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Guest blog suggesting all is not well in NHS treatment of Boozeland

Posted on 30 April 2012 | 8:04am

Regular visitors know how much I will stand up for the NHS, which does a great job for so many people, and whose basic values and principles are currently under attack from the top-down re-organisation that David Cameron said would never happen.

They know too that I have an ongoing interest in the issue of alcohol abuse, and its prevalence in the UK. So though it is rare for me to criticise the NHS myself, I am happy today to give the blog over to Johnny Selves, who contacted me after my Panorama programme on alcohol a few weeks ago. Aged 44, from Hampshire, he runs his own software development consultancy.

Awareness and education are most definitely at the root of dealing with what to other countries seems to be the UK’s alcohol obsessed society. But our NHS, and the labelling in our society of addiction as self-inflicted, weak, selfish and unintelligent behaviour,is shamefully letting down those who desperately need and want help.

I had a background of habitual/social drinking going back twenty years, coupled with a temperament that has made me prone to anxiety and “relief” drinking (“self-medication”). In the autumn of last year the stress of work, personal frustrations, the annual onset of winter blues, and an adverse reaction to mis-prescribed anti-depressant medication conspired to create a perfect storm and devastating decline into near catastrophic alcohol abuse.

The initial tipping point led to a visit to A&E, where I was given general advice on cutting down and dealing with anxiety. I was discharged and sent on my way.

To me it was obvious that this was just the start. A few weeks later, my (then) GP angrily instructed me to stop drinking, go to Alcoholics Anonymous and keep taking the anti-depressant medication. This was appalling advice. I had already reached a point where simply quitting overnight on my own was not possible. AA, as wonderful an organisation as it is, is an abstinence support group. They do not offer (or claim to offer) professional help for dealing with giving up or the very real and dangerous effects of withdrawal. The anti-depressant medication coupled with alcohol was continuing to give me dreadful psychological side-effects, and the fact that I was having difficulty with them made me take them sporadically, which exacerbated matters.

Over the next few months, things got steadily worse. I would have a week, maybe two, where things appeared to be getting better. But both my physical mental state had suffered such blows that these remissions came to inevitable ends. I sought the help of more GPs, who gave a range of different advice, including gradually reducing the amount I was drinking over time and visiting a local drop-in centre, where the key-worker I was assigned barely spoke English. I was advised that as a last resort, an NHS detox facility would be able to help. When the time for this final option came, I was dismissfully told that my drinking still wasn’t really bad enough to warrant their care and that in any case they were not an A&E facility. Needless to say a few weeks later a letter did arrive, offering me an appointment a further three weeks down the line. It was now clear that the NHS would not be able to make me better. For the first time in my life, both my body and mind were starting to fail. It seemed that the only thing that would help the excruciatingly painful and intolerable feelings was alcohol.

A few days later I entered a private clinic. I knew that at last my road to recovery had begun. My illness was not complicated, not untreatable. It required medication and professional care, just like any other illness. When I left the clinic, my life was mine again. I now had the ability to finish the job that the doctors and nurses there had started. The journey was not over but at last I was back at the helm.

So as I said at the beginning, the significance of my story is twofold.

The stigma of alcohol abuse in society creates dreadful complications in dealing with what is, in no other measure, an illness. It makes it difficult for people to concede when they are ill and difficult for people to seek help in the same way that they would with other illnesses. I was lucky to have the love and support throughout of my parents. The strongest of my friends too were with me to the end. But others looked on in genuine bemused bewilderment.

But far more tragic is that possibly thousands of people, who, even after they have acknowledged that they are ill, are unable to get the treatment that they need, because, by its own admission, our beloved NHS is simply not able to provide it. In my case I fear that had I not been able to get private care, that my next encounter with the NHS may have been following a serious accident, for a liver transplant, or worse.

It is estimated that 34% of people in our prisons are severely dependent on alcohol – and without doubt a huge proportion their crimes are linked to their addiction.  How better it would be if the money spent on incarcerating them could be spent on NHS facilities and resources.

But the real cost is a human one. Broken homes, broken dreams, broken hearts.

