Dr Neal Brener: Why you can't just tell an alcoholic to stop drinking

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Alcoholism is not a silly little self-inflicted illness. It is a major problem for the NHS. One in five beds at any one time is occupied by people with drinking problems. Unfortunately it is often not well recognised by the medical profession, and treatment options in the NHS are limited.

All too often doctors are afraid to ask the question about alcohol addiction and feel ill-prepared in their training to treat people with alcohol issues.

Alcoholism is just one facet of the drinking issue. One has to look at the consequence of drinking, not just the quantity. A person who drinks two glasses of wine and then goes and beats his wife up has a drink problem.

When treating someone with a drinking problem it is vital to look at the physical and mental effects not just on the person but the people around them. Any good treatment programme has to have a family component. The spouse and children of alcoholics can be severely damaged.

The problems celebrities have with alcoholism are rarely different from those faced by anyone else. An alcoholic is an alcoholic - they do not need an excuse to drink. But it is harder for them to get treatment because it is very difficult for a celebrity to go into a rehab unit. The press follow them and people want to sell their stories.

Addiction is an umbrella with many segments underneath it, alcohol being only one of them. Drugs, gambling, over-shopping, relationships and eating can all be involved. You have to treat the whole addiction.

For a true alcoholic it is a lifelong illness that needs constant treatment and total abstinence. You cannot have a little, because if you have a little you have a lot. Simply telling an alcoholic to stop drinking is not going to help. If that were the case George Best would not be dead. A large number of people in this country have drinking problems. It is a serious, life-threatening illness where a significant percentage of people die from their addiction.

Dr Neal Brener is a consultant psychiatrist at the Priory Hospital, north London

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