The politics of drinking
             July 12, 2010

Alcohol Concern: a dependency on problem inflation

There is a serious lack of help out there for alcoholics, highlighted by figures that show there are twice as many problem drug users in treatment as problem drinkers, a situation that’s not likely to improve as we enter an era of cuts, NHS ring-fencing notwithstanding.

Rising unemployment is already putting greater pressure on alcohol services. Yet Cardiff Council’s Community Drug & Alcohol Team had its request for an extra £120,000 to fund more frontline staff turned down.

A report last week from Alcohol Concern called for greater investment in alcohol services. It claimed that alcohol dependency in England has soared by 24%, and that 1.6 million people are moderately or severely dependent on alcohol, costing society up to £3.7bn.

I agree we need better alcohol services, but hang on a minute, 1.6 million people alcohol dependent? That sounds a lot.

At first I thought the devil was in the definition of ‘dependent’. Alcohol dependency is by no means a straightforward concept and it’s not universally accepted as valid. Surprisingly, it’s a relatively new idea. Griffith Edwards put it forward in 1976 as alternative to the disease model of alcoholism.

In Griffiths’ model dependence is a continuum. You can be mildly dependent through to severely dependent, and Griffiths asserts on that basis that anyone can become dependent, and that’s one of the notions underlying whole population approaches to alcohol policy.

Alcohol Concern does not bother to explain what it means by alcohol dependency but refers us to a 2007 survey carried out by the University of Leicester and sponsored by the NHS.

People were interviewed using a standard questionnaire for this sort of thing that asked people already identified as heavy drinkers about certain symptoms such as shaking, sweating and craving a drink the morning after as well as how much they drink, producing a total score.

It’s actually quite robust, although on this basis most heavy drinkers, over time, will drift between different degrees of dependency. It’s hard to see how it’s a fixed state.

Alcohol Concern plays it safe by talking about only moderate and severely dependent drinkers. So how many of them are there? It’s 0.4%. I’m no mathetician, and I’m not going to work it out, but there’s no way 0.4% of the adult population comes to 1.6 million.

And there’s something else. Alcohol dependency has fallen, not risen, between 2000, when the previous survey was carried out, and 2007. I haven’t read it wrong. Alcohol Policy UK’s interpretation agrees with me.

What on earth is Alcohol Concern up to? I’ll be with them on the barricades in the struggle for better alcohol services (and it might well come to that), but this kind of sensationalising is counter-productive. Boys and wolves spring to mind.

Alcohol Concern must be worried that if it wavers for a moment from its tales of horror it’s going to lose the argument.

It’s a clear case of problem inflation dependency.

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