  • All the above I have no doubt is true. However, its the tip of the iceberg. Cirrhosis of the liver led to End Stage Liver Disease for my wife last year. She was diagnosed with Cryptogenic cirrhosis 2 years before, was not instructed to give up alcohol and sent on her way from Stoke Mandeville with betablockers and diuretics on repeat prescription and no further interest was taken until she was readmitted in 2011 with 95% of her liver destroyed. It was hoped that we would get her on the transplant list but c-diff finished her off before that got off the ground and she died in September last year at the age of 51. Those who have an addiction where they do not burn off the alcohol through exercise or todays generation of bingers present a ticking timebomb that the NHS is utterly incapable of dealing with. This is going to be like heart disease was in the 70’s and cancers were in the 80’s and 90’s, a major major problem for the health service to deal with. Your friend is lucky he had private cover. Had we had that, there is the remote possibilty my wife might still be alive. As it is, we relied on the NHS and she is not. I genuinely hope that for the sake of himself and his family that he is able to recover before it costs him his life. For a family to have to watch someone they love slip away because of something like this is emotionally devestating.

  • Anon

     This is an important issue.  I am myself currently trying to access treatment to enable me to ‘stop’ drinking’.  Followed advice ‘on the NHS website’, visited Dr.s, contacted local statutory service etc.  It’s over 2 months since my first GP visit who just told me to ‘drink less’.  Sadly I am still drinking and struggling to meet my work responsibilities.  Is there an answer to this problem?  It’s certainly worth debating.

  • Olli Issakainen

    Multinationals are circling around the NHS.
    The purpose of plan A is not to restore growth – which it cannot do even in theory – but to RADICALLY RESHAPE BRITISH SOCIETY in the interest of big business.
    This comes with a devastating social cost as lower growth means more and more cuts.
    Britain´s 1,000 richest people at getting richer at £414bn. Yet the Tory-led government is cutting benefits for the sick and poor.
    Only a totally out of touch chancellor would cut the top rate tax in the age of austerity.
    Budget deficit reduction took about eight years after the 1976 IMF crisis and 1992 ERM crisis with 50% by lifting taxes.
    Yet after the biggest economic crisis since 1930s Mr Osborne tries to eliminate deficfit in just FOUR YEARS with four-fifths by spending cuts!
    About 90% of the cuts are still to come, but confidence went down a long time ago.
    Britain is facing a DEMAND problem, not a supply-side problem as the Tories and Blairites think.
    David Cameron claims that eurozone is to blame.
    But eurozone has grown faster than Britain since 2010. Exports to Europe, 15% of GDP, are up 8.1% on a year ago.
    Construction (-3.0%) is a wholly domestic issue.
    All Mr Cameron has to offer to the country at this critical moment is that “we are doing our best”. Unfortunately this is not enough.
    A PLAN FOR GROWTH is needed!
    Jonathan Freedland wrote in the Guardian that Labour must choose whether the government is useless or evil.
    Well, it is both.
    It is incompetent on NHS, schools and economy.
    It is evil because it is totally in the pockets of City bankers and has bias towards rich.
    Back in 2010 the new cabinet was worth £60m with 23 millionaires. (Jeremy Hunt, by the way, is worth £4.5m.)
    There should not be any cuts on capital investment, but Osborne has not been able to cut current spending at all.
    As Alistair Darling said, there should be spending on infrastructure.
    Balanced-budget stimulus would not increase debt.
    Osborne´s cuts are doing long-term damage.
    Tories have committed to a policy of privatisation.
    First Thatcher government privatised British Aerospace and Cable & Wireless.
    The focus was on privatising profitable entities to raise revenues to reduce public borrowing.
    Then government sold Jaguar, BT and British Gas. Policy came from Hayekian ideas.
    It was a culture war.
    British Steel, BP, Rolls Royce and water plus electricity followed.
    Market-driven measures were introduced to public sector.
    Neoliberalism continued with British Coal, National Power and British Rail.
    1997 New Labour could have chosen Will Hutton´s stakeholder model of capitalism.
    Tony Blair played with the idea for 24 hours, but then opted for neoliberalism. Thatcherism had won the day.
    Thatcherism had demolished trade unions and militant left.
    New Labour introduced PFI originally pioneered by Norman Lamont.
    Then Gordon Brown was forced to NATIONALISE falling banks. But intention was to restore banks to private ownership as soon as possible.
    And now we have Thatcherism 2.0. Tories represented global financial crisis as a case of overspending by the state!
    Royal Mail, roads, education and NHS are now for sale. Police too.
    Outsourcing will be extended to every place.
    We are all in this together – except Lakshmi Mittal (£12.7bn). 
     

  • Anonymous

    I am one of those people who are unsympathetic.  My family had many alcoholics (father and brothers) and I also worked in the Criminal Justice system where I dealt with people who were addicted to various substances. I have also volunteered in residential homes for addictions and worked for the Samaritans.  Yes, everyone deserves help but it gets very tiring offering help over many years with efforts being thrown back in ones face.

