Arielle Cruz
Alcohol consumption is a significant issue in Italy and France, two countries with traditionally high levels of drinking. Alcohol use disorders (AUDs) affect over 100 million people globally each year, and Italy has the highest per capita alcohol consumption among European countries. While Italy has seen a decline in alcohol consumption, particularly in wine drinking, France has experienced an increase. Both countries face challenges in addressing alcohol-related health issues, with Italy reporting a growing trend of binge drinking and France having a high overall consumption rate. The availability of treatments for AUDs varies, with Italy offering pharmacological treatments in all regions, but France approving Sodium oxybate for AUD treatment. These countries' drinking cultures and patterns differ, impacting their approaches to tackling alcohol problems.
| Characteristics | Values |
|---|---|
| Alcohol consumption in Italy and France | Italy: 7.7 litres per person; France: 10.4 litres per person |
| Alcohol consumption change between 2010 and 2020 | Italy: decrease of 23% (from 5.6 drinks per week in 2006 to 4.4 drinks per week in 2014); France: decrease of over 1.5 litres |
| Alcohol consumption in Italy compared to other countries | Italy has the highest per capita alcohol consumption among European countries; Germany (10.6 litres) had the highest consumption among the EU's "Big Four" in terms of economy and population, followed by France, Spain, and Italy |
| Alcohol-related health issues | Alcohol is recognized as a major risk factor for non-communicable diseases; Alcohol is estimated to cause 2.5 million deaths annually worldwide; Italy has seen decreases in death rates for liver disease, cirrhosis, and liver cancer |
| Alcohol use disorders (AUDs) | Italy: treatments are available, but there is reluctance from clinicians to prescribe them; France: Sodium oxybate is approved for AUD treatment |
| Alcohol consumption among adolescents | Studies in Italy found that early initiation of alcohol use is associated with an increased risk of binge drinking and alcohol dependence; the WHO estimates that weekly drinking among 11-15-year-olds in the EU ranges from 5% to 29% |
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What You'll Learn
Alcohol consumption in Italy and France is decreasing
Alcohol consumption in Italy and France is on a downward trend. While Italy had the highest per capita alcohol consumption among European countries, a study from 2015 showed that the country's per-person alcohol consumption had decreased by 23% in less than 10 years, dropping from 5.6 drinks per week in 2006 to 4.4 drinks per week in 2014. This decrease was largely due to a 31% reduction in wine consumption, as beer and spirits consumption remained unchanged.
The decline in alcohol consumption in Italy has been attributed to several factors, including the growing popularity of non-alcoholic and low-alcoholic drinks, as well as increased awareness of alcohol's negative impact on health. As a result, Italy has implemented new national policies, such as regulating alcohol sales, banning its advertising to minors, and lowering the maximum legal blood alcohol concentration (BAC) for drivers.
France has also experienced a significant decline in alcohol consumption, with a decrease of over 1.5 litres per person between 2010 and 2020. This reduction is part of a broader trend in Southern European countries, including France, Italy, and Spain, where wine is traditionally the most consumed alcoholic beverage.
The decrease in alcohol consumption in Italy and France has had positive health impacts. In Italy, for example, there has been a reduction in death rates from liver disease, cirrhosis, and liver cancer. Additionally, the overall alcohol consumption in the EU and WHO's European Region has decreased by 2.9 litres per person in the last four decades, corresponding to a 23% decrease.
While the decline in alcohol consumption in Italy and France is encouraging, both countries continue to face challenges related to alcohol abuse and dependence. Italy, in particular, struggles with a cultural shift towards risky drinking patterns, especially among the youth, including binge drinking and heavy episodic drinking.
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Alcohol use disorder medications
Alcohol consumption is a significant issue in Italy and France, with both countries recording increases in per capita alcohol consumption in recent years. Italy has the highest per capita alcohol consumption among European countries, with 7.7 litres, while France is close behind with 10.4 litres.
