There are fears that more and more of us are literally drinking ourselves to death. Health Editor Barry Nelson meets a reformed alcoholic and the specialist nurse who helps patients like him stay on the wagon.
JIM knew he was drinking way too much. He had always liked a few pints in the evening with his mates but now he was getting through a couple of bottles of wine a night as well.
Despite his increasingly heavy drinking, Jim managed to hold down a demanding job, working 12 hour shifts. But life was passing him by in an alcoholic haze - until something happened which made him reconsider his lifestyle.
He had been trying to cut back on booze and was mowing the lawn outside his home in Guisborough when he suddenly blacked out. His body had suffered an alcohol-related seizure, an acute form of withdrawal symptom.
"They got me into hospital, detoxed me and then released me again. I thought I could just go back to normal, but drinking at a lower level," recalls Jim.
But booze started getting the upper hand again, so Jim tried to cut back his daily consumption of beer and wine. He had heard that it was better to cut right back rather than cut alcohol out completely.
"I was down to about two cans of lager a day," he says. "I went to bed one night at about 10.30pm when I must have had a seizure."
Jim (not his real name) can't remember much of what happened that night, which is probably just as well. His neighbours heard him plunge downstairs bringing down part of the banister as he fell. It was probably the duvet which had wrapped itself around his head that prevented him from suffering more serious injuries.
"The neighbours had a key, heard the crash, came in, took one look at me and rang for an ambulance," says Jim. "I was very woozy from the fall and had no idea of what was going on."
When he became fully aware of his surroundings, Jim was on ward eight at James Cook University Hospital in Middlesbrough, one of the few specialist NHS treatment centres in the region for patients with alcohol-related liver problems.
That was last summer and after a week of specialist detoxification treatment, which involved a cocktail of drugs and vitamins designed to get him off booze and boost health, Jim was ready to meet Jill Emmerson.
Jill is a cheerful, positive and highly experienced senior nurse who for the last five years has worked with problem drinkers from Teesside, South Durham and North Yorkshire at the Middlesbrough unit.
As one of the region's few specialist alcohol nurses, Jill's job is to help problem drinkers to either quit the demon drink completely or - in a small minority of case - cut back so that drink no longer rules their lives.
In Jim's case, she was a lifesaver. "She advised me to never drink again. It has not been easy but my life is so much better without booze. People think drinking makes you feel better but I can tell you that is a load of rubbish. I feel great."
Jim still sees his old pals but drinks water or other non-alcoholic drinks. He is particularly popular because he always volunteers to drive when his mates go out for a drink.
Jill is delighted at Jim's progress. Many of her patients do well after they are discharged, thanks to regular appointments and follow-up phone calls.
But not every story has a happy ending.
"There is no doubt we are getting more and more people referred to us with alcohol-related liver damage," says Jill. "Not everybody makes it and we have recently seen more and more deaths of patients in their early 30s."
Twenty years ago it was unusual to have more than one or two people on the ward with cirrhosis of the liver. Now it is common to have the victims of alcohol abuse occupying half the beds on the 30-bed ward.
Professor Mike Bramble, a consultant gastroenterologist, who was in charge of ward eight for several years until recently becoming medical director of the South Tees Trust, says the increase in cirrhosis cases, including many women, is very depressing.
He believes alcohol is too cheap, encouraging excessive drinking, and is opposed to the recent relaxation of the licensing laws. And he contrasts the significant recent investment in services to support people who abuse drugs with the "pathetic" level of investment in treatment and support services for people who abuse alcohol.
"Many of the people we see are young, in their 30s and 40s, and many of them die because of liver damage caused by alcohol," says Prof Bramble.
"You don't get a new liver unless you stop drinking and many cannot give up because they are truly addicted."
There is more hope for those who are not physically or psychologically dependent on booze - and that is where Jill Emmerson comes in.
"Jill has been a really powerful addition to a team which tries to get these people to stop drinking. She provides a lot of support," he says.
Prof Bramble would like to see more invested in providing an extended range of treatment and support services to people with drink problems, though he admits that it is difficult to decide where NHS resources are best spent.
"You could spend £10,000 on anti cancer drugs which would give someone two more months of life or spend the same amount and get 100 people off alcohol. That is a policy decision," he says.
Jill also feels more should be done to support those who are trying to overcome serious drinking problems.
"Services on the alcohol side are pretty poor compared to the drugs side. There is very little money and no mechanism to refer them on," says Jill, who is hopeful that new day centres could open in the near future.
The Department of Health points out that a total of £15m will be spent on improving alcohol treatment services between 2007-8, including an extra £3.2m for new initiatives designed to intervene early with people who may be damaging their health with alcohol.
That expenditure can't come too soon for Mick Davies, who manages the Tunstall Unit, the region's only specialist detoxification and rehabilitation unit in Sunderland.
Mick is frustrated that many of the beds at his specialist unit are unoccupied at a time of soaring demand from problem drinkers, including growing numbers of women.
"We are getting ever-increasing numbers of people who have suffered long term harm through alcohol abuse and who need help and support," says Mick. "We are missing anything like an effective strategy to deal with alcohol problems in this country. There is almost a complete absence of resources or adequate treatment arrangements."
With some of the highest levels of problem drinking in the country, people in the North-East struggle to get help," he says. "It is a real postcode lottery in the region. In terms of funding, there are huge differences between one authority and another and between PCTs."
"We have beds lying empty when we have a massively increased population of people with serious alcohol problems."
Dr David Walker, acting regional director of public health, agrees that treatment facilities are poor in the UK compared with many other western European countries but points to a marked change in drinking habits in the last decade which have put pressure on the NHS.
Former alcoholic Jim agrees, believing from harsh experience that society as a whole needs to get real about the damage being done by alcohol abuse.
"It is everywhere you look - when you turn on the telly everybody in the soaps are drinking. It is not just the health problems it causes, it is the accidents, the fights and the drink driving. Drink is wrecking a lot of lives."
THE FACTS ABOUT BOOZE
Every year around 40,000 people in the UK die from drink-related illnesses
Latest Government guidelines advise men to drink no more than 28 units of alcohol a week and women not to exceed 21. (A unit is a small glass of wine, a half pint of ordinary beer or a single measure of spirits. Strong lagers can have up to four units in a single pint).
Men who drink between 21 and 50 units a week and women who drink between 14 and 35 units a week are believed to be at risk of health problems. Drinking above those limits is considered to be dangerous.
New figures show the number of people dying from cirrhosis of the liver (usually caused by excessive drinking) in the UK is rising at a faster rate than anywhere else in western Europe.
A total of 430 people died from alcohol-related disease in the North-East last year, compared with 339 in 1997. In North Yorkshire, the number of deaths jumped from 39 to 54 during the same period.
Alcohol consumption in the UK doubled between 1960 and 2002.
About one in ten heavy drinkers are believed to be at risk of developing cirrhosis of the liver, an irreversible scarring of the liver which can only be 'cured' by a transplant.
Drinkers are advised not to drink for two days after a particularly heavy night to give their liver a chance to recover.
Apart from cirrhosis of the liver, heavy drinkers are also at increased risk of mouth cancer, heart attack and stroke.
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