    I do not think it is the job of the NHS to offer alcoholic services such as you suggest. I have direct experience of alcoholics who have had several kidney transplants and that is for the NHS as well as other associated health problems caused by alcoholism.  Addiction is not just a health problem and in my experience the NHS is not the correct place to deal with the issue.  Drugs can be prescribed by GPs and the charitable sector does wonderful work in offering groupwork support as well as residential treatment.  I tire of people thinking the NHS can meet the demands of all groups.  I think of those people who need live saving drugs or urgent operations and somehow offering counselling to those with alcohol problems when this is provided for in the voluntary sector does not seem a priority.

    You are wrong to say that offenders with addiction problems should not be incarcerated.This is a selfish attitude as you fail to acknowledge the damage caused to the community/family by these offenders. I have often had to support parents of alcoholics who lived in constant fear of their offspring, had been robbed of their moneys and who themselves suffered poor health because of the stress.  Others need respite from alcoholics – you totally ignored this.  Further, it is a recognised part of our law that being drunk or under the influence of drugs is not a mitigating factor in terms of sentencing.  Not every alcoholic commits offences.

    I tend to think of alcoholics as being demanding, beligerent when they do not get their own way, self destructive personalities, egotistical and always very sorry for themselves. This article has done nothing to change my mind…….. 

  • Sday12

    So are you an alcoholic or not?

  • Sday123

    There is, it’s called AA. An institution Alistair commends but doesn’t attend. His will is somehow stronger than ours, the same will that kept him drinking and unable to stop. It takes people to admit they are powerless over alcohol, only then can they recover and not be a burden on th NHS.

  • MarkH

    You seem to be labeling people with alcohol problems as inherently “bad” people, or are you saying that it is the alcohol that makes them “bad”. It is understandable that your experiences have given you such a negative viewpoint, however it would seem that the author is saying that if you can arrest the alcohol problem at its earliest stages, then the subsequent health and social problems would never take place. Seeing as nobody is born an alcoholic, and at it’s most basic level alcohol dependence is a medical problem (caused by neuroreceptors in the brain) surely the NHS are best placed to deal with it ?

  • MarkH

    The AA is an institution whose aim is to help people once they have stopped. In Alistair’s documentary he says he sees a psychiatrist – which is surely a valid alternative if you have the money. Are people who become overweight and then suffer heart problems or diabetes putting a burden on the NHS ? Where do you draw the line ? If you believe recovery from alcohol or solely about willpower – then you clearly haven’t researched the subject very thoroughly.

  • Anonymous

    The NHS has a budget of over £100 billion per year. It also employs over 1 million people. The money for all this comes partly from taxes on alcohol & cigarettes. If people didn’t consume alcohol (or smoke cigarettes), then NHS funding will be affected severely. E.g. in 2009, £2.7 billion was was spent by NHS on alcohol-related A&E cases. If alcohol -related A & E cases were eliminated, that’s £2.7 billion gone. And it also means that less people employed in A&E. This will include police reduction and possibly fire service reductions as well. And what about the other knock-on effects? Pub closures all over the land. Off-licenses closing down, shrinking supermarket profits due to lack of alcohol sales. We could easily see another 3 million people unemployed.
    Are you mad?

  • Anonymous

    OI, FGS, FFS if you prefer. This is a topic on alcohol. J F C!

  • Eohara72

    Alcholism is not always straightforward, whilst not being an expert, I do agree it is an illness and someone who seeks treatment within the NHS, should be entitled to it. Having been on the receiving end of discrimination many times due to my mental health issue, anyone who followed my guest blog( june 30th 2011) maybe please to know that my CRB has come back clear! I have posted a comment under that blog and hope that my result gives encourgement to all those suffering discrimnation in one form or another.

  • Thinkingaboutdrining

    ‘Alcoholic’ is not that helpful a label in most cases outside of AA:
    http://thinkingaboutdrinking.net/2010/12/18/alcoholic-binge-or-sensible-part-1/

  • JeffSmart

    Well after his problem with alcohol, Alistair did go on to be one of the top people in government so perhaps his will power is greater than most peoples ?

  • Gilliebc

    It’s also on the subject of the NHS scooke.  Perhaps that doesn’t concern you?

  • Anonymous

    Unfortunately obesity is now just as much of an issue as alcoholism.  We already hear that diabetes is going to bankrupt the NHS if people prove incapable of leading healthier lives.  And we know (because Alastair has told us) that the country has a significant drink problem. So goodness knows what the cash-strapped and no doubt increasingly chaotic NHS is going to do in the face of all this.   

