Alcohol has overtaken drug misuse as a direct cause of death in Scotland, according to the latest annual statistics.
The report from the National Records of Scotland (NRS) reveals that there were 1,276 alcohol-specific deaths in 2022, up by 31 on the previous year.
At the same time, the number of fatal overdose cases fell from 1,330 in in 2021 to 1,051 last year.
The number of people dying as a result of alcohol in Scotland is now the highest since 2008, with males continuing to account for around two thirds of the deaths.
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People living in the most deprived communities are also more than four times as likely than the most affluent to die as a consequence of their drinking, although this gap is narrowing.
In 2002, the difference was nearly nine-fold, but mortality rates have declined since then in the poorest areas while staying almost static in wealthier parts of the country.
Daniel Burns, Head of Vital Events Statistics at NRS, said: “Looking at the long term trend the number of deaths from alcohol-specific causes fell between 2006 and 2012 but has risen since and is now about the same as 2010 levels.
“In 2022, the average age at death for females from an alcohol-specific cause was 58.7 years and for males it was 60 years.”
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Dr Alastair MacGilchrist, chair of SHAAP - an umbrella body of clinicians working in alcohol-related harm - said: “We are saddened to see that the number of people who lost their lives to alcohol once again increased in 2022.
"It is important to recognise that each of these 1,276 deaths represents a personal tragedy which could have been prevented.
“Scotland is facing an ongoing crisis with alcohol which requires urgent attention. We simply cannot continue to accept this level of avoidable alcohol harm as the Scottish reality."
Laura Mahon, deputy chief executive of Alcohol Focus Scotland, said: "For the third year in a row we've seen deaths caused by alcohol increasing.
"This is completely unacceptable, with each of these deaths being preventable.
"We need to be going further and faster in our efforts to reverse this appalling trend."
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Alcohol-specific deaths mostly include alcohol-related liver disease - also known as cirrhosis - but can also cover mental and behavioural disorders brought on by alcohol harm and cases of alcohol poisoning.
The NRS report comes amid pressure from doctors, charities and public health scientists to lift the threshold for minimum unit pricing (MUP) from the current 50 pence per unit to at least 65 pence, although the Scottish Government is also consulting on a possible increase to 80 pence or more.
This would mean a bottle of wine could retail for no less than £8, and a six-pack of Tennent's lager for no less than £10.
MUP is subject to a sunset clause, which means that that the law will lapse automatically after April 2024 unless MSPs vote to extend it.
Since the landmark legislation was implemented in May 2018 the age-adjusted mortality rate from alcohol in Scotland has climbed from 20.8 deaths per 100,000 to 22.9 last year.
However, an analysis published earlier this year estimated that the policy had prevented hundreds more people from dying and that without MUP Scotland's death toll would be much worse.
In July, Dr Carina Ferreira-Borges, the World Health Organisation's advisor on alcohol for the European region, said there was there was "robust evidence to support the efficacy of Scotland’s MUP alcohol policy" and encouraged other countries to follow its example.
The NRS report shows that alcohol-specific death rates, by council area, are highest in Inverclyde, Glasgow city, and the Western Isles.
By age group, mortality rates are highest among those aged 65 to 74.
Among 75 to 79-year-olds, however, the mortality rate was 39.6 per 100,000 - the highest level on record and roughly five times higher than it was in 1994.
Scotland continues to have the highest alcohol-specific death rate in the UK, although this difference has generally narrowed over the past 20 years.
Compared with England, alcohol-specific mortality in Scotland was 1.6 times higher in 2021 versus 2.9 times higher in 2001.
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Carol Mochan, Scottish Labour's public health spokeswoman, said the latest figures were a legacy of the SNP's "shameful cuts" to Drug and Alcohol Partnerships (ADPs) back in 2015, when £15 million was taken from their budgets.
She added: “The SNP’s failure on public health is costing lives and devastating the poorest communities – we urgently need a comprehensive plan to support treatment services and ensure those struggling with alcohol can get the help they need.”
Scottish Conservative shadow health secretary Dr Sandesh Gulhane MSP, accused the SNP of wedding themselves to a minimum unit pricing policy which "simply isn't working".
"It is increasingly proving to be a blunt instrument to tackle a complex problem," he added.
Drugs minister Elena Whitham said the Scottish Government is making £113 million available to ADPs this year to ensure that "local services can respond to local needs".
She added: "We are also working to ensure that people continue to receive the same quality of care as those with problematic drug use."
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