The latest issue of Drink and Drugs News (DDN) includes a special feature on alcohol and health, aimed at raising awareness and understanding amongst professionals and individuals.
Supported by Alcohol Research UK, the introduction states:
'...heavy drinking can cause more than liver damage. Its impact on mental health, hypertension, and cancer risk are only now becoming widely recognised. The revised ‘low risk’ guidelines of 14 units per week for men and women reflect this growing awareness and are based on a comprehensive analysis of the full range of conditions associated with alcohol consumption. Of course, many people reading this supplement will be dealing with individuals drinking at far higher levels than those set out in the guidelines, and here the risks become very significant. However, the signs of harm are not always obvious, which is why a guide such as this is so important.'
Understanding and awareness are key. Non-specialists can’t be expected to provide detailed diagnoses, which is why one of the most important messages from this supplement is to get people to check in with their GP. However, knowing what some of the symptoms look like, and having a sense of what kinds of questions to ask, is invaluable. As with all things, early intervention is essential to preventing potentially tragic consequences down the line.'
The special issue provides brief overviews of the main health conditions associated with heavy drinking, whilst noting the World Health Organization (WHO) states alcohol as a ‘causal factor in more than 200 disease and injury conditions’. The resourece also highlights a range of key issues such as rising alcohol problems amongst older adults and information on reactions with recreational drugs such as cannabis and cocaine, though notes the limitations in understanding over more recently popular Novel Psychoactive Substances (NPS).
A section on identifying potential problems aims to help identify 'when substance misuse staff should recommend that clients see a GP to discuss their symptoms, as well as when wider health professionals should think about referring patients to specialist alcohol services'. Notably, 'alcohol-related liver disease often will not show any symptoms – even with cirrhosis – until the very late stages when the liver has already undergone severe damage', whilst the highlighting the alcohol use disorders identification test (AUDIT) for use by health professionals to assess a client’s risk level for alcohol harm. Clients of drug and alcohol services should also 'be encouraged to visit their GP for check-ups as a matter of course so that they can be seen by a qualified medical professional.'
A section on referral pathways explores key partners, potential barriers and agencies that have identified successful or innovative approaches. Agencies who need to respond to alcohol problems 'encompasses a wide range of healthcare and other bodies' whilst professionals should be carrying out alcohol screening as a routine part of their practice. At-risk drinkers should be offered 'brief advice', whilst 'anyone showing signs of moderate or severe dependence should be referred to specialist treatment'. However NICE guidelines also advise 'using professional judgement to potentially revise down AUDIT scores in the case of certain groups, such as older people, teenagers or women who are planning to become pregnant' given that not offering an intervention could have serious consequences in some cases. Three case studies include examples of interventions that may be considered as a harm reduction approach, a multi-agency example including an 'asset-based approach focused on increasing recovery capital', and an outreach approach resulting in actions to overcome lonliness and achieve a controlled drinking goal.
Alcohol information on the world wide web..
The special issue also includes a section on sources and contacts, which includes links to key professional guidance such as NICE resources including alcohol pathways, though in the digital age there is little doubt many drinkers are now using online information for alcohol health questions or concerns.
Indeed Drinkaware, the alcohol industry funded charity, boasts impressive numbers and has developed extensive resources. NHS public facing information meanwhile has become much more limited, with the NHS Choices alcohol pages consisting mainly only of basic information and a local services directory. The One You campaign however does also include alcohol elements and a drink tracker app, whilst Drinkline (0300 123 1110) is still a freely available Government funded telephone helpline for anyone with concerns about their or another's drinking.
Meanwhile a growing number of apps and others tools are becoming more widely available, albeit that there is no current verification. Many will note however the current issue of information on alcohol labels and packaging, with calls for mandatory information on units and health risks set to continue.
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