    I completely understand the desperation of the guest blogger, and it sounds as if his initial advice was hopeless (what was he doing on anti-depressants at all?).  There have always been holes in the NHS’s performance and this is clearly one.  But it isn’t going to be plugged any time soon and it would be better if support services for alcohol addiction could at least offer advice on alternatives.  

  • Dave Simons

     I think we have the NHS to combat ill health for everyone. The ideal is that everyone should be in good health, and prevention, rather than cure, is the means. I don’t think we should be encouraging ill health just to keep the NHS in the business of curing it.

  • Anonymous

    The pillock who insists on bleating about irrelevantly is Olli, the fictitious Finn, not me. Why don’t you ask him? Are you blind? It’s not the first time & it won’t be the last.

  • Clear Head

    It is a
    scandal that the NHS does not prescribe Baclofen for alcohol
    dependency. The drug has just been approved by the French
    authorities.

     

    In a recent
    study in France 80% of participants treated with Baclofen had their
    motivation to consume alcohol suppressed.

     

    This compares
    with, at best, the 25% efficacy of drugs such as Naltrexone which UK GPs
    currently prescribe.

     

    Baclofen is
    extremely safe, having been around over 50 years, and is cheap, being generic.

     

    Why haven’t
    most people heard of it? Baclofen is out of patent so there is no potential for drug
    companies to make money from it. As a result, no funding for research into, and marketing of, the drug as a treatment for alcoholism is available.

    The pharmaceutical giants are currently spending millions researching and developing many new drugs which they hope will be the ‘cure’ for alcohol dependency and will make them huge profits.

    So a drug that has been around for a long time and costs very little, compared to what drug companies can charge for new drugs in the 10-year patent window, is of huge concern to them. If Baclofen succesfully treats alcoholism it makes their new drugs redundant.

     

    Thousands of
    people like me are being forced to self-prescribe and self-medicate with the
    drug, with remarkable results.

    At the correct dose, Baclofen completely suppresses cravings to have a drink so one becomes totally indifferent to alcohol. It is truly life-changing and is a medical breakthrough.

    I am writing a blog to track my progress. After just a week or so taking Baclofen I lost the desire to drink. After many, many years of getting dunk on a daily basis. I would never have believed this possible.

     

    http://clearhead247.wordpress.com/

     

  • Ehtch

    Not making any excuses for drinking, but what I would like to point out is diet. It is worrying that some people booze with following a vegetarian diet, plus a low fat diet with or without it. Essential fatty acids are essential for keeping body organs healthy. Meat is high in choline compounds, which helps the liver keep health, even with it being battered with alcohol breaking down functions. Also, pork, for instance, is high in the thiamine B vitamin also, which tends to get reduced within the body with alcohol consumption. Eggs are high in a particular choline compond, which is one of the more efficient ones the body can use, as well as healthy fatty acids. Oily fish too is packed full of healthy fatty acids and choline too.

    But there again, if people drink with missed meals, that is the road to ruin.

  • Michele

     You need to stop seeing CRB checks as repressive Eohara, they are also intended for the protection of recovering people.

    My DiL has not had a certified illness but, as a qualified psych nurse on a forensics ward, having to look after people that have, for example, killed their children, is finding it all very affecting.

    Very few situations are simple black and white and CRB checks are essential for all concerned whether you like it or not. 

    Try to be objective and not take offence about something that is much more rounded than an accusation or a suspicion about you, it’s also to protect you from certain others (society has that duty).

    Remember the woman who cut the throats of her three infants a couple of years ago?  Some people actually have to look after such a person and not be affected by her.

  • Michele

     

    PS:  VERY glad to hear that your new check is clear.

  • Michele

     There’s a very simple solution scooke.

    So long 🙂

  • Gilliebc

    I don’t know what you’re getting so wound-up about. You don’t have to read Olli’s posts, which you clearly do not understand.  You are not alone in that, one or two others do not understand either, as yet. 

    That doesn’t mean that Olli shouldn’t continue to post in the way he does. He shouldn’t have to dumb-down to suit you and other ignoramuses. 

    Just ignore Olli’s posts scooke, all this self-inflicted angst can’t be good for you.
    You only ever visit AC’s site to write negative stuff anyway.  Have you nothing positive to say about anyone or anything?

  • Richard

    Olli is right: Round Table and Tony Blair  destroyed our world. The more he says it the more it is true! We have been shown the light.

