We are all in denial about alcohol-related illnesses

'Take a lawn full of drunks and their families and contemplate the fact that only a quarter will recover'

Fergal Keane
Saturday 02 March 2002 01:00 GMT
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It is one of those media friendly terms that covers up a multitude. Alcohol-related illnesses. This week we were told that these illnesses are in danger of destroying the NHS and are responsible for 33,000 deaths every year, and that eight out of 10 people attending emergency units have alcohol related injuries.

It is one of those media friendly terms that covers up a multitude. Alcohol-related illnesses. This week we were told that these illnesses are in danger of destroying the NHS and are responsible for 33,000 deaths every year, and that eight out of 10 people attending emergency units have alcohol related injuries.

In a society that encourages us to escape pain rather than face it, alcohol is the favourite anaesthetic. Yet alcohol related illnesses doesn't have the "oh my god", scare-you-witless, let's-find-a-cure-fast resonance of a word such as cancer or leukaemia, nor is it loaded with dread like the phrase sexually transmitted disease. How many people hear alcohol-related illness and think of a sick head in the morning, a transitory discomfort that will be gone by afternoon?

Before I get going, let me enter an all too important caveat: I am not remotely anti-booze. God bless good wine and beer and whiskey, "beakers full of the warm south with beaded bubbles winking at the brim and purple stained mouth" etc. Or as Flann O'Brien's "poet of the people" put it when eulogising Guinness stout in the comic masterpiece At Swim Two Birds: "When food is scarce and your larder bare, and no rashers grease your pan... a pint of plain is your only man."

If you can drink and not succumb to one of those mysterious alcohol-related illnesses, the best of luck to you. But if you are one of those whom booze seduces and then betrays, if you spend your days and nights chasing the warm rainbow, then this week's news should be very scary indeed.

Are you the one in company who is watching the wine bottle and wondering whether the others will think it odd if you order another and then saying to hell with what they think? Or the one who sees a friend leaving a glass of wine unfinished and wonders what in God's name is wrong with them? Maybe you are the guy who wakes up and for a few terrifying minutes has no earthly idea where he is or what he did last night, or the woman who rolls over and looks into the face of a stranger and wonders if she will be able to get up and get dressed and escape before they wake. And if you have known that morning where nothing lifts you – not beer or wine or whiskey – then alcohol-related illness is already with you. It's screwing with your head and in time will get around to your body.

That poor body. There's no end of misery that alcohol can bring. Liver, pancreas, heart, bowel slowly poisoned to death. That's usually well under way before the exterior starts falling apart: before pissing blood and the yellow pallor and parchment skin; before the amputated leg or the body immobilised by a stroke; before the brain reduced to mush from all those tides of booze washing over it down the years.

I have been to the funerals of many friends who have fallen into alcoholic death. It is never, ever an easy death. Scrub from your mind forever the notion of a romantic drunkard's death, disregard every admiring profile you read of the rebellious drunken singer/poet. I read that rubbish and think of a man who choked to death on his own vomit, a man who died of heart failure and wasn't found for a week, the beautiful woman with an angel's voice found bloated and poisoned on her kitchen floor, a man who died far from those he loved in a small room in a town where nobody knew him. Every one of them left people behind burdened with the question: why?

Alcohol-related illnesses. If you have ever visited a hospital for alcoholics on a weekend when the kids are visiting, you'll have seen the illness in its saddest and most cruel form. Take a lawn full of drunks and their families and contemplate the fact that at best only a quarter will recover from alcoholism. Regard every alcohol-related illness as a huge stone cast into a small pond, as a family broken and bewildered, made sick too by the disease in its midst.

I agree with Alcohol Concern; there is no bigger health crisis facing Britain. Yet we remain curiously indifferent to the damage done to family life and the immense burden being placed on the health service. Ask any recovering alcoholic and they gladly accept that responsibility for their sobriety is theirs alone. But that is the rationale of a person who has made the first vital step towards recognising that a problem exists.

The first obstacle is the chronic denial around alcoholic illness. It is everywhere around us, the elephant in the sitting room we refuse to acknowledge. Hardly a family in the land is unaffected by the problem – most people know a cousin or a friend who battles with booze – yet there was a sense of shock when this week's statistics were unveiled. It is difficult for families to face up to the issue in a society that is awash with denial.

Booze is embedded in our national rituals, the socially acceptable drug. Far easier to rave on about heroin and junkies than to face alcohol addiction. Popular culture celebrates drunkenness (for a good example of what I mean, witness the moronic behaviour trotted out on ITV's Holiday Reps programme each week). We ban cigarette advertising from television but allow the continued flogging of booze. We have high-alcohol drinks cynically aimed at the most vulnerable – I mean imagine the marketing strategy behind Special Brew. Just who is the target market? I can think of two immediate candidates: the young and the poor with little money who want to get pissed fast, and the alcoholic chasing oblivion.

When victims of alcohol abuse get sick they find a medical system woefully ill equipped to deal with the crisis. Alcohol Concern carried out a survey last August that found that 71 per cent of doctors and nurses interviewed felt they had insufficient information to help dependent drinkers. You might imagine that, with alcohol costing the NHS £3bn a year, politicians might express a sense of urgency. But like the rest of us they are cocooned in denial.

This isn't a crisis that can be solved with drugs. They can help you out of detox, but meaningful treatment depends on skilled counsellors. Right now we have a chronic shortage of hospital places for those suffering from alcoholic illnesses. We dry out the drunks and put them back on the street and they come back again and again. Many find their way into the criminal justice system. Not just the street drunks banged away for being drunk and disorderly, but also the businessmen and women hauled off to the cells because they've trashed the house or committed an assault, the man who kills in the middle of a blackout.

I normally rush for the door when I hear a politician or civil servant droning on about "co-ordinated strategy". But the scale of damage being done by alcohol-related illness demands action across the widest range of areas. It means a huge increase in funding for alcoholism treatment and research and a willingness on the part of political leaders and the media to end the denial. We must talk about this stuff that kills so many, bring the healthcare professionals, the criminal justice system, the media and the drinks industry into a public debate. To the millions caught in the middle of this nightmare, something better is owed than the present dishonest shambles.

The writer is a BBC Special Correspondent

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