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Suggestion for GPs to take greater role in treatment of alcohol dependency

Suggestion for GPs to take greater role in treatment of alcohol dependency

The failure of the Government to tackle harm from alcohol dependency over the past decade has led to a serious public health crisis, influential MPs have warned.

Deaths have risen by 89% over the past 20 years including a sharper increase since the start of the pandemic yet the number of people receiving treatment for alcohol dependency has been falling, the Public Accounts Committee (PAC) said.

In a highly critical report, MPs said a ‘staggering’ 82% of the 600,000 dependent drinkers in England are not in treatment.

Yet treatment is a success in about 60% of cases and on average, every £1 spent on treatment immediately delivers £3 of benefit and significantly more in the longer term, the committee said.

Despite widespread harm and a cost to the NHS and wider society of £21bn, there has been no alcohol strategy since 2012 and the Department of Health and Social Care (DHSC) figures on dependency are 10 years out of date ‘meaning it is not even in a position to identify an appropriate response’, the inquiry found.

The committee heard that more could be done by health services to identify people with alcohol dependency and direct them to treatment and that GPs and outreach could be used more to deliver services.

The suggestion came from Dame Carol Black, who led an independent review into drugs treatment and recovery on behalf of the Government in 2021.

The PAC concluded it was ‘surprised and disappointed’ that the Department is not taking a more ‘proportionate and serious approach’ to addressing the problem.

This includes acting decisively on evidence around preventative measures such as price, availability, and marketing. 

But also addressing key issues of funding uncertainty for local authorities around delays in public health grants, barriers to accessing treatment local variations in outcomes and severe and worsening healthcare workforce shortages, the committee concluded.

More also needs to be done to ensure those who have both mental health issues and alcohol dependency are able to access treatment services.

‘Given the well-established relationship between substance misuse and mental ill health, we were concerned to hear that some people are denied access to mental health services because of their alcohol dependency (and vice versa),’ the committee said.

Dame Meg Hillier, PAC chair, said: ‘The harms from alcohol are appalling and the benefits of every £1 spent on treatment are immediate and obvious.

‘It is linked to over 100 illnesses, mental disorder and suicide and to 42% of violent crime. It also costs the NHS and wider society at least £25 billion a year with inflation – and possibly more.

‘But the Government has had no alcohol strategy in place since 2012 and abandoned its latest effort in 2020 – just as deaths from alcohol began to rise sharply over the terrible, unacceptable toll it was already taking.’

She added: ‘What more does DHSC need to see to act decisively on this most harmful intoxicant? In doing so it must give local authorities the certainty and stability over funding to maintain and improve the treatment programmes that are proven to work, and stop dithering over the evidence on industry reforms.’

Professor John Holmes, professor of alcohol policy at the University of Sheffield, said deaths due to alcohol have risen gradually since the early 2000s despite alcohol consumption falling driven by drinking rates in middle- and older-age groups. 

‘The largest part of the increase in deaths occurred since 2019 and is due to the wider effects of the pandemic. 

‘The precise reasons are unclear at this point but are likely to include heavier drinkers increasing their consumption during lockdowns and not reducing it afterwards; people being less likely to seek or access help from general and specialist health services and alcohol problems combining with other problems that were exacerbated by the pandemic and people getting more ill as a result.’

A DHSC spokesperson said: ‘Alcohol misuse can ruin lives and destroy families, so we are taking serious action to support those most at risk.

‘We’ve published a 10-year plan for tackling drug and alcohol-related harms and are investing an extra £532m between 2022/23 to 2024/25 to create over 50,000 places in drug and alcohol treatment centres with high-quality care.’

A draft NICE quality standard published earlier this year asks GPs to formalise recording of patients’ alcohol use so they they do not miss out on interventions.


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Please note, only GPs are permitted to add comments to articles

Matt Hancock 24 May, 2023 11:30 am

As per always when a problem needs solving get the GP to sort it.

Why not properly fund specialist services that can be accessed without a referral

Same goes for physio, podiatry etc

Dr No 24 May, 2023 11:58 am

Ok guys, what do you want me to STOP doing to allow time to do this?

Robert James Andrew Mackenzie Koefman 24 May, 2023 12:54 pm

Do we not have enough to do and where is the money coming from to do this. ?

David Church 24 May, 2023 1:44 pm

I used to do this, but LHB decided it was not cost-effective, and told us to stop it.

Michael Green 24 May, 2023 7:25 pm

Sorry too busy fixing boilers and filling out parachuting forms

Mark Funnell 24 May, 2023 7:34 pm

Agree with the above, we have not got the skills or capacity to deal with this. These patients need proper psychological support & when ready to make change a prompt service to help them stop & to maintain abstinence. That is not something that we can deliver.
We can offer brief interventions only, aiming to bring them to the point of recognising the need for change & then it should be over to a specialist service with time & capacity to give them what they need.

Northern Trainer 24 May, 2023 8:18 pm

It’s not the predicable lack of evidence or funding – I’m simply too busy being the pseudo house officer to broken consultants, the prescriber to unsupported specialist nurses (who are seemingly only allowed to work on zoom), the community hospital complaints officer, the private adhd clinic dogsbody and the econsultation agony aunt I’m afraid.

Ian Haczewski 24 May, 2023 8:43 pm

Why not chuck more work at us , if this carries on , some of us will require the service ourselves !