  • John Newton

    Hi. great blog.
    I am a recovered alcoholic of some eight and a half years sobriety. I also was very disappointed in the reaction I received from doctors and hospitals and the NHS in general when I was an active alcoholic.
    There is a general dislike and a sense of, ‘well, they did it to themselves’ attitude to alcoholics within the NHS and to some extent this is justified. Nobody held us down and poured the alcohol down our necks, we did that, and acceptance that I was responsible for my own addiction was key to my recovery..

    But no alcoholic decided that this was going to be their lifestyle choice, it wasn’t planned. Alcoholism is very baffling and confusing to the sufferer and to those around them.  The alcoholic doesn’t easily acknowledge that he is one, this is part of the condition. Every time he starts to drink he is convinced that he can stop whenever he wants to, only to find that he can’t. Alcoholism is like a mugger. It creeps up behind you, beats the crap out of you, takes everything you have, and then it kills you.

    I understand the people who are unsympathetic, I really do. And I can definitely see that this is a very difficult thing for the NHS to deal with. During my many times in hospital being detoxed, there was never any attempt by staff to offer any follow up treatment by voluntary or any other agencies. It was a matter of get him out of here as quickly as possible, even though they knew that I would be back again. Most alcoholics have no idea about what to do about their situation, and in my case I would be drinking again with days, sometimes hours, of leaving hospital.

    Alcoholism is both a physical and psychological addiction. Even after the physical addiction has gone, after a period of sobriety, the alcoholic still has to contend with the psychological problems. He is convinced that he has either never been an alcoholic or has been cured. Both convictions are wrong. The desire to be normal, to be able to drink like other people is overpowering, overwhelming. It is not until he is prepared to accept that this is no longer the case, that he can never again drink alcohol, that he can begin to get well.

    Alcoholism almost killed me, and did considerable damage to both my mind and body, and perhaps more importantly, to those people who loved me. Thankfully things are much better now.

    In my case it was rehab that helped, and contact with AA and their Big Book. It took seven or eight months from my first meeting with a counselor until I arrived at rehab, and that was hard. I was still drinking up until the last minute because I could not stop.

    And this is the thing that people who have never been addicted do not understand. The alcoholic is not drinking for pleasure. There is no joy in it. They drink because they have to. There is no choice. They absolutely cannot function without it. At my worst, it took half a bottle of brandy just to get out of bed, and I was drinking two bottles of brandy every twenty four hours. I would drink until I passed out, then a while later my body would wake me because it needed more alcohol, it was starting to withdraw. Alcohol withdrawal is terrifying and can in and of itself be deadly, and alcoholics fear it greatly.

    In the end it was the NHS that paid for my rehab, and it was rehab that set me free. It is interesting to note that the vast majority of people at my rehab had been sent there by the courts as an alternative to prison. Not only is it cheaper than prison, it offers the chance that their addictions can be brought under control and they will stop offending. In prison, as we all know, there is access to all manner of drugs, so the chances of recovery are negligible.

    It cost society a few thousand pounds to send me to rehab. Since then I have been clean and sober. More importantly, I have once again become a hard working, tax paying, ‘normal’ member of society. My treatment, paid for by the NHS has paid for itself. Unfortunately the rehab I was at, along with many others has recently been closed due to lack of clients being sent to them. This is due to a belief by the powers that be that alcoholism can be better treated in the community. I doubt this, and I think it’s a false economy. I hope I’m wrong. Only time will tell. For more info an alcoholism please check out http://www.demonsinthedark.com

  • Michele

     Nope, the topic is the NHS, meaning that Olli’s post (no matter what it says if it’s as usual an economics crib sheet) must be more relevant than yours (ever are).

    You do come over like someone walking down the road thumping walls which can’t be good for your blood pressure.  Wear blinkers.

  • Sday123

    Will power keeps you drinking. Surrender frees you from it.

  • Sday123

    Will power kept him drinking. Surrender frees you, he’s still fighting.

  • Sday123

    Good luck with that!

  • Anonymous

     Awww – don’t worry about me poppet. I live a very healthy lifestyle – no alcohol, no cigarettes, no meat, no drugs (legal or illegal), no mental illness/depression…clean bill of health. The last time I saw a GP was 7 years ago for shingles. I used to get headaches. But I even solved that problem a long time ago. And I have not even registered with a GP since I moved.
    Of course, like everyone, I will pass away one day. But that’s ok. Dying is part of the deal.

  • Eohara72

    I do have a rounded approach and agree that checks are neccessary but having scrutinsed my police files and seen how they ( the police) made that judgment I do feel justifed in my complaint