Alcohol use disorder (AUD) is a chronic medical problem that affects over 100 million people worldwide each year, with approximately 80 million showing an AUD. It is characterised by a strong desire to consume alcohol, difficulty controlling substance use, withdrawal symptoms, neglect of other pleasures, and continued substance use despite negative consequences. AUDs have harmful economic, social, and health-related impacts.
When it comes to treating AUDs, psychotherapy is believed to yield the best results, but pharmacological methods can also be beneficial. Currently, there is no single drug that ensures significant efficacy in the pharmacotherapy of alcohol dependence. However, medications can be used to support psychotherapy and help patients manage their cravings and withdrawal symptoms. Here are some of the medications that have been used or studied for the treatment of AUD:
- Disulfiram: This is an aversive agent that has been used for over 40 years. It aims to deter alcohol use by producing negative side effects when alcohol is consumed. However, it has significant adverse effects and compliance difficulties, and its effectiveness in increasing abstinence rates and reducing relapse and craving rates is not clearly established.
- Naltrexone: Naltrexone is an anticraving agent approved by the U.S. Food and Drug Administration (FDA) for the treatment of alcohol dependence. It reduces relapse rates and cravings and increases abstinence rates.
- Acamprosate: Acamprosate is also approved by the FDA and has been shown to reduce relapse rates and increase abstinence rates.
- Sodium oxybate: This medication is approved for AUD treatment in a few European countries, including Italy, Austria, and France. It acts as an alcohol substitute, reducing cravings and preventing alcohol withdrawal syndrome.
- Gabapentin: Gabapentin is an oral anticonvulsant that has shown potential in reducing alcohol consumption and cravings. It may be used as a second-line therapy option, but there are concerns about its abuse potential in people with substance use disorders.
- Psilocybin: Psilocybin is a substance with low toxicity and minimal side effects that is being researched for its potential in treating depressive disorders. Some studies suggest that it may facilitate behavioural changes in people with substance use disorders, leading to a reduction in heavy drinking days.
- MDMA-AT: There is preliminary evidence that MDMA-assisted therapy may be effective in treating PTSD, alcohol comorbidity, and substance use disorders.
- Nalmefene: In one study, nalmefene significantly reduced relapse to heavy drinking in outpatients with alcohol dependence when compared to a placebo group. However, it did not show a significant difference in the percentage of abstinent days or the number of drinks consumed on drinking days.
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Alcohol-related deaths
Alcohol is a major risk factor for non-communicable diseases and is responsible for 2.5 million deaths annually, representing 3.8% of total worldwide mortality. Alcohol consumption is linked to an increased risk of cancer and liver disease, and it is a particular problem among young people in Europe.
Italy has the highest per capita alcohol consumption among European countries, with a country prevalence of alcohol consumers of 60%. However, Italians are drinking less alcohol than they did a decade ago, with a 23% decrease in per-person consumption rates between 2006 and 2014. This drop is mainly due to a significant fall in wine consumption, with beer and spirits remaining unchanged. Italy's drinking culture is characterised by regular alcohol consumption, often with meals, and a high tolerance for the social outcomes of drinking. However, there is zero tolerance for public drunkenness. Despite the overall decline in alcohol consumption, Italy still struggles with alcohol problems, particularly among young people, who are engaging in binge drinking and heavy episodic drinking.
France, on the other hand, has seen a decline in alcohol consumption, with a decrease of 1.5 litres per person between 2010 and 2020. While France has a traditionally Mediterranean drinking culture similar to Italy, with wine as the most consumed alcoholic beverage, it now ranks second among the EU's "Big Four" in terms of alcohol consumption, with 10.4 litres per person.
Both Italy and France offer pharmacological treatments for Alcohol Use Disorders (AUDs), but there are challenges in terms of clinician reluctance to prescribe medications and patient adherence to treatment regimens. These countries are also implementing stricter laws and policies to regulate the sale and advertising of alcohol, as well as enforcing lower maximum legal blood alcohol concentration (BAC) levels for drivers.
