FOUR years ago, Scotland became the first country in the world to introduce minimum unit pricing (MUP) for alcohol.

The landmark policy promised to “save lives and reduce hospital admissions”. Modelling by Sheffield University forecast that a 50 pence threshold would prevent 400 alcohol-related deaths and 8000 alcohol-related hospital admissions in the first five years.

HeraldScotland: Alcohol sales fell immediately after minimum pricing but have levelled offAlcohol sales fell immediately after minimum pricing but have levelled off

Initially, the signs were optimistic: alcohol sales fell by eight per cent with research finding a “sustained drop in overall units bought by some of the highest-consuming households” during the first two years.

A 10% year-on-year drop deaths between 2018 and 2019 was hailed as early evidence that that the policy was working - reversing a steady climb since 2012. Bigger drops were anticipated in the years ahead.

READ MORE: Alcohol deaths fall by 10 per cent in first year of minimum pricing

Then Covid struck. Alcohol deaths rose by 17% in 2020, and again - by 5% - in 2021.

Although liver disease - the main cause of alcohol-specific deaths - takes years to develop, many sufferers will have no symptoms until the late stage of the disease when they suddenly become critically ill.

The polarisation of drinking habits in lockdown saw consumption spiral for the heaviest problem drinkers, tipping many into a danger zone.

HeraldScotland:

And while alcohol-related hospital admissions fell by 10% between 2019/20 and 2020/21, Public Health Scotland notes that “measures put in place to respond to the pandemic are likely to have contributed to the decrease”.

READ MORE: Heaviest drinking men consumed more after minimum pricing 

The pattern in Scotland was actually exceeded by the UK overall, with the alcohol-specific death rate climbing by 18.6% between 2019 and 2020 (compared to 15.6% in Scotland) - the highest year-on-year change in two decades.

As a paper in the Lancet this February put it:”Patterns in the consumption of alcohol in the UK changed after a national lockdown was implemented in March 2020.

"The long-term consequences are still being revealed, not only with regard to sustained and higher-risk drinking habits and their subsequent effects on health, but also in the treatment of patients with alcohol-related liver disease, whose access to care and support services has been interrupted, with potentially serious ramifications.”