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Hay G., Bauld L.
[UK] Department for Work and Pensions, 2010
Estimates the number of problem drinkers in Britain who draw the main unemployment and welfare benefits in order to assess how many claimants may need additional help for addiction and related problems before they can move into employment. Contrasts with similar figures for problem drug users.
Summary This study aimed to estimate the number of people who are accessing Department for Work and Pensions (DWP) benefits and who have a problematic relationship with alcohol. It follows a similar study, also commissioned by DWP, which estimated the number of Problem Drug Users (PDUs) who access DWP benefits. This study combines the most accurate, relevant and up-to-date data on the number of dependent drinkers with a score of 20 or more in the Alcohol Use Disorders Identification Test (AUDIT), The AUDIT is a clinical assessment tool designed to identify people who may be dependent drinkers. A diagnosis of dependence is made by a clinician following further tests. Dependent drinkers with an AUDIT score of 20+ are very likely to be experiencing physical and social problems (including, possibly, problems maintaining employment) due to their excessive alcohol consumption, or storing up such problems for themselves in the future. derived from survey data, with benefit uptake data to produce estimates for 2008.
Alcohol dependence is defined as "a cluster of behavioural, cognitive, and physiological phenomena that may develop after repeated alcohol use [typically including ...] a strong desire to consume alcohol, impaired control over its use, persistent drinking despite harmful consequences [such as liver disease or depression caused by drinking], a higher priority given to drinking than to other activities and obligations, increased alcohol tolerance, and a physical withdrawal reaction when alcohol use is discontinued".
The AUDIT 20+ group was selected for these estimates as it is believed to contain those individuals who are most likely to require treatment before they can overcome their alcohol misuse issues, and those for whom alcohol misuse is most likely to represent a barrier to employment. A separate report contains the findings from a literature review and qualitative study with problem drinkers accessing treatment, and professionals who work with them, to illuminate these individuals’ experiences of employment and the benefit system.
The Coalition Government has stated that it is committed to tackling drug and alcohol addiction, which is one of the most damaging root causes of poverty. The Government has also stated that it advocates an approach to addressing addiction that is firmly rooted in the concept of recovery and reintegration; a process through which an individual is enabled to overcome the symptoms and causes of their dependency and reintegrate back into society. DWP have responsibility for the ‘recovery and reintegration’ strand of the 2010 Drug Strategy. This strand acknowledges that recovery does not begin or end with treatment, but encompasses employment, education and skills, family support, probation and wider health services around treatment in a holistic fashion to support sustained recovery. The population estimates contained here will inform the development of this strand of the strategy by providing information on the estimated number of individuals who may need additional help for their addiction, and related problems, before they are able to move off benefits and into employment.
Estimates were derived for each of the following benefits, which are known as ‘main benefits’ throughout the report:
• Disability Living Allowance (DLA).
• Incapacity Benefit Employment and Support Allowance (ESA) was introduced in October 2008 to replace IB, IS and Severe Disablement Allowance (SDA) for new claimants. However, it is not included in these estimates as they were derived from 2007 and 2008 survey data, and so predate the introduction of ESA. (IB).
• Income Support (IS).
• Jobseeker’s Allowance (JSA).
A combined ‘main benefits’ group was constructed to estimate the number of individuals in receipt of one or more of these benefits. The number of people within the main benefits group will be smaller than the sum of those in receipt of each individual benefit as individuals can be in receipt of more than one type of benefit at the same time. Estimates for the main benefits group were also derived by gender, age group, and Government Office Region (GOR).
Alcohol (or drug) dependence does not of itself confer entitlement to disability-related benefits including IB. To qualify for these benefits, claimants have to undertake a medical assessment of incapacity which assesses the effects of their condition on their ability to carry out a number of everyday activities relevant to work. People with alcohol or drug dependence may have other diagnoses, for example mental illness, which result in their incapacity for work.
