NHS offering alcoholics ‘potentially lethal’ treatment, say campaigners

UK Advocates threatens legal action against health authorities providing drug-based treatments over rehabilitation. Alcohol dependency affects 1.1 million people
NHS authorities that offer alcoholics controlled drinking treatments relying on medication rather than total abstinence could face legal action from a patients’ organisation. UK Advocates, a pressure group campaigning for the wider availability of rehabilitation courses for addicts, is preparing to file claims against the Department of Health and local health services.
The charity maintains it has found evidence of thousands of patients with severe alcohol problems being given “psycho-active drugs” while they are still drinking. The combination, it is alleged, can be “potentially lethal” and is at odds with the manufacturer’s prescription advice and guidelines. “In many cases,” UK Advocates claims, “drugs and controlled drinking programmes are administered to sufferers without the doctor or clinicians involved having performed effective liver function tests to establish the extent of liver damage from excessive drinking.
“Treating alcoholics with drugs and on a basis of ‘moderation’ is similar to advising someone with lung cancer to cut down their smoking,” says Bob Beckett, founder of UK Advocates. “Controlled drinking programmes … hark back to the 1960s and 70s when we believed pharmaceuticals would cure everything, including addiction to alcohol. They simply have not worked.
“There are nearly one million people with alcohol problems taking up NHS beds. If we are serious about dealing with alcohol addiction then we have to look at cessation programmes, not drug-based detox, not hypnotherapy, but properly defined, intensive abstinence treatment.”
UK Advocates says its insistence on abstinence programmes follows guidelines adopted by the World Health Organisation (WHO). The organisation is now assessing whether programmes offered by primary care trusts (PCTs) meet “these statutory requirements as adopted by the European Union in accordance with WHO recommendations”. It says it will take “legal action against those it believes have been negligent by failing to offer day and residential abstinence treatments where clearly required”.
In May, the all-party parliamentary group on alcohol criticised “a general lack of capacity and variety in alcohol treatment services, due to poor levels of funding and, in some cases, a harm reduction agenda driven largely by crime and disorder rather than health considerations”. The committee found that although as many as 1.1 million people are classified as alcohol dependent nationally, only 1 in 18 enter any sort of specialist treatment each year. Spending on drug addiction outweighs that on alcohol dependency. UK Advocates says that it will issue proceedings in the administrative division of the high court “against PCTs and clinicians who may be proven to have acted negligently”.
Tom Gard, a spokesman for the group, said: “We have heard of someone who has been drinking two bottles of wine a day and has [only] been told to cut down to one and a half.” The charity claims that an audit of PCTs across the East Midlands and Yorkshire has revealed a picture, reflected nationwide, of many trusts offering no residential or intensive day abstinence treatment at all.
“In many areas those suffering from alcohol dependence are instead offered only ‘controlled drinking’ programmes, often without appropriate prior tests to establish whether or not the person needs to stop drinking completely to avoid developing serious physical and mental health problems.”
A Department of Health spokesperson said: “We have a comprehensive strategy to tackle health-related alcohol harm. The number of structured alcohol treatment places is increasing. Around 104,000 people were recorded as receiving treatment in 2007-08, against an estimated number of 63,000 in 2004.
“We have launched the alcohol improvement programme which assists PCTs in understanding local need and planning commissioning decisions. Most specialist alcohol services aim to help people reduce the harm associated with drinking. For those with moderate and severe dependence, this will usually involve advice and support to become abstinent, whether in the community or in-patient settings.
“Where a clinician considers medication would be the most appropriate treatment it is normal practice to discuss the effects and potential side-effects of the medication with the patient.”
Source: guardian.co.uk, Monday 3 August 2009

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