Sunday, 4 March 2012

One size doesn’t fit all

Nobody with an interest in pubs and beer can afford to ignore the issue of alcoholism, an affliction that unfortunately takes hold of a minority who go well beyond just liking a drink. But it was interesting to see, the other week, a Panorama documentary (whose general message was frothing at the mouth about supposed “hidden” middle-class problem drinking) presented by former New Labour spin-doctor Alastair Campbell, who claimed that he had been an alcoholic, but had now managed to revert to being a moderate, social drinker.

This, of course, goes right against the core message of Alcoholics Anonymous, who have always held that the only salvation for the alcoholic is total abstinence, for life. For some people, that may be the cure, but I’ve always believed that, for others, it was possible to change from being a problem drinker to someone who kept it under control. This is a view echoed by Phil Mellows in this very perceptive blogpost.

If you look at the statistics on alcohol consumption by how rich you are, the wealthiest fifth of the population do indeed drink slightly more than the poorest fifth. Yet the poorest fifth are six or seven times more likely to die an alcohol-related death than the wealthiest fifth.

This is because dying of drink is over determined by other factors such as depression, obesity, nutrition and social conditions in general. It would be reasonable to say that it's not the alcohol that kills poor people, it's the poverty.

Of course, middle class people die, too. But they have a much better chance of survival. And it explains, too, why they are better at 'functioning'. They also present well on television documentaries.
Everyone who has a problem with drink has to find their own personal salvation, and it is dishonest to insist there is a single, one size fits all, cure.

13 comments:

  1. The beard club told Mudge to go to rehab, he said No No No.........

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  2. P.S, Your own assumptions regarding AA are incorrect. There is no direct instruction or “core message” to total abstinence, it is more that those unfortunate to need its assistance are incapable of controlling their addiction and wish to stop. It is helping those that wish to stop, not telling drunks to stop.

    AA advocate a 12 step program. It’s all about giving yourself to a higher power.

    I don’t believe any GP faced with a patient seeking help with a drink problem points them first to AA. My understanding of AA is that it is a worthwhile organisation that helps people in a truly sorry and miserable state. People who have tried all other solutions and failed. It is a last resort of the desperate. People you can only pity, people who have lost pretty much everything.

    I don’t believe they advocate prohibition in the manner of alcohol concern, they only help the desperate who have hit a low we are fortunate enough not to experience.

    http://en.wikipedia.org/wiki/Twelve-Step_Program

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  3. I'm not remotely suggesting that AA advocate prohibition, or that they don't do a lot of good work. But you get the impression (which may come as much from the press and TV drama) that their view is that total abstinence is the only answer to alcoholism. How often in TV dramas do you see the "recovering alcoholic" try "just the one drink" and then inevitably end up on an almighty bender?

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  4. Drama misrepresents many organisations and simplifies life. That is dramatic licence. Drama is life with the boring bits removed.

    Your post stated AA has a core message of abstinence. A misrepresentation of their organisation. Their 12 step programme is for people seeking abstinence. They do not advocate it. A subtle difference, but nevertheless a difference.

    Those that seek their help may very well be at the last chance saloon, and unable to drink moderately, and such TV dramas may very well be accurate regarding those specifically that have resorted to AA. On that I think neither of us would know.

    There may be a gap in drama for those that have a drink problem without being alcoholics, those who go to their GP, get a leaflet and start having a few booze free days where they leave the wine unopened and then go on to notice how life is better without hangovers if they stick to a limit. Can’t see as that makes for engaging TV but feel free to propose it the makers of Corrie.

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  5. It's a very difficult dilemma for a publican. We do have one customer does seem to be drinking himself into an early grave, (along with his total lack of exercise and terrible diet.) He can soak it up, and doesn't get staggering or slurring, but does tend to drink 7-8 pints a night. (Not all in my pub, I hasten to add. There are lots of local pubs and he travels around.) If I stopped serving him, it wouldn't stop his drinking at all, he would just spend more time in the other pubs. Talking to him about his drinking seems a very difficult task, and he seems happy enough.

