For people with alcohol issues, abstinence isn’t the only answer

Forcing everyone down the same path means losing sight of many on the way.

By Julie Breslin, Head of Drink Wise, Age Well

Walk into one of Drink Wise, Age Well’s MAP (Mutual Aid Partnership) support groups and you’ll meet a whole host of people in different situations. Some will be abstinent, others will be attempting to reduce their alcohol use and some will see themselves as ‘controlled’ drinkers. All these people support and respect what works for each other, no matter how much this varies.

Drink Wise, Age Well is a programme that helps older adults make healthier choices about their drinking. Statistics show younger generations are consuming less alcohol while older adults are drinking more. People aged 45 or over now account for 69% of hospital admissions where the main cause was due to alcohol. It’s vital we support more older adults to make healthier choices when it comes to alcohol, but promoting abstinence as the only option can often be counter-productive.

It’s true that for people with a long history of harmful and dependent drinking, or other significant health problems, continuing to drink at any level will pose a huge risk to health. After people have stopped drinking for a sustained period, they often show significant improvements in health and wellbeing, including improved levels of cognitive functioning.

However, people approach recovery in many different ways and, similarly, the reasons they develop problems with alcohol in the first place vary. For some, this will be linked to early trauma, while for others it could be job loss, poor housing or the need to self-manage physical or emotional pain. For late-onset drinkers it can be due to bereavement, retirement or loss of their sense of purpose. Regardless of the root cause, each and every path is individual so we need to offer personalised responses.

More than 80% of the people we support drink alone at home, often driven by loneliness and isolation. They are hidden behind closed doors and often our first engagement with them is through a home visit. Through one-to-one support, we can often help to change the drinking behaviour, but this is like an initial bandage on a wound. Once people have changed their drinking, they are still living with the pain or loss their drinking previously anaesthetised. They may still feel desperately lonely and disconnected, a recognised public health concern in itself. Because of this, any recovery support must be ongoing. It also needs to be holistic and include social, educational and wellbeing activities that give people the chance to grow and make new connections.

But to do this we have to persuade people to access support in the first place. Many older people find the idea of walking into a drug and alcohol service extremely daunting. For someone who’s drunk heavily for many years, the idea of giving up alcohol completely can seem like an insurmountable mountain. Shame is also often a huge factor in their drinking meaning they fear if they open up they will be labelled an “alcoholic”. At Drink Wise, Age Well we make it clear we aren’t only offering abstinence as a solution, but rather we want to help people make healthier choices. No one who comes through our service is defined by their alcohol use and this is a big factor in helping people retain their sense of self.

Some people tell me they do still have the occasional drink, or have two or three planned drinking days a week. However, due to changes they have made in other aspects of their lives, they feel more in control. We see people getting involved in MAP meetings, social activities and volunteering, so that each day their confidence and self-worth grows, with that, the need to drink reduces. Although this is not an option for everyone, it is so important to acknowledge the different types of recovery and changes that people make in their lives. Trying to crowd everyone down one particular path means you will lose sight of many on the way.

If you or someone you love needs help or support, reach out. You can chat to a trained advisor at addaction.org.uk.

Julie Breslin is Head of Programme at Drink Wise, Age Well.