Working with change resistant drinkers: The Blue Light Manual, first edition

1 October 2014

Researchers:

Mike Ward and Mark Holmes

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The first edition of the Blue Light Manual was developed by our predecessor organisation Alcohol Concern. It sets out some key principles and a range of advice and tools for working with clients who are not in contact with services.

Introduction

In 2011 a man was murdered by his former wife in Rochdale. For decades, he had subjected her to abuse and the homicide was the tragic result.

The subsequent inquiry into the case described the man as having a “chronic addiction to alcohol,” and went on to say that: “Appropriate referrals were made to addiction and medical services. He had a stubborn resistance to engaging with them, preferring it seems to continue his drinking unabated whilst deliberately avoiding medication. On occasions he refused permission for referrals. Services cannot be effective unless the client wants to change...”.

The perception exists that if a problem drinker does not want to change, nothing can be done to help until the person discovers some motivation. This message has been repeated many times over the years and is still heard frequently.

Sometimes from specialists themselves:

  • If the substance abuser does not wish to change or does not believe that change is possible, no treatment programme, no matter how complete or excellent, is likely to yield positive results.
  • If a client is in denial there is little we can do to help them.

Alcoholics Anonymous’s preamble states that:

  • The only requirement for membership is a desire to stop drinking.

Alcohol Concern’s Blue Light Project challenges this approach. It shows that positive strategies and alternative approaches can be used with this client group. More importantly using them will target some of the most risky, vulnerable and costly individuals in society.

Return on investment

In Lincolnshire, after five months of operation there has been a 67% reduction in police incidents relating to the targeted Blue Light clients.

In the Sandwell multi-agency group:

  • 44% of clients have successfully completed a course of treatment with community alcohol services or are currently accessing community alcohol support services with some degree of sustained engagement
  • all other individuals are subject to a range of on-going harm reduction and engagement approaches

In one year, the Sandwell multi-agency group reduced the costs of these clients by £150,000, a return on investment of 450%.

Evaluation and reports