For England only in 2008, it was estimated that there were 630,000 working age individuals who were dependent drinkers with an AUDIT score of 20 or more.
Below are estimates of the number of dependent drinkers with an AUDIT score of 20+ in England who are in receipt of each of the four main DWP benefits, and one or more of those benefits.
Disability Living Allowance (DLA) 29,400
Incapacity Benefit (IB) 99,200
Income Support (IS) 93,200
Jobseeker’s Allowance (JSA) 26,500
Main benefits (one or more of above) 159,900
Approximately 160,000 individuals in receipt of one or more ‘main benefits’ are estimated to fall into the AUDIT 20+ dependent drinker group. Around 100,000 of this group are in receipt of IB, around 90,000 in receipt of IS, and just under 30,000 in receipt of DLA. Approximately 25,000 receive JSA.
It can be inferred from the findings that individuals in receipt of benefits are almost twice as likely to be AUDIT 20+ dependent drinkers as those who are not on benefits although this difference has not been tested for statistical significance. It is not surprising that AUDIT 20+ drinkers are more prevalent in the benefit population given the symptoms and behaviour surrounding dependence which may make it difficult to achieve and sustain employment. However, it should be noted that only a quarter (25%) of individuals who are AUDIT 20+ dependent drinkers are in receipt of benefits, meaning that the majority are managing to sustain employment or support themselves in other ways.
The estimated number of AUDIT 20+ dependent drinkers in receipt of the four main benefits is around 100,000 fewer than the estimated number of problem drug users (PDUs) who are in receipt of the main benefits (160,000 compared with 270,000). It appears that dependent drinkers in receipt of benefits are almost twice as likely to be on IB and DLA as PDUs in receipt of benefits, but less likely to be on JSA. The proportions claiming IS are roughly similar. However, again these differences have not been tested for significance.
It is interesting to note that whilst 80% of PDUs of working age in England are estimated to be in receipt of benefit, only a quarter (25%) of AUDIT 20+ dependent drinkers are estimated to be claiming benefit. This suggests that dependent drinkers are more able to sustain employment, or support themselves in other ways, than PDUs.
It should be remembered that the alcohol and drug using groups are not mutually exclusive. An indication of the extent of this overlap is given by 2008/09 National Drug Treatment Monitoring System (NDTMS), which shows that 16.5% of problem drug users presenting for treatment also have alcohol misuse problems.
Data from the NTA shows that, in 2008/09, around 100,000 people accessed treatment for alcohol misuse problems. It is not known what proportion of the 100,000 in structured treatment were in receipt of DWP benefits. However, we do know from the National Alcohol Treatment Monitoring System that around 75% of those individuals of working age who entered treatment for an alcohol misuse problem in 2008/9 had not undertaken any work in the month prior to entering treatment. It is therefore reasonable to assume that those who seek treatment are significantly more likely to find that their alcohol misuse represents a barrier to employment than those dependent drinkers who do not access treatment, and (based on this) are more likely to be in receipt of benefits.
We can also conclude that a substantial number of the 160,000 AUDIT 20+ dependent drinkers in receipt of one or more of the four main benefits in England are not receiving structured treatment for their alcohol problems (although they may be receiving other interventions).
This study has estimated that there are around 100,000 AUDIT 20+ dependent drinkers in receipt of IB, however only approximately 40,000 individuals cited As reported in the Local Alcohol Profiles for England: http://www.nwph.net/alcohol/lape/download.htm alcohol misuse as the main reason for claiming that benefit. This may be because many IB claimants who fall into the AUDIT 20+ group have other conditions, for example mental illness, which result in their incapacity for work.
This study has demonstrated that a substantial number of individuals who are in receipt of the main DWP benefits have a problematic relationship with alcohol.
Last revised 19 December 2010
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HOT TOPIC 2015 Promoting recovery through employment
HOT TOPIC 2016 ‘Recovery’: meaning and implications for treatment