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  6. Saga, I'm sure we all know people like that, and as long as he doesn't cause trouble or start passing out in the toilets I would say it's his business, as is his diet and exercise regime. Indeed going from pub to pub probably gives him a fair bit of exercise anyway. I recall one CAMRA member (no longer living in the local area but still going strong) who gave the impression of being a pretty enthusiastic regular drinker but could still leave the rest of us panting in his wake in the long-distance speed-walking stakes.

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  7. Never confuse acquaintance with friendship, and it’s sad so few have friends or family.

    A pub landlord, a drinking pal, a beard club member would let someone drink into an early grave, because its nowt to do with them. That’s not a criticism, it’s an observation. A friend, a father, a brother, a son would intervene.

    What surprises me about those that want to campaign to keep pubs alive. They would not campaign to keep you alive. Most pubs would bleed an alcoholic to death then hope for another mug to fill his stool.

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  8. It is very noticeable within CAMRA that there is a wide range of levels of drinking. Some claim that they virtually never drink except two or three times a week at CAMRA events, and even then only two or three pints. Others give the impression they're out round the pubs most nights.

    I would say subjectively that CAMRA events are significantly less boozy than they were twenty years ago - maybe because the average age of the membership is 15 years higher now ;-)

    In my experience members of CAMRA would not take kindly to any suggestion they were drinking excessively, and would probably regard it as a personal affront. The one person I know who actually declared himself as an alcoholic, and as far as I know remains completely dry, is someone who, while he clearly liked a few pints, never gave any impression of being out of control.

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  9. I was not suggesting that you intervene if one of your bearded drinking pals was an alko, nor criticising that. I would not intervene for anyone other than a member of my family.

    I think most people encounter those that appear to be an alko, I recall one or two work colleagues over the years that clearly needed someone to care enough for their welfare to question their behaviour. It wasn't me.

    I would hazard a guess, without having a pop at CAMRA or its members, that there is a fine line between supporting pubs, having an interest in beer and having a drink problem, and a fare few of your beer club will in all probability be drinking themselves to an early grave. They may be happy with that, they may have no family, and certainly it is none of your business.

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  10. As I commented on Boak & Bailey here:

    I think in the past (but less so now) many people who found pubs and pub life congenial would unconsciously (or even to some extent consciously) make the decision that they would become “a boozer”, just as others become cyclists or gourmets. This is, to my mind, something very different from being an “alcoholic”. Yes, it might get them in the end, but it’s only a risk factor and many people live to a ripe old age despite adopting that lifestyle. This is undoubtedly true of a lot of members of CAMRA, and I’ve known plenty of people who, by their own admission, are drinking five pints every night and more at weekends, and yet hold down responsible jobs and have unblemished driving licences.

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  11. It doesn't make me happy to think that I might be contributing to anybody's early grave through addiction. The thing is, with alcohol, it's not a given that heavy drinkers are alcoholics. I think that some heavy drinkers do it simply because they enjoy being drinking or being drunk, and probably could stop if they wanted to, or had the need. As you say, it's not really my business, unless they clearly need help. Landlords do have legal responsibilities.

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  12. I find your perspective interesting, Saga, as it’s more than beer. It’s a whole morality of life question. I would suspect the shareholders, managers & shelf stackers of Tesco have no problem selling booze to alcoholics. I doubt it even crosses their minds and if it did they would say it is none of their business. They cannot determine which customer is an addict. Tesco may even give money to charity, including charities helping alcoholics. The Spoons is anonymous enough too, for the barstaff not to think too much about the guy that comes in every day and is drinking bang on 9am. The off licence or pub where the retailer runs his own business, he has a more personal relationship with his customer. So how do you sell a product to an addict, knowing it’s killing him? Well the justification is that he would buy it elsewhere. It happens to be the same justification drug dealers use to sell crack cocaine, and they sleep at night too, and the justification is no worse for that. It is a powerful argument capable of justifying many actions. If you didn’t, someone else would.

    It’s not a criticism of you, or your business, Saga. I’m sure you are a decent man. It’s more the capacity of people to morally justify acts that is interesting. In this case selling a harmful product to an addict.

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  13. If there was somebody who was on a clear downward spiral, I like to think that I would try do something. In my last pub, we had a very occasional customer, who looking back was clearly sinking into the depths. He only came in every two or three months or so, but it was after hearing of his tragic death, that I began to look at the few photo's we had of him. The change over two years was apparent, if you view the pictures in sequence.

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