Alcohol treatment

While anyone can experience harms caused by alcohol, problems are particularly acute among the heaviest drinkers. Just 4% of all drinkers consume around a third of all the alcohol in the UK, and it is estimated around 600,000 adults in England alone need treatment for dependence. People can find themselves struggling with their drinking for a whole variety of reasons and the consequences can be devastating. This is why they need support to turn their lives around.

Alcohol treatment varies from emergency interventions, such as detox programmes to deal with withdrawal, to psychiatric support using methods such as cognitive behavioural therapy. It can include the use of prescribed medications, group-based therapy, residential rehabilitation – and often a combination of all these. There are private treatment facilities, and also free, mutual support fellowships. The most famous of these is Alcoholics Anonymous, but there are other similar groups such as SMART Recovery. Community-based alcohol treatment services play a critical role in this landscape. Community services are funded by local authorities, but often delivered by charities, and they provide a range of treatment options for people in need of support.

Without community treatment services, help would only be available to either those for whom fellowships are effective, or those who can afford to go private. This is why they are so important. Without adequate services enormous numbers of people would be left to fend for themselves in the face of difficulties than can seem insurmountable. Community services can also provide support for families affected by dependent drinking. Research shows that family support, where available, can be essential in making change possible – and families also need help themselves in coping with the difficulties they may face.

Despite this, the vast majority of dependent drinkers are not receiving structured support. Public Health England estimates that less than 20% are currently accessing treatment. Furthermore, this number has fallen sharply in the last few years. Between 2013 and 2018, the number of new people entering treatment for alcohol fell by 19%.

Our 2018 report on alcohol treatment services documented the enormous challenges being faced by treatment providers at the moment. Many areas have seen huge cuts to their budgets and are now working at minimal capacity. Most areas have also merged their alcohol and drug treatment services. This can have benefits in terms of reducing costs, but can also lead to a loss of alcohol expertise as well as creating environments in which people seeking help for alcohol don’t feel at home.

To help address these issues, we have recently called for the Government to introduce a ‘treatment levy’: a 1% increase in alcohol duties to be spent on supporting treatment services. This would add around £100 million to national budgets, and allow services to not only tackle the huge levels of unmet need, but also extend the use of approaches such as ‘assertive outreach’ which can help support drinkers with some of the most complex problems. This is a key ask in the Alcohol Charter, supported by over 30 organisations and cross-party parliamentarians.

Treatment services make an essential contribution to reducing alcohol harms to individuals, families and communities. That is why supporting services, and seeking to ensure they can reach as many people as possible, is one of our core priorities.

• Drug and Alcohol Findings ‘Hot Topics’ – a unique collection of summaries and commentaries on research into alcohol treatment
  
• National Institute for Health and Care Excellence. Guidelines on alcohol use disorders: assessment and management of harmful drinking and alcohol dependence – the key guide for practitioners on alcohol dependence and treatment