, that supermarkets
shouldn't advertise on the basis of price. All of these suggestions
from the health organizations were met with complete stony silence.
The health lobby also claim that the crucial issue of pricing was
off limits. Every alcohol expert in the world looking at the issue, the
World Health Organisation down, will tell you pricing and
availability are two incredibly important planks. So being told
that they were off the table was extremely worrying.
They were so concerned by what they saw and heard that in March of this
year many groups, including the British Medical Association,
decided to withdraw from the consultation process. I think it's
a tragedy. I think it's so sad because the goodwill of the health
lobby is enormous. The health lobby stopped talking to you because they
just felt you were way too close to the drinks industry. That's what
they say. They wrote to you and told you that. I'm really sad
actually that people stopped talking to us because it's never
productive. We have to talk to people that we disagree with. But
it's really important because actually when you look at public
health and alcohol is a public health issue, what we need to do is
to employ every tool in the box and everybody but everybody has got a
part to play. Now, since coming to power the
government has increased the tax on super-strength beer and has taken
the first steps towards banning drinks being sold below cost. But
the main policy document - the delayed Alcohol Strategy - is now
expected by the end of the year. So right now the government's deciding
just how far it should go to tackle The problem comes with who it
chooses to listen to. For many of those on the front line at the
Royal any solution would need to be dramatic. They see a problem that's
moved a long way from just Friday nights, even Tuesday lunch is
dominated by booze. This is really common. They say at peak times, 70%
of A&E presentations are alcohol- related in some way, whether it's
directly or indirectly. Kelly is 29. She's here with her younger brother.
They're both drunk. He's being treated for a cut. We have had a
drink and that we've had a few, two bottles of vodka and a crate of
lager, but it was my birthday, and on Saturday we just carried on.
Kelly's brother David gets back and explains the drunken game that led
to his fall. I swung around a lamppost, hit the lamppost, but
missed me foot and ended up on me chin. It was like a blood shower.
We're still going for a pint, aren't we? Let's just go and get a
pint and a packet of crisps. Overall, alcohol consumption is
absolutely fall but in our hospitals, alcohol-related
admissions continue to soar. Last area for the first time there were
more than a million. Alcoholed a mightss have doubled in a decade.
And every single case has a big ill pact on our Health Service. The
average in-patient costs �400 a day, so this unit at the Royal is an
attempt to reduce those admissions. You're still a little bit shaky.
Lynne Owens runs a team that works across the hospital with the
thousands that come here with alcohol problems.
Most people would imagine that most of your work would take place in
A&E, but in this hospital, which areas would you go to? There isn't
an area we wouldn't go to - our coronary care unit and heart
assessment unit, alcohol plays a major role in sexually transmitted
diseases, orthopaedics, lots of broken bones. Clearly,
gastroenterology wards with all the gut and liver problems, so I don't
think there's anywhere that we wouldn't go. We need some LFTs,
full blood count, clotting screen, random glucose. At least nine
million of us are still damaging We must have a look at how we
advertise and how appealing we make alcohol seem to young people. We
must look at pricing. It's absolutely crucial that we look at
how affordable alcohol is. that's the professional, what about
the drinker? Brian Collins is only 32. He's been in here for three
weeks with acute pancreatitis. He's about to go home. What were you
drinking before you came in? Up to 11 litres of strong cider a day.
day? Of 7.5 stuff. That's a huge amount of alcohol. That quantity of
alcohol is taking its toll. Your pancreas, it's a chronic condition.
You have it all the time, don't you? Alcohol sets it off, makes it
what we call an acute condition. I don't know what the pain's like but
it must be unimaginable. So all these health problems can all be
traced back to the alcohol, can't they? So what you need to think
about is how can you change things. Worst case scenario, it will kill
you if you continue this. Have you been told this before? They said if
I'd carried on I wouldn't have lived to see this Christmas. Brian
was treated by Professor Robert Sutton, another senior clinician
whose work is dominated by the impact of alcohol. In terms of
those people who have acute pancreatitis, then approximately 35
to 40% have alcohol as the principal cause; and of those
patients who have chronic pancreatitis, then 60-70% of those
patients have alcohol as the principal cause. So a very
substantial number of our patients have alcohol at the root of their
How long were you here, then? two-and-a-half months. A few weeks
after he'd been discharged, I caught up with Brian Collins. He
wanted to show us where he used to stay when he was drinking. Where
were you getting the money? I was going into town and begging. That
was like your job? Yeah, it was embarrassing and stuff like that,
it was really embarrassing in case you bumped into anyone but, the...
The illness and the problem was that bad that I couldn't do nothing
else. This is the place where I was actually staying. Here? Yeah, it
feels a bit mad now, looking at it, it looks a lot cleaner. So this is
where you stayed? Yeah. A cave. Yeah, that's where I was staying
and that. Let's have a look. So what time would you get here, then?
Just before dark or something, so I'd basically find it. I'd just get
right in at the back over there or over there and that and then if I
heard anyone coming round I'd get here. So where would you sleep?
sleep there, or over there but if I heard anyone coming round the park,
gangs, I'd get here so it was quicker to get out so you're not
trapped in, if anyone came in and I didn't have no cover or nothing.
What does it feel like being back in here now? It feels weird. I mean,
I think to myself now how bad and knowing what you've got, do you
know what I mean? And look at the state of it now. It is embarrassing,
like. Now, Brian drank strong cider - the drink that got David Cameron
so exercised before the election. �1.99. You drink that lot, �1.99.
You'll be completely smashed. Despite his shock, David Cameron
hasn't managed to increase the price of strong cider. Health
experts says that's what has to change - price and availability.
