Taking away benefits

The government are considering taking benefits away from people with drug and alcohol problems, and those with obesity, unless they go into treament. Full story here http://www.bbc.co.uk/news/uk-31464897  This blog is much longer than I usually would post, but bear with me, there’s a lot of reasons why this idea is a nonsense.

1. We know that genes, environment and social factors all contribute to whether a person drinks too much/takes drugs/can’t control their weight.  In other words, some people are more vulnerable than others.  I recently looked at a sample of women who drink too much coming before the family courts.  71% had a history of psychiatric problems, inclding 58% who had attempted suicide.  23% of them had been in local authority care when they were children.  87% had experienced domestic violence.  And we think the solution for these women would be to dock their benefits?

2. We know that under austerity measures all treatment services have had funding cut by local authorities over the last 4 – 5 years.  In my role as a trustee of a charity which provides such treatment services http://blenheimcdp.org.uk/ I see how we are being asked to provide more and more for less and less.

3. So treatment services, currently undervalued and not a priority, are suddenly going to have to gear up to treat a new wave of people who CRUCIALLY do not currently want to be treated.  In addiction treatment, the common model is called the Prochaska and DiClemente Cycle of Change, and it involves working with clients to find out where they are on a cycle of motivation.  People who have been coerced into treatment do not do as well as people who have come into treatment of their own free will.  You don’t have to be a rocket scientist (or an addiction scientist) to work out why. And for women with children going into treatment can be an extremely unattractive option – who is going to look after your children when you’re in treatment? Will they go into care?  Will you lose them through the courts while you’re trying to address your problems in a system which is underfunded, without the resources to treat you properly?

4. Addiction is often described as chronic and relapsing.  Chronic means long-term – this is not something people get for a few weeks, then go into treatment to get fixed, then come out again and all is fine.  Relapsing refers to the fact that even after years of non-use of alcohol or drugs, people may slip back into addiction.  Recent high profile cases include Phillip Seymour Hoffman, and Robin Williams who checked himself into treatment not because he was drinking again after years of not doing so, but because he was terrified that he would.  It’s a myth that treatment works well for everybody.  I see people in services who are back for the seventeenth, eighteenth time.  The inspiring thing about these people is their resilience.  It takes guts to keep picking yourself up and keep coming back, desperately hoping that this time you’ll be able to make it.

4. Governments very rarely take action to address any of these issues from prevention, yet there are some things we know would be effective in driving down rates of addiction and obesity in the population as a whole.  These include measures affecting price and supply such as minimum unit pricing for alcohol and a sugar tax.  WE HAVE ENOUGH EVIDENCE NOW TO KNOW THAT THESE WORK.  In countries where they have been introduced, related problems have dropped, droppped, dropped.

5. And if goverments can’t do the easy things, listed above, then how bad are they when it comes to other prevention measures?  Think back to my first point, and although it’s crude, let’s characterise a woman from my recent study who was drinking excessively:  in care as a child, mental health problems, having experienced domestic violence.  We’re rubbish at tacking social problems such as these – look at Rotherham as just one example.   So, we punish those we’ve let down by taking away the safety net we promise to provide for those who are in trouble?

It might take a generation to see results, but if we start looking at causes, and putting our energy into that; plus if we gear up treatment services; rather than taking little bits of money away from people we have by and large failed, who knows?  We might actually start doing the right things.

“The stigma of addiction is a pernicious and inhumane phenomenon”

Not my words, but the words of a North East policeman, Mike Barton, Chief Constable of Durham Constabulary.  It’s good to see a policeman arguing for changes in how we deal with drug addiction from three angles:  money, health and humanity. Read his full blog for Huffington Post here.  Mike Barton’s Huffington Post blog

Meanwhile in London, we are reminded of the phrase “good cop, bad cop” by a tweet from Ray Hodgson at Alcohol Research UK


Alcohol and the armed forces

More research coming out of King’s today on high prevalence of alcohol problems in the armed forces.  The BBC have summarised it here Armed forces alcohol abuse strategy criticised

This follows the excellent BBC 2013 Panorama documentary Broken by Battle, examining high rates of suicide in those who leave the armed force.  It’s no longer available on iplayer, but iwas widely reported at the time, and is summarised here ” UK soldier and veteran suicides “outstrip Afghan deaths”

The link?  Alcohol is strongly linked to suicide, and strongly linked to mental health.  Suicide is also strongly linked to mental health.

We understand these links exist.  So why can’t we get it together to support those in the armed forces, both whilst in service and after they leave?

Times article on “tied” pubs: Freudian slip?

A Times article today reports that the Commons vote on an amendment to the Small Business, Enterprise and Employment Bill (removing the right for big companies to charge their pub tenants inflated prices for beer)  “could help to revive the pub trade. Cheers to that……   Cutting the beer tie would slowly bring back market forces to a sector that is sclerotic and skewed, and bring hope to others snared in the coils of oligopoly.” Times article (warning includes Murdoch’s paywall!)

