Director of Public Health Annual Report 2019: Alcohol and us

"One of the biggest challenges we face is the ‘I’m not an alcoholic’ phenomena. Some of the patients I see do not define themselves as having a problem as they perceive an ‘alcoholic’ as someone who sits on a park bench drinking high strength alcohol. Many of these people are well educated and highly functional in their day-to- day life. Despite evidence that alcohol is causing them harm, such as a diagnosis of cirrhosis or the loss of their licence as a result of a drink driving conviction, they still refuse to accept that alcohol is causing them harm.

What we need is a national conversation/campaign to broaden people’s perceptions of what constitutes harmful drinking and help them understand that drinking is not always a free choice. It is my hope that if the stigma of ‘alcoholism’ was removed then it would allow more people to admit to themselves and others that there is an issue that needs addressing, which is the first step towards them making the lifestyle changes required to improve their health."

"As a GP I see quite a lot of people drinking at a moderate level but not realising it is bad for their health in the long run. Often these are middle class men and women who are drinking in the evening at home, drinking half a bottle to a bottle of wine. Many of them share the wine with their partner, which legitimises their drinking. I see this pattern in working people aged 30s to 60s, and also in active retired people into their 60s and 70s.

When we talk about their drinking some people chuckle, but for lots of them they are surprised when I explain it’s a bit too much, and for some it’s a bit of a shock. In a way it’s the silent socially acceptable problem but it shouldn’t be. Alcohol affects people’s mental health, and if they have some anxiety or depression it often makes it worse.

I think the public are more aware that guidelines have changed and alcohol levels that were considered acceptable in the past are now harmful, but they don’t necessarily apply this to themselves. I think this is because alcohol is so readily available nowadays, its cheap and you can buy it in the supermarket, people think ‘if you can buy it in a shop then it’s ok’.

I’ve been a GP for a long time and it’s only recently that I’ve seen active retired people drinking more alcohol. In the past the stereotypical picture was for older people to have a “tot” before bed but now working age people and retired people are drinking earlier in the evening. They have a glass of wine with a meal, and then finish the bottle because they don’t want to waste it. I think this is because nowadays people’s social life is at home.

Also as a GP I’ve become more aware of problem drinking as well as dependency, so maybe I’ve become more enquiring. I’ve been on a journey and so have my colleagues. One way I think GPs can help is to make asking and talking about alcohol along with smoking and physical activity normal. We need to capitalise on the opportunities open to us to have those conversations."

"I had previously tried to come into a 12 step programme/AA in my mid-twenties. I had attended certain groups but had not listened and talked myself out of the fact I had a problem. I thought I could control it by myself.

I knew what I was in my 20’s, but I masked it from friends and colleagues. I held down a job most of the time, but things were starting to slide. Days off work were happening more frequently, my behaviour was becoming erratic, but it wasn’t until the last few years of active addiction that I became scared of my addiction and myself. I was quick to anger, irrational and would get myself in dangerous situations. I had drunk drove at certain times just to get to the shops to get more alcohol. My loss of control scared me, my addiction had taken over.

It took until my 40’s to have a drastic rock bottom. Every day was a constant battle to either get through work to get another drink, or if off work I would drink constantly for weeks on end, all day every day. The physical effects took over, uncontrollable shakes in the morning, sleepless nights, not eating for days. I tried to detox on my own and the physical withdrawal saw me in A & E, twice. I was too scared to ask for help, I thought I would die on my own in bed.

After a dawn walk to a garage for alcohol, I forced down a bottle of wine and lay on my dirty unwashed bed, covered in my own vomit. I hadn’t washed properly for weeks, I smelt. I simply just cried, uncontrollably I screamed out for help. It was 6am in the morning. I finally admitted to myself I had a problem. For some reason that morning, I started researching detox/ rehab units, and found a place which could take me a few days later. I went through a 7 day controlled detox, which allowed me a slightly clearer head to realise I must go back to AA.

That evening I went to my first AA meeting in 15 years. My recovery started there.

I attended two meetings a day for the first few months and then started working the 12 step programme. My GP recommended that I get in touch with One Recovery Bucks, for advice and support. I was sceptical, feeling let down by services in the past. This was not true of One Recovery. I called, they understood, and saw me the next day. I was assigned a key worker who I met with every other week. I was not judged, I was understood and I was listened to. I felt safe, it was the first time in years that I started to trust another person.

Throughout my recovery I have learnt some very important lessons. My drinking was in isolation towards the end, I didn’t talk to many people. I had a good job, when I was able to work. I still had my home, drove a nice car and had a bit of money. If I’m honest, I was judgemental, I thought alcoholics are homeless or poor. Obviously this is not true. At One Recovery Bucks I met a lady in the waiting room. She was so kind to me. We were both the same as each other and I felt a relief and acceptance of who I really was.

Over the years I had given every excuse under the sun as to why I wasn’t an alcoholic. I couldn’t stop because social situations would be difficult, I wouldn’t be confident, I would never get a partner, and I enjoyed it too much. The reality was I ended up in one room of my house, not going out, having not washed, drinking alone, talking to myself, no partner, spending money I didn’t have. If I had carried on, I would have lost everything. If I had carried on, I would have died.

Life now has improved so much. Days are not dark, my liver is back to health, I have confidence in social situations, and I have friends, real friends. I still attend AA meetings 5 to 6 times a week. I have a sponsor and I love going to meetings. And I have confidence in the fact I know who I am these days.

It’s one day at a time."