HIQA publishes two reports to help inform an update to Ireland’s low-risk alcohol guidelines

Date of publication:

HIQA has today published two reports to support an update to Ireland’s low-risk alcohol guidelines. This work was requested by the Department of Health, and will be used to inform an update to the guidelines.

The first of these reports models the risk of death and admission to hospital due to alcohol consumption, using Irish mortality, hospital admission, and alcohol consumption data to characterise the risks at different levels of alcohol consumption. Between 2022 and 2024 in Ireland, alcohol was estimated to account for an average of 1,420 deaths and 27,066 hospital admissions each year.

Since Ireland’s low-risk alcohol guidelines were last revised in 2015, new evidence and improved quantitative modelling methods have enabled more accurate estimation of the health risks associated with different levels of alcohol consumption.

The report found that the risk of death before age 75, death at any age, years of life lost, and the rate of hospital admissions all grew in line with increasing alcohol consumption. A substantial amount of risk occurred among people drinking lower levels of alcohol, indicating that Irish low-risk alcohol guidelines may need to be reconsidered to accurately highlight the risk at lower levels of alcohol consumption.

The estimated difference in risk between sexes was minimal, suggesting that there is no strong basis for sex-specific thresholds. We also found that the pattern of alcohol consumption has an impact, with more concentrated levels of drinking across fewer days of the week bringing higher risk.

The second report published today by HIQA is a systematic review of international evidence on the association between alcohol consumption and mental health. This review examined 104 international studies on the link between alcohol and the presence of or later development of mental health outcomes such as depression, anxiety, and suicidal thoughts.

Differences in how the included studies were conducted limited the ability to draw definitive conclusions. There were wide variations in the way alcohol consumption was measured and how mental health was assessed, and studies had limited follow- up. Overall, across the mental health outcomes, mixed results of an association between alcohol consumption and mental health outcomes were observed.

Commenting on the findings, HIQA’s Deputy Director of Health Technology Assessment, Michelle O’Neill, said:

“Low-risk alcohol guidelines provide information on levels of alcohol consumption associated with a lower risk of health outcomes, and on circumstances in which alcohol should be avoided. The research published today shows a clear link between increased alcohol consumption and
mortality and hospital admission rates. It also shows that the difference in risk levels between men and women are minimal. This tells us that Ireland’s low- risk guidelines may need to be reviewed to help people understand the risks associated with alcohol and make informed choices.”

Selecting specific alcohol consumption limits for the updated guidelines cannot be determined by modelling alone. Defining risk thresholds for alcohol consumption requires a judgement by guideline developers. The modelling carried out by HIQA provides a quantitative evidence base to inform that judgement.

ENDS

Notes for Editor:

  • HIQA has today published the following documents:
  • Together, these reports provide evidence to support the update of the Irish low-risk alcohol guidelines.
  • Alcohol-Attributable Mortality Risks and Hospital Admission Rates in Ireland:
    • At the request of the Department of Health, HIQA undertook a modelling study to estimate:
      • the lifetime risk of alcohol-attributable mortality, including
        premature mortality (that is, death occurring at an age of up to 75 years).
      • the lifetime risk of alcohol-attributable years of life lost.
      • the relative rate of alcohol-attributable hospital admissions.
    • Between 2022 and 2024, alcohol was estimated to account for an average of 1,420 deaths per year, representing 4.0% of all deaths
      (6.0% in males and 1.9% in females). Alcohol was also estimated to account for 27,066 hospital admissions per year.
    • Across the range of alcohol consumption examined, the lifetime risk of alcohol-attributable premature death, overall death, and years of life
      lost increased with higher average daily consumption for both males and females.
    • The analysis is restricted to health outcomes with established causal relationships, and does not include harms to others and broader social or economic impacts.
  • Association between alcohol consumption and mental health outcomes:
    • In 2018, Adelaide Health Technology Assessment published a systematic literature review on the association between alcohol consumption and mental health disorders. This was updated in 2022 by Cochrane Canada, with a specific focus on depression, anxiety and suicidal ideation. An update of this review was undertaken to build on this existing evidence base.
    • Differences in how the studies were carried out limited comparability of findings, with wide variation in how alcohol exposure was measured and how mental health outcomes were assessed. All of the evidence was deemed to be of low or very low certainty. 
    • Evidence from national surveys and registry data shows that Ireland
      has one of the highest rates of heavy episodic drinking in Europe. This is observed mainly among young adults. In Ireland harmful drinking patterns have been linked to increased depressive and anxiety symptoms.

About HIQA

The Health Information and Quality Authority (HIQA) is the independent body that promotes safety and quality in the provision of health and social care services in Ireland.

Through its regulation, standard setting and evidence to inform decision-making functions, HIQA supports health and social care services to consistently deliver excellent standards of care and the best possible health and social care outcomes for all.