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Binge drinking
Public health efforts in Italy have focused on delaying the initiation of alcohol use among adolescents. Exposure to alcohol at a young age is a known risk factor for developing alcohol dependence, and early alcohol use is associated with a higher risk of binge drinking in late secondary school. A cross-sectional study among Italian adolescents found that alcohol consumption is common among their fathers, with more than 20% drinking alcohol daily, while 35% of mothers never consumed alcoholic drinks. This suggests that parental drinking habits may influence their children's attitudes and practices towards alcohol.
To address the problem of binge drinking, Italy has implemented stricter laws regulating the sale and advertising of alcohol. These laws include banning alcohol advertising to minors and reducing the maximum legal blood alcohol concentration (BAC) for drivers to 0.05%. Additionally, the spread of non-alcoholic and low-alcoholic drink options has contributed to the decline in overall alcohol consumption. However, despite the availability of pharmacological treatments for alcohol use disorders (AUDs), there is reluctance among clinicians to prescribe them due to insufficient knowledge and limited resources.
In France, alcohol consumption has also been a concern. Between 2010 and 2020, France recorded a decline in alcohol consumption of 1.5 litres, contributing to an overall decrease in the EU. Despite this decline, France had the second-highest alcohol consumption among the EU's "Big Four" economies in terms of population, with an average consumption of 10.4 litres per person. While France has implemented policies such as taxation and restrictions on alcohol availability to limit alcohol consumption, their effectiveness has been hindered by poor implementation and limited resources.
Overall, binge drinking is a significant issue in Italy and France, particularly among young people. While both countries have taken steps to address alcohol consumption, including public health initiatives and policy changes, there is still work to be done to reduce the negative impacts of binge drinking on individuals and society.
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Alcohol consumption in adolescence
In Italy, alcohol abuse is a notable problem among young people. A 2017-2018 cross-sectional study among Italian adolescents found that early initiation of alcohol use is a predictor of impaired health status and an increased risk for alcohol dependence and abuse later in life. The study also revealed that 943 students from 13 schools in the Bari district had been exposed to alcoholic beverages during adolescence, leading to heavier drinking habits. The age of alcohol initiation was found to be a critical factor in determining alcohol dependence.
The World Health Organization (WHO) estimates that in the European Region, 5% of 11-year-olds, 12% of 13-year-olds, and 29% of 15-year-olds drink alcohol weekly across the EU. Alcohol abuse contributes to a significant number of deaths among young people, with 1 in 4 deaths among young men (aged 15-29) and 1 in 10 deaths among young women attributed to alcohol abuse.
To address the issue of alcohol consumption in adolescence, Italy has implemented stricter laws regulating the sale of alcohol and banning its advertising to minors. There is also a growing trend towards non-alcoholic or low-alcoholic drinks, and increased awareness of alcohol's detrimental health effects. However, despite these efforts, Italy still faces challenges with alcohol dependence and binge drinking, particularly among young people.
France, on the other hand, has also witnessed a decline in alcohol consumption, although it still has relatively high drinking rates compared to other southern European countries. While specific data on adolescent alcohol consumption in France is scarce, it is safe to assume that it mirrors the broader cultural drinking patterns and trends observed in the country.
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Frequently asked questions
Italy and France have traditionally been countries with high alcohol consumption. However, in the last decade, Italy has seen a 23% decrease in per-person alcohol consumption rates, mainly due to a significant fall in wine consumption. France, on the other hand, recorded a decline of over one litre in alcohol consumption between 2010 and 2020.
The decline in alcohol consumption in Italy can be attributed to various factors, including the spread of non-alcoholic or low-alcoholic drinks, growing awareness of alcohol's detrimental health effects, and stricter laws regulating the sale and advertising of alcohol.
Alcohol consumption has been a significant contributor to Italy's disease burden, with alcohol-related deaths and disabilities. Liver disease, cirrhosis, and liver cancer have been prominent health issues associated with alcohol consumption in Italy.
Italy offers pharmacological treatments for alcohol use disorders (AUDs) nationwide, including medications such as acamprosate, naltrexone, disulfiram, and sodium oxybate. France has also approved the use of sodium oxybate for AUD treatment. These treatments aim to reduce alcohol cravings and prevent alcohol withdrawal syndrome.
