Daily Archives: 13/10/2014

Early intervention in alcohol misuse & dependence

My CBT therapist and I were discussing this recently as she works for Improving Access to Psychological Therapies (IAPT).  It is an NHS programme that rolled out services across England offering early interventions approved by the National Institute of Health and Clinical Excellence (NICE) for treating people with depression and anxiety disorders launched in 2008.  I’ve attached the 3 year summary from 2012 here.

What the chart below shows is their recovery rates following use of IAPT and the red bar (click on chart to enlarge) is for mental and behavioural disorders due to the use of alcohol.

IAPT data 2013-2014

What it shows is a number of people approaching them with issues to do with alcohol which IAPT was not set up to treat.  They are not trained or equipped to deal with this issue and to be fair to them they would refer on to the local Drugs and Alcohol Services.  But if we have early intervention for mental health, and a slew of other health related issues, why does it not exist for alcohol?  Yes we have the Alcohol Brief Intervention (ABI) that GP’s and Practice Nurses can use but that’s it.  Do we need a more robust early intervention programme for alcohol?  I would argue categorically yes because all of us out here getting alcohol free online are doing so, partly through choice, but also because of a lack of existing services.  Granted many may not chose to go to their GP or practice because of fears of the consequences for them and their family and because of the stigma that still surrounds alcohol issues but for many counties you can self-refer to IAPT therefore bypassing your GP if that is what you would prefer.  Who says a similar service would not work for alcohol and these IAPT figures suggests there is a need.

I’ll leave you with the thoughts of the Chief Medical Officer who said in 2013

CMO 2013

This desperately needs to change to prevent this silent public health epidemic getting worse than it already is.   Taken from the National Treatment Agency website:

Alcohol misuse is the third largest cause of avoidable ill health. It’s not only binge drinking or dependent drinking that cause harm. Around nine million (One in five) adults in England are drinking at a level that significantly increases their risk of diseases such as high blood pressure, diabetes, some cancers and depression.  An estimated 1.6 million adults in England have some degree of alcohol dependence.

If this service existed for alcohol would you have accessed it?  I would have done.