Imagine what your waiting room might look like if everyone gave up drinking this January. While a month off won’t have a lasting impact on the liver it could inspire the kind of behaviour change which could hugely benefit the health of many patients.
As a GP for over 22 years I know that our problem with alcohol stretches far beyond clichéd images of binge drinking youngsters and heavy drinkers sitting on park benches. Every day GPs all around the country see patients who are drinking at above recommended levels and whose visit may be alcohol-related.
We’re not talking about alcohol dependent drinkers, we’re talking about social drinkers. The NHS estimates that nine million of us in England are drinking over recommended limits and the health implications of this can be seen in almost every GP’s surgery in the country. About 15,000 people in England die from alcohol-related causes each year including liver disease, cancers and cardiovascular illnesses, such as heart disease and strokes.1 The latest Dr Foster report found that problems related to alcohol and drugs now cost the NHS £607m a year.2
GPs, along with other health care professionals, must support Dry January. It’s not a detox or for those with dependency issues so it’s not right for everyone. But there’s no doubt that too many people are drinking too much too often.
One of the aims of Dry January is to start a new conversation about alcohol, to get people thinking and talking about their drinking and ultimately to inspire behaviour change following a positive month of sobriety.
After last January, more than 80% of people surveyed who took part in Dry January said they’d drink less during the rest of the year as a result of their experience.3
In general practice we have a unique opportunity to improve the health and wellbeing of our patients. Through high quality planned, proactive, preventative care we can help reduce alcohol related harm in our patients.
How to do it
A good starting point is to develop a clear strategy within the practice involving the entire team. An understanding of safe drinking levels, harmful effects of alcohol and the types of patient scenario in which alcohol problems directly or indirectly play a part is vital. You could also map community resources, voluntary groups and self help resources which can support patients.
Dry January fits in with alcohol identification and brief advice (IBA): information acquired from the AUDIT screen, which can help to stratify the risk of an alcohol problem,can be used to suggest to patients that they could give the Dry January challenge a go.
If you’re using the FRAMES (feedback, responsibility, advice, menu, empathy, self efficacy) model for guidance for brief advice you can use this to encourage patients to take their first steps by trying a Dry January.4
You can also take an informal approach if you have a patient you think might benefit. Dry January is a great way of bringing up the topic of alcohol in a gentle, non-threatening way. It’s a universal campaign, not targeted and not an intervention so it doesn’t look like you’re singling anyone out.
Many people would benefit from giving Dry January a go, even those of us who like to think our regular glass of wine is not a problem. That’s why I’m leading by example at my practice and have pledged to give the challenge a go.
Dr Nav Chana is a GP in Mitcham, Surrey
References
1 NHS Choices. Social drinking information page.
2 The Guardian. Middle-aged drink and drug abusers put strain on NHS.
3 DryJanuary.org.uk. FAQs.
4 Alcohol Learning Centre. Clinical approach to brief advice.
