Drink and Drugs News DDN 1806 | Page 31

Alcohol policy

Some people are so chronically damaged by alcohol , particularly through cognitive im pair - ment , that they are no longer able to look after themselves or control their behaviour , and so pose a risk to themselves or other people . In the UK , people whose mental illness places them in a position where they can no longer live safely without harm to self or others can be detained under the Mental Health Act . This is not to punish them , but rather for protection , assessment and – hopefully – positive treatment to improve their lives .
But these powers are not easily extended to people whose problems arise mainly from heavy drinking , despite their facing many of the same challenges , and needing intensive support . Without these powers in place these people often do not receive the help they need . As a result , many end up in the criminal justice system , which does not provide them with the correct protection and treatment . This also consumes a huge amount of police time .

‘ It can be argued that people are free to drink , even to the point of extreme harm and death , if they choose to do so .’

Should we be doing more to protect people from harmful drinking , asks Mike Ward

Dying with their rights on ?

In too many instances these people are never adequately supported , leading to tragic outcomes – for example in the case of Angela Wrightson from Hartlepool , who was severely incapacitated by alcohol and unable to look after herself . In the end she was killed in her own home by two teenage girls , and is now the subject of an adult safeguarding death review ( https :// bit . ly / 2kLjObe ).
How did we end up in this position ? Since 1983 our mental health legislation has sought to separate problems due to alcohol misuse from those due to mental illness , with chronic alcohol problems seen as a matter of lifestyle choice . It can be argued that people are free to drink , even to the point of extreme harm and death , if they choose to do so .
But modern Britain is unusual in this . Many other economically developed countries have powers that allow for the protective and rehabilitative detention of people with chronic alcohol problems . This is true of Holland , Switzerland , France , Germany and many states in the USA and Canada . Protective detention is allowed in the European Convention on Human Rights , Article 5 ( e ). The language is now outdated , but the intention is clear .
These powers are not simply archaic legislation that has lingered on the statute books . A good example of this kind of legislation in action is the Swedish Care of Alcoholics , Drug Abusers and Abusers of Volatile Solvents Act ( 1988 ).
Probably the best evidence of the positive impact of such powers comes from New South Wales , Australia . In her YouTube presentation , clinician Glenys Dore sets out the positive impact of their relatively new ( 2007 ) legislation . She describes how patients are admitted to dedicated units , with 60 per cent abstinent or improved as a result of these positive interventions .
On entry to these units all patients are screened for cognitive impairment . The average score shows that they are operating at the level of someone with Alzheimer ’ s and some even lower . However , after four weeks in a unit their score is moving much closer to the normal range . Chronic drinking often moves beyond a matter of choice to an impaired mental state where people need outside help to break them free . At this point , they can begin once again to make choices for themselves .
The development of compulsory powers is not an easy option . It would require solid criteria and safeguarding , reinvestment in inpatient units and the development of a workforce trained to manage such clients . However , doing nothing is not a cost-free option ; the current cost to the police and other emergency services , to communities and to individual lives , is immense .
People have the right to drink , even when it is doing them harm . But for some , is this a free choice ? In reality , is society is doing far too little and allowing people to – in the words of Glenys Dore – ‘ die with their rights on ’?
Mike Ward is senior consultant for the charity formed by the merger of Alcohol Concern and Alcohol Research UK , www . alcoholresearchuk . org
In his next article , he will discuss the problems with the legislation currently used to meet the needs of heavy drinkers who cannot look after themselves : a patchwork of the Mental Health Act , Mental Capacity Act and the Care Act .
Sweden ’ s Care of Alcoholics , Drug Abusers and Abusers of Volatile Solvents Act ( 1988 )
The Act ’ s aims are to ‘ immediately stop a destructive way of life ; motivate patients to seek further treatment , if such a process is required ; and to overcome addiction and hence achieve a better lifestyle .’ Under the Act , social workers must take a person into treatment if they match the four criteria set by the Swedish government :
» If the individual is risking his / her psychological health on purpose or by helplessness
» If the individual is destroying the prospect of his / her future due to substance misuse
» If the individual is risking the security of him / herself or intimate associates
» Necessary intervention is not possible on a voluntary basis . www . drinkanddrugsnews . com June 2018 | drinkanddrugsnews | 23