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As a group requiring specialist support , people can fall between the cracks – seen as too complex or challenging for alcohol treatment services whilst not fitting the typical profile for disability or dementia services .
‘ By increasing awareness and the understanding of those engaging with individuals living with alcohol use disorders , we hope that more people will make the connection between harmful levels of alcohol consumption and confusion , forgetfulness or atypical behaviours in the patients they see in front of them day to day ,’ says senior research assistant at the University of South Wales , Dr Darren Quelch . ‘ We hope that by doing this , not only will it help facilitate further assessment and detection of ARBD in patients with alcohol
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use disorders , but it will also act to reduce some of the stigma surrounding alcohol dependence and ARBD .’
‘ There is a huge lack of availability and consistency of ARBD services across the UK ,’ says Quelch . ‘ Many patients fall through the gaps of existing services for memory problems due to a variety of reasons – for example age , current dependent patterns of drinking , or lack of a formal diagnosis . This work will start the process of formalising services dedicated to those with ARBD . We are in conversation with our health partner experts , mapping examples of good and complete provision whilst simultaneously noting barriers or gaps in services . We hope that by working with our colleagues in health services , we will be able to generate a service delivery pathway template , that is acceptable , inclusive , and impactful for patients , feasible for health services to deliver , and translatable to regions outside of Wales .’
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NEGATIVE ATTITUDES So what ’ s driving the negative attitudes and beliefs people very often experience , and that mean accessing appropriate care can be so difficult ? The combinations of stigma experienced are complex but we might simplistically list a few of the characteristics of ARBDrelated experiences that help us understand what ’ s happening . |
Dr Darren Quelch is senior research assistant working in the Addictions Research Group at the University of South Wales . The Addictions Research Group has recently been awarded a grant from Welsh government to start working towards improving service delivery for those at risk of developing , or living with , ARBD . This work will bring together interested health partners to map out current services for ARBD and plan pathways from initial identification of symptoms to discharge from treatment .
Firstly , this is an alcoholrelated condition and as such people suffer from misattributed judgements related to addiction – that addiction is self-inflicted harm as a result of a moral failing . These beliefs surrounding personal responsibility tend to span the majority of alcoholrelated conditions . Furthermore , we seem to have a much greater understanding of the impact of alcohol on our livers , and the link between alcohol and cancers , for example , but relatively less understanding of the detrimental effects of alcohol on the brain . These factors potentially give rise to additional attribution errors whereby we relate the symptoms of ARBD ( such as disinhibition , impulsivity , or unpredictable behaviours ) to the personality of the affected person rather than their health condition .
ARBD affects people ’ s ability to process information and plan future actions . In practice this means people find it hard to engage in a structured manner in their own care planning and attendance at organised healthcare appointments . This means people are more likely to turn up late or miss appointments and use emergency or crisis services . Therefore , people may experience negative attitudes from over-burdened health and social care professionals working in busy and stretched services – especially when non-attendance at planned healthcare appointments has become a source of social disapproval and
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policies to fine people for missed appointments have been floated by government .
ADVOCACY As a group requiring specialist support , people can fall between the cracks – seen as too complex or challenging for alcohol treatment services whilst not fitting the typical profile for disability or dementia services . Medium term , specialist residential care and support is a treatment option for people with ARBD , but accessing funding can be complicated . A lack of advocacy for the individual in question may underpin this . This can be secondary to patient factors , for example social isolation or minimal family support , and healthcare service factors , such as limited awareness of treatment avenues or service availability . Funding processes for residential care can disproportionately favour those who are impacted to a lesser degree by ARBD and people best able to advocate for themselves – for example those who demonstrate higher levels of organisational and motivational skills that can engage in funding processes for residential treatment programmes , or those able to gain advocacy through existing healthcare services .
So people with ARBD find themselves in a particularly marginalised situation , forced into navigating a system that doesn ’ t work for them . And yet there ’ s great inclusive practice for both ARBD-specific care and harm reduction . In future articles we ’ ll look at how best practice can mitigate stigma-related barriers . Right now though we need your help . Hopefully you can see why this is an important areas for the Anti-Stigma Network to help address . We ’ re keen to speak to people with lived experience of ARBD in order to bring their experiences of accessing health and social care to life .
If you know of anyone willing to share their story contact us at the Anti Stigma Network ( ASN ), www . antistigmanetwork . org . uk
James Armstrong is director of marketing and innovation at Phoenix Futures
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MAY 2024 • DRINK AND DRUGS NEWS • 25 |