A while ago there was an article here regarding aspects of alcohol dependency which I did not entirely agree with. The article appeared shortly after I joined the party and began authoring for the Daily, so I’ve delayed commenting but I feel a response is needed because for onlookers and commentators ignorance and dogma surround the subject so a real understanding of why people continue to behave in a way that is damaging to their lives remains poorly understood. This is the main reason we have very little success in permanently changing alcohol related behaviour on a personal and societal basis.

Statistics are only a part of the story. There are lots of alcohol-related hospital admissions and deaths for which the principle cause is excess alcohol consumption, but just knowing the consequences doesn’t add anything to our understanding of the reasons why people behave this way or how to help them modify their behaviour.

The article said:

I want to draw your attention to alcohol dependency element, as when someone becomes physically dependent on alcohol they cease to function normally, often losing their jobs and becoming a burden on both their families and on society as a whole.

This is manifestly untrue. Most people with even a severe dependency on alcohol can function perfectly well most of the time. Winston Churchill might be an example or perhaps Dylan Thomas, but closer to home many will know someone with an engrained, excessive and consistent drinking habit who, for most of the time, will show little sign of excessive alcohol consumption.

The article also introduced the concept of physical dependency with no real understanding of what that might mean. Principally, the need to excessively use alcohol is much more an emotional dependency than a physical one and the overwhelming majority of dependent adults fit this scenario.

People who consistently drink more alcohol than they should may see themselves on a spectrum of dependency and consumption. Some will be more dependent than others and generally the degree of dependency and consumption will go hand in hand but that is not always the case. At very extreme and consistent consumption levels the body adapts the way it processes alcohol and when that level of intake lessens it then has to go through the reverse process which can be painful and life threatening, but also can be managed with medication. There are, of course those who are helpless and manifestly disabled because of their consumption patterns but that is not because of a ‘physical dependency’ but rather the other way round.

The article continued:

I have known alcoholics and there are two types: active and dormant. Once someone has become an alcoholic, they are always an alcoholic.

This whole paragraph is simply a regurgitation of well worn and wholly inaccurate dogma and seemingly lifted straight out of the AA ‘bible’. The AA is an association that, whilst being earnest, honourable and well intentioned, is spectacularly unsuccessful in promoting long term behavioural change for most and completely unsuccessful in actually resolving the issue for anyone.

It’s no real surprise though because the AA and other 12 step adherents do not address the cause and follow a 100 year old dogma that has never really been tested for validity. What they can do very well is halt a spiral of destruction with help and support but it’s a sticking plaster not a suture so long term healing is unlikely. Having said that though, those who sustain their abstinence can recover their lives but the fear and threat of relapse is always present.

The article continues in this vein slavishly following ideas and concepts that don’t work. It adds nothing to the debate to recycle this stuff as if it were the absolute truth.

As for the concept of alcohol dependency being a disease this also misunderstands the nature of the beast. In what sense can it be a disease? It isn’t bacterial or viral, there is no external (or internal) physical malfunction causing it but such a diagnosis does underpin continued dependency and a belief that ‘it’s not my fault’. Classifying behaviour as an unavoidable illness is a clear recipe for engendering helplessness as well as rationalising dependency in the patient.

However, people with dependency issues do need help but have very little chance of getting any that might be useful from the current helping structures. All the while we are content to shovel money to the vested interests to follow a path that fails most, it is hard to see much improvement for the future. We must not forget that even helping organisations have a need to survive and will oppose anything that threatens their sustainability. Vested interests are alive, well and very active in the alcohol-helping industry so no one will alter an approach that takes so much taxpayers’ cash.

I’ll finish by injecting a touch of realism into the oft-levelled argument of cost to the NHS caused by lifestyle behaviours such as heavy drinking. A much better argument for individuals is to do with life quality and not premature treatment costs. After all we are all going to die but we don’t have to suffer such self inflicted illness for years and years before then.

Were these people to be ‘cured’ from whatever induced physical ailment presents, overcome their dependency (as opposed to returning for ever more costly treatment) then go on to live a full and healthy life, one might well consider that those ongoing medical costs have simply been deferred to the geriatric wing where, in all likelihood, they will be significantly greater. The same deferred support costs apply even to those with acceptable lifestyle behaviours.

However, the NHS is a reactive organisation and by the time the organ damaged patient arrives for surgery or medical treatment it is often too late (as the statistics will attest). Thousands will die early and do not, in fact, experience the utopia and post treatment longevity described above.

A harsh but perhaps true observation might be that those who volunteer their lives early are, in fact, saving money for the state over the longer term as opposed to squandering it.

 

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