Doctor on front-line in battle with problem drinkers insists they would benefit

Published on Wednesday 23 December 2009 21:41

TREATING some of Scotland's most serious problem drinkers, Dr Jonathan Chick knows the damage alcohol can do to people's lives and those of their families.

The consultant psychiatrist at NHS Lothian's Alcohol Problems Service said they currently had 2,000 patients under their care – a figure that has doubled in the past 15 years.

He said that the increased availability of cheap alcohol had helped boost the number of Scots suffering serious problems.

Dr Chick's own patients' experiences show how dangerous alcohol can be when taken in large amounts.

"More than 60 per cent of overdoses – poisoning and self-harm – happen when someone is drunk," he said. "In people who have isolated themselves from others by their drinking, this can be very common."

Dr Chick said that, for the first time in the past couple of years, he had seen someone in their 20s dying of alcoholic liver disease – that person was a university graduate.

"What has been very frightening for the liver clinics has been a shift to the left in the age of people suffering liver disease.

"The average age of dying of alcoholic liver disease is now ten years earlier than it was 15 years ago – now in the 40s rather than in someone's 50s."

Dr Chick said he also saw patients who had suffered severe epileptic fits brought on by alcohol abuse.

He said there would be advantages if levels of drinking dropped across all groups of drinkers – from heavy drinkers to more moderate consumers. He also said introducing minimum pricing would see beneficial effects on the nation's health within five years.

His clinic's own study of patients with serious alcohol problems found they consumed very cheap alcohol – in particular cider and cheap vodka.

"These are the drinks that would be most affected by minimum pricing legislation," he said.

"Some of our patients say, 'I am so addicted that I would get the alcohol whatever it cost'.

"We don't know whether that's true or not.

"But at the moment, out of the 377 people we studied, there were only four who said that sometimes they had stolen.

"And there was only one person who said once she had drunk alcohol substitute."

Dr Chick said one of the objections to minimum pricing was the argument that drinkers would turn to stealing, home distilling or drinking substitutes such as perfume.

He said that was possible, but it would take quite a shift in the way the drinkers did their drinking.

"I can see that, overall, there would be a general reduction in the average amount that is being drunk if there was minimum pricing and that will bring health benefits," Dr Chick said.

"I also think that it will bring a shift away from white drinks, such as cheap vodka and cider, which could possibly – and this is theoretical – reduce the high prevalence of brain and liver damage which may be related to the low antioxidant content of these white drinks compared to drinks including whisky and beer, which contain more antioxidants.

"The evidence is not totally watertight, but it suggests there is some protective effect in some of the constituents of some alcohol drinks, compared to the white drinks."

Dr Chick said another benefit of minimum pricing might be people drinking more outside of the home in licensed premises. "Extreme drinking becomes very solitary and unhealthy heavy drinking. At least the club and the pub have some benefits in social interaction, which for many of our patients is sadly lacking," he said.

Dr Chick said his clinic had had year-on-year rises in referrals for the past 15 years.

He said part of the reason for this could be the growing trend for women to drink due to changes in use of their leisure time.

He also said that huge spending on advertising alcohol was likely to have made it more acceptable.

"But the most striking thing is the relative price," Dr Chick said.