Alcohol: Problem drinkers getting help down 40 per cent

Researchers commissioned by Shaap interviewed 20 alcohol-frequent attenders (AFAs) – people who had been admitted to hospital for alcohol-related issues 10 times in the previous year or three times in the previous three months – at the Royal Alexandra Hospital in Paisley, Renfrewshire.

The study, carried out by the University of the West of Scotland, found that all participants had previously been treated for alcohol dependence.

A majority (13 of the 20 participants) had experienced trauma including sexual abuse, losing a baby late in pregnancy, or life upheavals such as losing their home and livelihood.

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Dr Mathis Heydtmann, a liver specialist who previously worked at the Royal Alexandra Hospital and is one of the authors of the report, said AFAs "represent a population of long-term, harmful and dependent drinkers, who present with wide-ranging and complex needs, sometimes in crisis".

He added: “Their impact on both emergency departments and hospital admissions is very significant.

“Throughout my medical career, I have witnessed this first-hand.

“A unique service dedicated to helping people with alcohol problems who repeatedly arrive at the hospital entrance would help to prevent further admissions, would reduce the strain on the NHS and would save lives.”

The number of alcohol-specific deaths in Scotland in 2021 was the highest since 2008 (Image: National Records Scotland)

Dr Alastair MacGilchrist, the chair of Shaap, said: “This study makes clear that it is essential that people who are frequently attending hospital due to alcohol are identified as early as possible, and that a rapidly available, effective treatment service should then swing into action.

“This service should be tailored to the specific needs of this complex group, ensuring that no patient falls between the cracks of services in the future."

It comes as figures compiled by Alcohol Focus Scotland reveal that there has been a 40% drop in access to specialist alcohol treatment in Scotland over the past 10 years.

The charity's analysis found that the number of people starting alcohol treatment fell from a peak of 32,556 in 2013/14 to 19,617 in 2021/22.

This is based on data drawn from Public Health Scotland and published by the Scottish Government in response to a Parliamentary question by Scottish Conservative MSP, Miles Briggs.

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The decline pre-dates the pandemic and coincided with a period when funding for Alcohol and Drugs Partnerships - which oversee local alcohol services - was cut by 20%, from £69.2 to £53.8 million.

Laura Mahon, deputy chief executive of Alcohol Focus Scotland, said the figures were "shocking and deeply concerning", adding: "The Scottish Government urgently needs to invest in alcohol treatment – as they have in drug services – and to monitor provision to ensure these vital services are maintained.”

It comes amid a Scottish Goverment consultation on potentially raising the minimum unit price for alcohol from 50 pence to between 60 to 80 pence.

The policy is estimated to have prevented hundreds of deaths from alcohol since it was introduced in May 2018, yet there were still 1,245 deaths directly caused by alcohol in 2021 - the highest number since 2008.

Dr Seonaid Anderson, vice-chair of the addictions faculty at the Royal College of Psychiatrists in Scotland, said people with complex mental health needs and trauma "are often the heaviest users of our services and tend to experience the most harm".

She said: “The Scottish Government should look to improve access to joined up services spanning acute hospital and community settings where several different healthcare professionals come together on a patient’s treatment plan.

"This is commonplace in England but not so much north of the border.”

Matt Lambert, CEO of the Portman Group – the alcohol social responsibility body and marketing regulator - said the Alcohol Focus Scotland figures were "incredibly concerning", adding: "We urge the Scottish Government to implement targeted interventions to reach this minority of high-risk drinkers and tackle the complexities underlying their drinking.”

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A Scottish Government spokesman said it had made £106.8 million available to Alcohol and Drugs Partnerships last year, along with a further £50.3m as part of its National Mission to reduce deaths and improve lives impacted by drugs and alcohol. 

He added: "We expect mental health and substance-use services to work together and we are working with partners on ways to improve co-ordination.

"We are also supporting a review and update to clinical guidelines for alcohol treatment which will introduce new approaches in a broad range of settings including hospitals - helping ensure anyone with problematic alcohol use receives the right treatment at the right time.

"This is in addition to wider activity to prevent and reduce alcohol-related harm - including introducing our world-leading Minimum Unit Pricing (MUP) policy in the face of significant challenge.

"Recent research estimated it has saved hundreds of lives, averted hundreds of alcohol-attributable hospital admissions each year, and is having an effect in our most deprived areas."