Health Minister, Edwin Poots has announced plans to increase the price of alcohol to combat irresponsible drinking habits. But as figures reveal almost 300 people die every year due to alcohol addiction in Northern Ireland, Natasha Millar asks whether the focus should be on treating the problem which is already here and tightening its grip on a generation….
It’s a problem we believe we are familiar with. We may know someone who has a problem with alcohol. It might be the friend who has too much shiraz at dinner, or the colleague who looks bleary eyed on a Monday. It might be office gossip or a growing concern. Yet the term alcoholic conjures up different imagery, of park benches and brown paper bags, but it is a reality for many Northern Ireland homes. The stress and problems which stem from this can tear apart marriages, families and careers. As anyone who has battled addiction will testify, little else matters but the bottle.
It comes then as little surprise that the British Medical Association announced alcohol misuse costs Northern Ireland £700m a year. The figure includes £160m in health services and a further £82m in social service costs. Justice Minister, David Ford, told the Assembly in November, that the cost to the justice system, including policing, courts and prison services was estimated to be £382million for 2010. It’s an expensive problem for the public purse. So what is being done to tackle alcohol addiction?
The Health Minister is determined to introduce legislation to raise the price per unit of alcohol following similar legislation in Scotland. No figure has been confirmed but it could be in the region of 45p per unit in a bid to limit alcohol misuse. But critics of a levy claim it contravenes free trade and the NI Retail Consortium argue that prices and promotions do not cause irresponsible drinking. But what happens when choice is no longer an option?
Sarah Davies*, 42, struggled with her husband’s addiction for 20 years. “I didn’t admit there was a problem until after my second daughter was born. I realised that he needed the drink rather than enjoyed it,” she said.
Fast forward 15 years and he had lost three jobs and missed most of his daughters’ childhood. “He would literally lose weeks on end due to his binges”.
So when the addict turns to the chronic phase, where do you turn? For Sarah it was a never ending cycle of closed doors and unanswered calls.
“I found the help and caring services I needed where strictly office hours only, but ironically the off license trades for 12 hours a day.”
GP’s and Out-Of-Hours services have strict policies on visiting patients who are drinking, due to the risk of violence. When she contacted them for help during his binges, Sarah was told on every occasion to ensure her husband was sober for at least 72 hours before he could be considered for the residential programme which he desperately required. He was asking for the help but yet she was handed a prescription for Libruim and Diazepam, and had little other support.
This ‘drying out’ period is leaving many addicts and their families in desperate circumstances. “When the body is mentally, physically and emotionally craving drink this is a mammoth task, not just for the addict but for the family around them” said Sarah.
“There were nights he would throw up blood, sometimes for days. He couldn’t keep down food or water for anything up to 36 hours when he was drying out. I had to be with him 24/7. He would violently shake thanks to the DT’s, and even hallucinate rats were running up the walls” recalls Sarah.
One evening, after he threatened to commit suicide, she tried to get her husband sectioned. “I was praying for admission, for both his physical and mental well being. He had one light beer in a 24-hour-period” said Sarah, “but once the crisis team knew this, they were unable to admit him and we were yet again sent home.”
Sarah feels that some of the agencies, such as the residential clinics and AA groups are “invaluable when the craving is over” but worries about the interim period, which in her experience, leaves the addict and the family with nowhere to turn. “The problem is the mix of physical, psychological and psychiatric symptoms” she said, “no department will treat all three”.
At present, Northern Ireland has no facilities to detox an addict. Pat McGinn, part of Friends of Cuan Mhuire addiction clinic, Newry, feels that during a ‘window of opportunity’, an alcoholic will agree to treatment and go anywhere, but if the phones are not answered or the criteria is not met, the window closes, sometimes for good. Pat says that such a system is “sending out the wrong message”. “Addiction to alcohol is poison, and it will poison everything and anybody around it” he said.
Pat, who himself battled addiction, is passionate about recovery but feels it is becoming “tougher and tougher” for people to get help. He said detoxification is essential on site. At present Cuan Mhuire only has an isolation room to help if the person has been drinking. Pat says that once the “DTs” begin, they need medical supervision. “We can only talk support not treatment”. He said voluntary centres, like Cuan Mhuire could deal with addiction if the resources where together, as this is “the only way treatment will work”.
“The mantra from ministers is that not one department should deal with this, but yet they actually work in splendid isolation” said Pat.
Poignantly, Alcohol Awareness Week and Remembrance Sunday fell only a day apart this November. While thousands in the province remembered fallen soldiers, a wall at Cuan Mhuire stood as testament to another group of men and woman. This list contains the names of over 920 people who have died due to addiction. “There is not a week goes by that we don’t add a name” said Pat.
Addiction is a lifelong illness and there is no cure only recovery. Thankfully Sarah’s husband has embarked on such a journey and will continue with outpatient programmes. However the marriage has not survived the addiction. As for the minimum price per unit, Sarah fears that for chronic drinkers, the family behind the addiction will suffer.
“If it had come down to food for the children or drink, it’s a no-brainer for an addict. I know we would have gone without electricity or food if the price of alcohol had been raised” she said.
Pat is also clear that any price increase must be part of a wider change in light of our “win or lose, we booze culture”.
Perhaps Mr Poots should consider where, if it succeeds, the extra income from the alcohol increase will go? Into the assembly coffers or reinvested into the treatment programmes and facilities that are desperately needed? The Assembly purse might be full of coppers at the minute, but perhaps the question should be asked at what level are we willing to help a drunk? If we wait until the gutter, it may be too late. The next stage is the grave, a reality some will face.
“If I had the obstacles which have now been enforced, I would be dead” said Pat. “There is no half way house between death and recovery for some”.
From christenings to birthdays, weddings to funerals we spend our life celebrating and commiserating with our favourite tipple. It is not the homeless and socially deprived who suffer with the illness but the mothers, fathers, husbands, wives, daughters and sons from our community. Alcohol addiction does not discriminate against gender, class or religion.
Surely asking for three days of sobriety is like asking a newborn to sleep through the night? It might be an ideal, but with all the will in the world it is an unreachable goal. Addicts need support and an environment which is cohesive to recovery. The experience for many chronic alcoholics is not one of straight-forward acceptance, treatment and sobriety. But they are faced with a quandary, to get help they must be sober, yet to be sober they need the help……
*Names have been changed to protect identities
A man lies on his sofa. The room is dark and the curtains remain closed. The smell of stale cigarettes and sour milk catch in the back of his throat. The TV is the only source of light. It flicks in the background but the sound is muted. The silence is deafening. The man has spent four hours trying to move from the sofa. It is soaked with urine. He floats in and out of consciousness. His body is covering in excrement. His muscles weak and drained. As he manages to rise to his feet, aided by the furniture, the ground feels like it will swallow him whole. He wishes it would. As his vision focuses on the mess around the room, he notices the bottles that litter the floor. His first thought is not to clean them but to check if they are empty. They are. He struggles to the bathroom. He wishes someone would help. But no one will come. No wife, no mother, no GP, no hope. He looks in the mirror. Its smashed but he can‘t remember why. His hair is matted with dried blood. His clothes hang over his bony frame. His cheeks are sunken and his pallor grey. He is unshaven, bruised and battered. Now imagine the reflection is your father, brother or husband? Do you know where to turn? Who do you call?
Better yet imagine the reflection is you…..