We're not trying to have alcohol banned, and we do know that
changing culture takes a long time. What we need to do is use the
levers we've got, and those are price, marketing, availability.
that could mean more legislation This is where the lines are drawn
on the battle of booze. The Government says the details of its
alcohol strategy aren't finalised, Voluntary codes can get a bad name
when people then don't follow through. So ASDA, for instance, has
said that they will take alcohol promotions out of the front of
their shops. That's a good step and we need to monitor that, so
anything voluntary must be monitored. The issue here is the
irresponsible consumption - dangerous levels of consumption -
of minority groups. That is why the industry invests millions of pounds
in campaigns to try and change their behaviour. And why, hopefully,
the conversations around this are going to deliver some change in
other areas, including the introduction of more low alcohol
But the health lobby say the Government is too quick to listen
to those who sell and produce alcohol. Panorama has found
evidence that seems to demonstrate a trend. The Government and
Partners Alcohol Working Group might sound obscure, but their job
is to advise on the coalition's alcohol strategy. There used to be
just a couple of industry representatives around the table, a
clear minority. By autumn of last year, that had changed. Of the 16-
person group, the drinks industry has one, two, three, four, five,
six, seven members. Nearly half of those who attend who are not civil
servants. I can only imagine it's because this government believes
that the drinks industry has a big role to play in shaping policy, in
setting the agenda, and so they have extended the invitations to a
larger set of people from the drinks industry. Nearly half of the
people who sit on that are from the drinks industry. That seems to show
a growing influence. I think we have a communications problem in
Whitehall, because you know something that I have never heard
of before. It's surprising she's never heard of the group. On it are
senior civil servants from the Department of Health. Those who
produce and sell alcohol certainly know about it. What you've got now
is a bigger awareness amongst many of the larger companies, that it's
important for them to be involved in these conversations, it's
important for them to be seen to implement policies that are going
to be tackling what is a very real problem. This might sound like a
Whitehall debate, but this is about saving thousands of lives and
billions of pounds - changing society's attitude to drink. Liver
disease is now England's fifth So what happens when patients leave
here? Hospital is a false environment. There's no booze in
there. Outside, well, alcohol is a legal drug. We live in a drinking
culture. There's temptation everywhere. So how do patients stay
This is Matthew. By 45 he'd drunk so much he needed a liver
transplant. They're expensive - �60,000 each. One in six liver
transplants in the UK is caused by alcohol. I was drinking maybe 15,
20 pints a day, seven days a week, which wasn't doing me any good at
all. Matthew was eventually referred to Dr Richardson at
Liverpool's Royal Hospital. When Mr Richardson literally said to me,
"Matthew, you're dying", it did sink in and I cried me eyes out,
cos I realised I've got family, you know. I've got people that I know
and I didn't want to die that early, I didn't want to die that early,
I've got to do something and the only way to do it then was to stop,
Now he's had the operation, he faces a life without alcohol.
didn't think I'd make it. I thought to myself, "No, I need a drink, I
need a drink." And everywhere you look, telly and everything, there's
drink, people are drinking on the telly, they're drinking, you know?
You're like, "Oh no, drink again, God, I want a pint." When I go on
Friday, I'll have to see him about the shakes. I've got this in my
mind, of the people I've got to really think of, is my wife, the
person who gave me the liver, especially, my wife, the doctors
who've looked after me, my family Do you want one, Ben? Yeah go ahead,
then, lad. Matthew's having to show real strength of character. Alcohol
remains all around him. Sometimes he still goes back and drinks with
his mates. He drinks an orange juice - they've not changed at all.
To see him now from what he was before. Especially with his new
teeth. I really miss having a drink. And it is hard to do it. We still
have the banter and that, you know? Yeah, as long as you're having a
laugh. All that matters, isn't it? It's a social thing, isn't it? This
is what we do, we all meet and have a laugh after a good day's work.
can't, I can't help him. Cos there's no way I'm drinking orange
juice with him. You know what I mean? But it's down to him. I don't
come out as much as I used to. I feel if I come here, I get a bit
tempted to have a drink but I've got to keep in the back of my mind
what I've gone through and that. Here's to staying off it. Good luck
to you. You'll do it. Across this city, across our country, we have a
difficult relationship with alcohol. Most of us like a drink, but a
large minority drink too much and the health service spends billions
Shall we start with ladies? Victoria? A week ago, Victoria
White's life had been on the line, but she's improved. It's really
sore, doctor. Slowly. It's quite swollen. Are you saw anywhere? My
hands might be a bit cold. I think there's been a lot of progress in
the right direction. Certainly the level of jaundice has fallen
considerably since when we last saw her, last Friday. She was very
poorly indeed and I was very concerned about her outcome. It's
been a tough week for her family. Horrendous. The thought of losing
your child. This has been the worst. That she's ever been. We tend to
have to help her when she comes out, we have to help her financially,
morally, we have to help her physically, we have to look after
her. So, as the Government tries to help a nation give up its addiction,
will it as health experts fear listen too closely to the drinks
industry? We all need to do our bit. It's very sad, if the media just
think there's a conspiracy. There's no conspiracy. We want to reduce
the harm that is caused by alcohol. For Victoria, the harm caused by
alcohol is obvious. She wants us to look at her life and learn the
lessons. Young girls, young boys, their parents, before handing over
�6, �7, �8 pocket money of a Friday night... Just for people to look at
Victoria is 35 and critically ill after a decade of heavy drinking. Forty-five-year-old Matthew was so sick from his alcohol abuse he needed a new liver. Brian, at 32, drank so much that he ended up living in a cave. Panorama uncovers the impact alcohol is having on a new and younger generation of problem drinkers, and asks whether the government is doing enough to stop us drinking ourselves to death.