The word sclerotic is more commonly used to describe livers ravaged by alcohol.  Does the journalist who wrote the leader have a dark sense of humour?

Not just a young person’s problem

Yesterday the media gave some coverage to a new report by Public Health England detailing the numbers of people in alcohol treatment.  In particular they picked up on the fact that increasing numbers of women over 60 are in treatment than were five years ago, compared with women under 29 where less are in treatment.  The same also holds true for men, but with slightly smaller fluctuations.

If you read my blog regularly you’ll know I get fed up with media stories about young people binge drinking.  That’s not to say there aren’t alcohol problems in young people, because there are.  However, there are problems in older people too, and these are rarely reported, which is why it was good to see so much interest in the figures.  I did seven media interviews yesterday alone on this topic, which gives some indication of the prominence it received, although most of these were in the morning/early afternoon, and by the evening, the story had dropped off the headlines and the websites.  However, something does remain:  for a taster, only a couple of minutes long, listen here to my interview with Sarah Montague on Radio 4’s Today

Drinking and pregnancy back in the news

Today the Court of Appeal will hear whether a child with Foetal Alcohol Syndrome whose mother drank while she was pregnant with her is entitled to criminal injuries compensation. the full story is here in the Independent

The label Foetal Alcohol Syndrome covers a range of deficits which have been linked to the toxic effects of alcohol when it crosses from the mother’s bloodstream into the foetus via the placenta during pregnancy.  These deficits can include learning and behavioural difficulties, congnitive deficits, and a particular set of facial features.  More here  National Organisation for Foetal Alcohol Syndrome UK

Sky News have been covering this story this morning, and it was good to see that both of their interviewees, one an adoptive mother of a child with Foetal Alcohol Syndrome, and one a doctor with a special interest in Foetal Alcohol Syndrome, both saw absolutely no merit in prosecuting women who drink while pregnant. Dr Mary Mather, Medical Director for Parents for Children said (and I paraphrase) Criminalising women is not going to help…..  no woman intentionally harms their baby.  Rather than dragging women through the courts we should spend the money on preventing this disability.

I blogged about alcohol and pregnancy earlier this year, and pointed out the inconsistent advice we give pregnant women in the UK:  Being pregnant is hard enough now this. NICE guidelines basically say don’t drink during pregnancy, but if you do, just drink a little bit, and only a few times a week.  The words fence and sitting come to mind.

Drinking, holidays, and travel insurance

The Financial Ombudsman has just found in favour of someone whose insurance company refused to pay out for a claim on travel insurance on the grounds that the policy holder had been drinking.  http://www.bbc.co.uk/news/business-29325740

As a society we have made a decision that alcohol is legal.  As a society, we also know that some people are more vulnerable to getting into problems with alcohol than others, and that the reasons for this include a person’s biology, their psychology, their life experiences, and their situtation at any given time. If we continue to sanction alcohol, then we also have a duty to pick up the pieces when it goes wrong for some people, and for the insurance companies not to play their part is simply hypocritical.  I wonder how many board members on alcohol companies also have interests in insurance companies, and vice versa.


Learning more about alcohol in Scotland

I’m in Edinburgh on a course organised by the UK Centre for Tobacco and Alcohol Studies UKCTAS where the subject under discussion is Alcohol Policy in Practice. There are two areas where I’m learning loads – the course itself is filling in gaps about alcohol policy for me; but also post referendum, the other delegates have already opened my eyes to aspects of Scottish independence debate I hadn’t even considered.

So, here are some images which capture both:  First a list of companies the 45% campaign is urging fellow Scots to boycott.

Boycotted companies Scotland


And second, a reminder of the importance of the alcohol industry in Scotland: an instantly recognisable association.

Glass of scotch whiskey and ice

Never read the reviews

I recently did another Radio 4 documentary, Painful Medicine, about being addicted to painkillers.  You can find it here Radio 4: Painful Medicine

There were some reviews, and they certainly covered the spectrum.  Whilst Catherine Nixey at The Times was good enough to pick the programme as a Radio Choice, her review opened as follows:

It’s not the most exciting programme opening I’ve ever heard. “I’m outside a pharmacitst in London” says presenter and scientist Dr Sally Marlow, “and I’m just going to pop in and buy a codeine-based painkiller.” I won’t ruin the suspense of whether she gets any.

I will admit to laughing.  She did then go on to be quite kind about the programme.

Meanwhile Priya Elan at the Guardian wrote a fabulous review saying the only thing wrong with the programme is that it wasn’t a series.  And as this is my blog, I’m posting that one up here Guardian review of Painful Medicine