SMMGP - Substance Misuse Management Good Practice

Substance Misuse Management Good Practice

Supporting good practice in drug and alcohol treatment

Post-its from Practice:
Always ask about alcohol (Jul 2011)

Britney burst into my room yesterday and before sitting down she said she needed a letter for court, adding "I'm the victim you know, not on trial!" I replied that she could have her letter but would she mind sitting down to tell me why she needed it. She sat down, instantly becoming a shy, vulnerable frightened girl. I leant across to give her a comforting touch as she told me it was her father who was on trial for physically and sexually abusing her and her younger sister. She was due to give evidence that day and could not face seeing him.

Britney is just 17 years old, the abuse had started when she was 12 and continued until aged 15.

Britney left home about a year ago and had been living in supportive housing. She has a support worker and a therapist who she sees weekly. She admitted that it was tough and she often felt disconnected. I asked her about drinking and smoking. She casually responded that she drank at least four half bottles of vodka per week and smoked 30 cigarettes a day. Asking her about other drugs she said she would "never do those". We worked out together that her units amounted to at least 60 per week and I enquired if she was working on this with her therapist. She answered that no-one had ever asked before therefore she hadn't mentioned it.

Britney went on to say that alcohol was the only thing that made her feel better as she tried to forget. We discussed the pros and cons of drinking and she was insightful about how it might negatively affect her mood. I asked if she wanted help to address the problem and she said that she would discuss it with her therapist and see how she got on. She asked if she could return if he wasn't able to help and I reassured her that my door is always open.

As a nation our alcohol consumption has been rising for decades, and with that the harms associated with this consumption. But it's more complicated in young people. The proportion of young people aged between 11 and 15 who reported having drunk alcohol decreased, but the amount they reported drinking increased from just over six units per week in 1994 to close to 13 units per week in 2007. Many teenagers are admitted to hospital every year for alcohol-related reasons and in one survey, one in five teenagers admitted to drink driving. Drinking alcohol can also make teenagers forget about safer sex. Starting drinking as a young person can result in a greater risk of developing long-term health conditions in later life. Deaths from liver disease have risen sharply in the 25-34 age group over the last 10 years and this is thought to be a consequence of increased drinking that had started at an earlier age. Underage drinking can also cause problems with mental development, as the brain is still developing.

Britney has been drinking at this level for about a year and seems keen to address this issue so I'm hoping that she can reverse the damage done so far. I really like her, view her as a survivor - but I'm so glad I asked the question. How many other young people are consuming unsafe amounts of alcohol, remaining undetected and without support.

- Dr Chris Ford
GP Lonsdale Medical Centre, Clinical Director for IDHDP, and a Member of the Board of SMMGP