Phil's Diary July 22, 2009

How to die of drink

I was going to write something funny but I keep thinking about the terrible story of Gary Reinbach who died of alcoholic liver cirrhosis the other day after being turned down for a transplant. At 22 he was one of the youngest ever to die this way.

Apparently he started drinking at 11 when his parents split up, and drank heavily from age 13. It takes cirrhosis 10 years on average to kill you so the arithmetic works out.

The papers, of course, called him a binge-drinker, allying him with the other young people who party in the high streets on Friday and Saturday nights. But if he drank to ease the pain of a broken family that's self-medication for depression, not youthful high spirits.

The big question for me is not whether alcoholics should get liver transplants (the subject, disgustingly, of a Daily Mail reader poll today), nor whether we have enough people donating livers (though, obviously, we don't, but why wasn't Gary Reinbach helped before he got to this stage?

He was, it seems, planning to go to Alcoholics Anonymous but was already too ill. But why AA? When AA works it does it, to put it crudely, by substituting a dependence on alcohol with a dependence on AA. Or rather the community of people that makes up an AA group who are bound together not just by a common plight but by a set of quasi (and not so quasi)-religious rituals rooted in right-wing evangelical protestantism. I'm not sure that's going to be terrifically attractive to a teenage boy, and indeed I have a figure here (it's a bit old but I bet it hasn't gone up much) of less than two per cent of AA members being under 25.

There are alternatives. Many are based on the AA 12-step programme anyway, some charge large fees and most are for a limited term (the great advantage of AA is that it's always there for you). What was on offer to Gary Reinbach? I suspect that by the time he went for help his liver was already shot. And if you want to be convinced someone's going to give up the booze before you let them live you've surely got to help them get to the root of their problems, in this case the way he failed to deal with his parents' break-up and no doubt lots of other rubbish picked up along the way.

This may not even require the total abstention from alcohol demanded by AA. It probably does, it's true. But did anyone ever sit down with Gary and go through the options? Or did they just tell him to go to AA?

And there's another problem (bear with me while I get it off me chest). There's a stigma attached to admitting you've a drink problem, especially if you're a young bloke. A stigma that probably stopped Gary Reinbach getting help when it could have been a lot easier. So why are we stigmatising drink like mad at the moment?

Release, the drugs (illegal drugs that is) agency, recently launched an ad campaign around the slogan “Nice People Take Drugs”. The laudable idea is to destigmatise drugs so that people come forward for help sooner. But it was too controversial for one London bus company and they pulled it.

Now, as a test of where we're at with alcohol, what would the reaction be to an undoubtedly true slogan that says “Nice People Get Drunk”?

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