Alcohol

Problem drinkers in one form or another will represent a significant number of any probation officers caseload. As with many aspects of problematic human behaviour, the form it takes varies from individual to individual and the reasons are many and varied. I make this point because in my experience there is no magic silver bullet treatment and never likely to be. It will be no great surprise to learn that trying to deal with clients who are problem drinkers can be extremely problematic, time-consuming and it has to be said, profoundly depressing.

When I started out many problem drinkers who had been through the prison system were aware of Alcoholics Anonymous and for some joining a community AA group proved helpful. But many others found the whole 10 step 'hair shirt' total abstinence and quasi-religious atmosphere too difficult to cope with. I found that some responded to counselling, especially if underlying traumas had led to heavy drinking and yet others went down the medical route of in-patient detoxification at the regional addictions unit (a facility now long gone) and treatment with antabuse.

For those unfamiliar with this treatment, it is a medication taken daily and leads to a violent and unpleasant reaction if combined with alcohol. In the early days it was available as a slow release implant in order to pre-empt the opportunity of frustrating it's effect by the simple expediency of stopping the medication. Unfortunately I've known cases of clients 'digging' out the implant so desperate they had become for a drink. Alternatively it is possible to drink through the nauseous effects of antabuse if someone is really determined. As far as I know it has not been available as an implant on the NHS for some time. 

In more recent time a whole host of specialist alcohol treatment agencies have sprung up offering counselling, support and advice and to a great extent the old AA model has lost favour. However problem drinking is still very much with us and by general consensus is an increasing problem and one that has significantly changed in nature. My period in court as a CDO brought home to me just how prevalent the phenomenon of teenage binge-drinking at weekends has become in every UK town and city. Historically heavy drinking has always gone hand in hand with Friday and Saturday nights out, often leading to male violence in garrison towns or areas associated with heavy industry. What has changed in recent years with liberalisation of the licensing laws is the massive growth in young female binge drinking, the copying of male bad behaviour and the concept of 'pre-loading' with cheap alcohol before even getting into town.

What quickly became clear to me as a CDO is that many of our towns and cities have become virtual war zones in the evenings at weekends with the police and ambulance service barely able to cope with the resulting melee. The resulting effects of violence inevitably end up before the courts and much discussion as to whether a perpetrator has a drink problem or not. I'm still not sure as this binge drinking behaviour is so widespread, limited to weekends and often the individual is otherwise leading a normal life, happily employed and often horrified when confronted with cctv evidence. I don't think they have a drink problem in the normally accepted and historical sense, but clearly something has to be done to encourage a different drinking behaviour. If behaviour is learnt, it can be unlearnt I feel. 

It looks as if London wants to blaze the trail for a new experimental way of dealing with problem drinkers. Boris Johnson and Kit Malthouse, respectively Mayor and Deputy Mayor want the government to sanction an American idea of enforced sobriety for some problem drinkers convicted of drink-related offences. The idea is to offer the option at court of compelling participants to undergo twice daily testing for alcohol at their own expense. Any positive readings would trigger a return to court and possible custodial sentence. The details haven't been finalised but could be combined with other conditions of a community order. The proponents seem keen on the idea of combining short custodial sentences, but this is not likely to meet with government approval given the current determination of reducing short sentences. Over all, I think the idea has some merit for a particular type of problem drinker, for example the motivated binge drinker, and is therefore worthy of a trial in my view.