The politics of drinking
           October 15, 2012

Drugs, alcohol and the treatment deficit

Let’s talk about drugs. Last week the NHS produced a fascinating report on drug use and treatment in the UK, fascinating because it presents an unusually positive picture. Drug use is down, fewer are using heroin and crack, fewer are injecting. More addicts are in recovery, fewer are in treatment. Drug-related crime is down.

“Contrary to popular perception, drug addiction is rare,” opens the report. “While many people use illegal drugs, only a few will ever become addicted.” And the next paragraph goes on:

“People addicted to heroin and crack are concentrated in the poorest communities of the country. They also tend to lack the social resources many of us take for granted. They have not succeeded in education, have little work experience, lack supportive relationships and often suffer with mental illness – all these problems contribute to their slide into drug addiction and make it so much harder to overcome.”

How unlike the typical report on alcohol misuse. After half a sentence acknowledging that many people enjoy drinking unproblematically the general thrust will argue that, actually, these people ought to drink less. The underlying theory that now prevails is that if everyone cuts down on their drinking, whether or not they have a problem, alcohol-related harm will magically reduce. There will be hardly attempt to understand how people most at risk from their drinking, the addicted, got that way.

This gap between how we see those addicted to illicit drugs and ‘alcoholics’ is also reflected in treatment. According to the NHS about 200,000 people are in treatment for drug addiction. My very rough calculation suggests that this compares to only 100,000 in treatment for a drink problem.

My estimate is worked out from Alcohol Concern’s flawed 2011 report Making Alcohol a Health Priority, in which the estimates for the number dependent drinkers must be doubted..

Yet while may be an exaggeration that , as Alcohol Concern believes, dependant drinkers are 10 times less likely to get treatment than a dependant drug-user, the idea that alcohol is the poor cousin here rings true.

And can it help explain why, in a period when alcohol consumption is falling alcohol-related hospital admissions and fatalities appear to be rising?

I say ‘appear’. How we calculate alcohol-related admissions is under review and liver disease stats are confounded by other factors, notably poverty and obesity.

But my point is that if politicians are genuinely worried about the alcohol problem they should take note of our successes with illegal drugs. The new NHS report quite clearly puts it down to the fact that over the past 10 years we have systematically improved the availability and quality of treatment for addiction. It helps people get their drug use under control, and it helps them keep it under control.

This level of service is, I would imagine, in theory the same for alcohol. But because alcohol and illicit drugs are put into different categories, even by the NHS it appears, it doesn’t work out like that in practice.

The drinks industry might not like it but the sooner we accept that alcohol is a drug, the better.

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