Alcohol Abuse and Alcoholism - The Cost to Society and Family

Sue Allchurch, Director of Mimosa Recovery which specialises in alcohol rehabilitation, writes for Expert Opinions on the need for a more long-sighted treatment based approach to the issue of alcoholism. She argues that the benefits to society as well as the individual of government funding for alcohol rehab would be immense- reducing related criminality, accidents and health problems as well as improving family relationships and worker productivity. Alcoholism, which is also known as alcohol dependence syndrome, is an illness that is characterised by the following elements:

Craving - a strong need or compulsion to drink Loss of control - the frequent inability to stop drinking once started Physical dependence - the occurrence of withdrawal symptoms, such as nausea, sweating, shakiness and anxiety when alcohol use is stopped after a period of heavy drinking. These symptoms are usually relieved by drinking alcohol or by taking another sedative drug. Psychological dependence - a compulsion to drink and the inability to control the desire to drink even though a decision may have been made to stop drinking. Approximately 1 in 10 of the population is affected by this addiction. It crosses all social boundaries. The effect of this illness, not only on the individual but on families and the workplace in fact society as a whole, can be devastating. The effect of alcohol on even normal drinkers can be extreme e.g.

Loss of inhibition Changes in judgment Loss of memory Loss of co-ordination Mood swings Aggression Emotional malfunction

Changes in perception and understanding of others It is no wonder then that alcohol dependence can cause family breakdown, loss of career or jobs, drink-driving, violence, theft, public affray, anti social behaviour, health problems and injury. Alcohol related crime has become a high profile topic in recent years. Staff in the emergency services and the criminal justice system are confronted daily with these issues. Findings from the Governments Interim Analytical Report in 2003 showed that the cost to the UK is 7.3 billion per annum to fund policing, prevention services and processing individuals through the courts. Statistics on the levels of alcohol related crime are difficult to obtain. It is estimated that around 60% alcohol related violent crime is not reported. In 1999 there were an estimated 1.2 million incidents of alcohol related violent crime. In 2001/2002, 47% of all victims of violence stated that their attacker was under the influence of alcohol at the time (Flood-Page, C and Taylor J, 2003). Around 50% of people arrested for breach of the peace, 45% arrested for criminal damage and 30% of those arrested for burglary tested positive for alcohol at the time of the arrest (New English and Welsh Drug Abuse Monitoring 1999-2001, 2003). One UK study showed that 58% of those imprisoned for rape had been drinking in the 6 hours before the rape. Clearly not everyone who has experienced or created problems because of intoxication is alcohol dependent. There are many people who drink to excess either regularly or occasionally who can stop when they choose. These people may still run into trouble with the law or need medical assistance but they will not usually continue until their lives and those of their families are ruined. Alcohol dependent people, in most cases, cannot stop without professional help. The help available at the present time is not easy to access as many medical and legal professionals do not see alcoholism as an illness. Many sufferers will be treated for depression or stress by doctors or fined or sent to prison by the legal system. Very often controlled drinking programmes will be recommended, and whilst these can be

effective for some problem drinkers, for the alcohol dependent they are rarely successful. Abstinence based, residential treatment in a specialist clinic is becoming more widely recognised as a solution. This is not a cure all and requires motivation and ongoing behavioural changes from the individual. This type of treatment usually starts with the detoxification process, which is medically assisted physical withdrawal from alcohol. This process takes approximately 7 days, at the same time the psychological therapeutic process will begin. This may consist of:

Educational lectures and workshops Cognitive behavioural therapy One to one counselling - to discover underlying triggers Written assignments to facilitate and understanding of consequences Group therapy - to facilitate identification with others and challenging of behaviours The goal of this type of treatment is to achieve an abstinent lifestyle without the need or compulsion to drink alcohol. To assist an ongoing and positive recovery attendance at aftercare groups and Alcoholics Anonymous meetings will be strongly recommended. It is difficult to quantify the success rate of this type of treatment, but some research carried out in the US showed that approximately 70% of people who completed the treatment programme and regularly attended AA maintained their abstinence. This type of treatment is usually funded privately by the individual and can cost between 6,000 and 40,000 per 4 week programme and although expensive would seem to be a cost effective solution not only in reducing crime, accidents and health problems, but also on a social level by improving quality of life, family relationships, work performance and social interaction.