THE BLOG

Early Intervention and Rehabilitation Is the Key to Preventing Alcohol Misuse, Not Minimum Pricing

21/08/2014 15:38 BST | Updated 21/10/2014 10:59 BST

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Alcoholism is a pernicious, progressive mental and physical illness which claims thousands of lives every year in the UK. Managing this epidemic has become a political priority, with various solutions proposed that largely rely on limiting the availability of alcohol, upping the price and adding cigarette style warnings to packaging.

Yet conversely, the NHS is doing comparatively little to treat and rehabilitate people with hazardous drinking habits. Recent government initiatives such as setting a minimum price for alcohol seem like a sticking plaster compared to the benefits of catching problematic drinking habits early and offering rehabilitation, counselling and care to prevent people developing severe alcoholism in the future.

As it stands, patients who go to their GP with concerns about their drinking are given a leaflet containing tips to help them cut down. The leaflet contains information about support groups including Alcoholics Anonymous, but this isn't an ideal solution for a large number of people. Their well known 12 step approach is steeped in Christian religion. Atheists and people from other religions are not barred from attending meetings, but it isn't easy to ignore the prayers and constant talk about God. As one atheist member describes it: 'God is everywhere. God is on the walls. God is in the opening prayer. God is in the book. God is in the steps. They even close the thing with the Lord's Prayer.'

Currently, AA is listed second on the NHS Alcohol Support website, right after Drinkline, a confidential phone advice service, followed by a number of charities. The next section refers to residential rehab. After stating that 'most people receive help in the community' - i.e., through groups like AA- there is an admission that residential rehab and care is useful for 'some people', followed by the crucial statement: "You may be referred to residential rehab through the NHS. It's also possible to pay to go privately."

Many people who drink heavily would greatly benefit from counselling or residential care rather than treatment in the community, where they are still surrounded by the day to day problems that cause them to drink, as well as other addicts who are still misusing alcohol. However, this is extremely hard to access unless you have severe, debilitating alcoholism. Take this account of the UK charity Addaction's own counsellors attempts to get help for herself and her service users:

"As an Addiction treatment counsellor, it is my job to provide impartial advice on treatment options available for those suffering from alcoholism and addiction problems. This means advising on both private care and NHS treatment options according to the individuals needs and financial means. I have to say that whenever a family or individual advise that they cannot afford private care treatment...my heart sinks. My own personal experience of trying to access the CORRECT treatment through the NHS services proved both frustrating and despairing."

There is no such thing as NHS rehab. There is, on occasion, the possibility of securing NHS funding to attend a rehab centre, but accessing this is extremely hard and waiting lists are very long indeed. You have little hope of receiving a referral unless you are categorised as severely alcohol dependent and in need of medically assisted detoxification. Instead, at the earlier stages the NHS uses something they describe as 'brief intervention'. It really is very brief indeed: this is what an intervention for hazardous drinking currently looks like:

"If you're drinking hazardous amounts of alcohol, it's likely you'll be referred to a short counselling session, known as a brief intervention. (This) lasts about 10-15 minutes and covers risks associated with your pattern of drinking, advice about reducing the amount you drink, alcohol support networks available to you and any emotional issues around your drinking."

And yes, in case you're wondering, one of those alcohol support networks, is - of course- the AA. In this climate, it's no wonder that people are increasingly turning to private rehabilitation centres. People who can afford to access residential rehab when they initially realise they have an issue with alcohol - before they become chemically dependent- are managing to avoid sliding to the bottom of that slope by paying for treatment. Many of these centres take a holistic approach and use a combination of counseling and alternative therapies to treat the 'whole' person and look at alcohol abuse from a variety of angles.

The US have been leading the way with holistic rehab and early intervention for some time now. Many medical insurance companies are happy to cover early treatment, with the US Government's own drug addiction site stating clearly that early intervention works best...a statement that can't currently be found on the NHS's own site.

This is something that leading UK charity Addaction are currently trying to change. In a recent Guardian article, they discuss how they're currently using their charitable funding to support early intervention approaches in some of the UK's most deprived areas. They describe it as a cost effective approach, as the additional funding spent on treating people early on saves the NHS and other government services money down the line. However, cuts to their funding and local authority addiction services mean that their ability to do this is being vastly reduced. It's the classic example of robbing Peter to pay Paul.

We can't solve the current epidemic with a few leaflets, some 'reduce your drinking' tips and referrals to the AA. If that's all we're willing to do for people who are drinking hazardous levels of alcohol then things are going to get progressively worse- minimum alcohol pricing or no minimum alcohol pricing. We need government funded early intervention and rehab, and we need it now.