Alcoholic neglect

Official national statistics indicate that the annual number of alcohol-related deaths in the UK more than doubled to around 9,000 between 1992 and 2008,1 and there are other suggestions that the figure could be as high as 30,000–40,000.2 Against this background, it is of concern that dependent drinkers are often neglected by healthcare providers and have sparse hope of consistent support in the community.

Hospitals see a large – and growing – number of patients with advanced alcoholic liver disease. Such individuals often have prolonged complex and expensive admissions with various problems, such as sepsis, ascites, renal failure, variceal bleeding and encephalopathy. Following recovery from such life-threatening episodes, and after withdrawing from alcohol, patients are often discharged back to their drinking environment, and, often, unstable social circumstances, with little or no support. Many end up in a downward spiral of hospital admissions, continued drinking, deteriorating liver function and ultimately death.

A key problem here is the wide variation in the provision of support services for people with alcohol problems.2^,3 Of note, primary care trusts afford a higher priority to services for dependent drug users and they are not required to commission alcohol-related services or to assess local alcohol-related needs.2 A much clearer and better resourced political and social care strategy, both nationally and at strategic health authority level, is urgently needed. The burden of alcohol-related harm continues to increase in the UK and ignoring this problem is proving a very expensive option. Let's call time on this unacceptable situation.

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