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Turning a blind eye to alcohol addiction

4 December 2006 1,090 views No Comment

A HARD-HITTING American study from the Rand Corporation – hardly a soft and fuzzy organisation – found that every dollar spent on treating drug and alcohol addiction saved seven dollars in law enforcement. But this research has had little impact on policy directions in any country, let alone the US. Treatment services remain under-funded while police and corrective services still get the big dollars. This does little more than service the status quo.

Meanwhile more recent research, the internationally acclaimed Australian Treatment Outcomes Study, which was completed in the past three years, has shown what can be effectively done in the field of public health and addiction. Co-ordinated by the National Drug and Alcohol Research Centre of the University of NSW, it is a multi-centred evaluation of all available forms of treatment conducted at different sites across Australia.It includes pharmacotherapy, detoxification and residential rehabilitation programs. All these methods had successful results for those patients who continued in treatment. Crime and chaotic drug use fell, while social, physical and mental health outcomes improved. In other words, when people receive treatment they can overcome addiction, but it is horses for courses as not one treatment suits everyone.

But the important point is that treatments work, for both legal and illegal drugs. In fact, more than half of those in treatment have alcohol as their primary problem; a fact that politicians also appear to be loath to address. They want to be seen as the victors over heroin, pot and, more recently, ice (crystal methamphetamine hydrochloride), rather than succeeding with addiction to alcohol which is endemic.

Why is alcohol treatment so marginalised? Junior hospital and emergency department doctors often throw up their arms and admit defeat when presented with a person affected by alcohol. To many medics, these are hopeless cases. And the senior doctors often don’t help because they often regard treatment of problems associated with alcohol addiction as relatively unimportant; put another way, it’s not real medicine.

Yet, with diabetes and coronary heart disease, doctors are proud of what they can do. Everyone with these conditions expects that their doctor will be able to treat them, that they will get good and effective treatment and hopefully get better. But treating alcohol disorders is different due to the social stigma. This is a shame because alcohol treatment is badly needed and as Ian Webster, chairman of the Alcohol Education and Rehabilitation Foundation points out, the treatment of alcohol dependence actually works.

“Alcohol treatment is just as effective as treatment for the chronic medical conditions which are the core business of the health system,” Webster says. “If you take the yardstick of function and quality of life, the effectiveness of treating alcohol dependence is equal to, if not better than, the outcomes for the treatment of diabetes, asthma and hypertension.”

Alcohol is not only a pressing immediate problem but a huge future problem. Never before have young women been exposed to such high levels of alcohol consumption. In teenage years the heavy drinking of young males has been turned upside down by binge drinking in girls. These patterns are being reflected in the juvenile justice and adolescent drug and alcohol rehabilitation centres in which the rates of binge drinking in teenage girls is as much as 50 per cent higher than in boys. What does this mean for the future of young women – their development, careers and health and for the children they will bear?

The federal Government, along with the NSW Police Commissioner, says that the drug ice is the present scourge of our society. In response, the NSW Government is to establish five ice treatment centres. These are knee-jerk responses to the depiction in the media of violent episodes in emergency departments and police cells.

Despite highly publicised claims of a connection between ice and armed hold-ups in urban areas, the NSW Crime and Justice Bulletin has recently concluded that “there is currently insufficient empirical evidence data to estimate whether, or to what extent, methamphetamine use has increased assaults in NSW”. Yet this report and a number of other Australian studies also clearly demonstrate the very strong links between alcohol misuse and all kinds of violence.

What a paradox. Treatment for alcohol addiction works but is poorly funded; while the treatment outcome for amphetamine use is uncertain but will be strongly funded. Alcohol is again relegated to be the Cinderella of public policy yet it continues to be our most harmful drug. How do you explain that?

The present situation in Australia is nothing less than a scandal and politicians, the liquor industry, the advertising industry and others profit from a legal drug which has a devastating effect on our society but is so often ignored because of incorrect assumptions about those who suffer from this most common of all drug addictions.