Drinkers in detox at Christmas

'IT'S nice to get up in the morning and brush your teeth without wanting to throw up," says Kev, a recovering alcoholic who has chosen to spend this Christmas at a drugs and alcohol rehab centre in Sunderland.

Kev, a tall, rangy man in his late 30s, reckons at the height - or should that be the depths - of his most recent descent into hell, he was drinking a quite astonishing amount of booze.

"Every day I was putting away about five bottles of seven per cent proof cheap wine and a couple of bottles of whisky on top of that," recalls Kev, ruefully.

"I would start drinking at six or seven in the morning, really, anything I could get my hands on. I would just drink and drink to the point of oblivion."

This is the third time that former shipyard worker and builder from Hebburn, South Tyneside has been 'dried out' at the Huntercombe Centre, a former care home which was turned into the region's only privately run drug and alcohol detoxification and rehabilitation centre more than a decade ago.

On the two previous occasions the good work of the detox centre was rapidly undone once Kev went home.

But this time his local authority has agreed to pay for Kev to stay on for a full 12-week residential rehabilitation course.

"I have done a couple of detoxes in here but the rehab was not funded so I just went home. It was a bit upsetting because the staff didn't want me to leave and I was doing so well," says Kev, who shrugs when asked about how he got into drinking.

Kev says he has been surrounded by heavy drinking and heavy drinkers all of his life.

"It's hard to get away from drink. If you switch on the telly there are adverts for drink coming at you all the time," he says.

Most people referred to the Huntercombe Centre for alcohol detox by NHS doctors are discharged after they have completed their treatment but without the underlying reasons for their drinking addressed by rehabilitation.

This is because rehabilitation is classified as social care rather than health care and many North-East local authorities are not willing to pay the fees.

Mick Davies, business development manager for the Huntercombe group of health care businesses, is the former manager of the Sunderland unit and is acutely aware of the problems caused by the split between health care, which is funded by the NHS, and rehabilitation which is discretionary.

It reflects the gulf between the money available to treat drug users - which is guaranteed as part of the Government's drugs strategy - and the relative lack of funds put into the treatment and support of alcoholics.

Mick is grateful the Government has poured millions into helping people who abuse drugs but questions whether the balance is right considering the North-East's biggest substance abuse problem is with alcohol.

"We have six beds, mostly used by clients with alcohol problems and eight mostly used by drugs clients," he says.

"We also have 20 rehabilitation beds. The detox side is mostly drug clients and that reflects the fact that the National Drugs Strategy is funded while the alcohol strategy is focused on control and prevention and does not actually say much about treatment."

Detox is mostly paid for by the NHS while rehab is overwhelmingly paid for by local authorities.

"For drugs clients the local Drug Action Teams pay. They are partnerships between the health service, local authorities and education authorities and the money comes out of what is known as the pooled treatment budget," says Mick.

But on the alcohol side, while it is usually possible to get clients referred for detox, they may have to wait longer than drug clients before being admitted.

On the rehab side, few local authorities are willing to pay for the 12-week residential course, even though the experts who run the centre feel this is particularly beneficial for clients who are coming off alcohol.

"With drug clients we can usually stabilise them on a heroin substitute like methadone, but alcohol clients actually have to come off the booze and there is nothing to help them, he says.

Gateshead and South Tyneside Primary Care Trusts are particularly good at commissioning beds for alcohol clients at the Huntercombe but many other North-East PCTs with comparable drink problems in their populations lag behind.

'On the alchohol side you really have a vast difference in provision from one area in the North-East to another, ranging from really good to completely disastrous," says Mick.

"This is because there is no central government diktat which defines what should be happening and the PCTs are not performance tested."

Jeanette Cornell, a senior nurse at the Huntercombe Centre, was drawn to this kind of work because of experiences in the lives of people around her. She says it is "a quite wonderful" place to work and is very rewarding.

But, like Mick, Jeanette is concerned that her alcohol clients do not get the longer-term support they probably deserve.

"Professionally, it is frustrating. When some of them leave here you know they are going to start drinking again," she says.

"The underlying psychological and social problems which led them to drink are still there. Rehabilitation will help those clients, otherwise many of them will self-medicate by picking up the bottle."

"Apart from undoing all the good work of detox, it also seems a terrible waste of money. It is a waste of resources because if you don't tackle the issues that cause people to drink and simply pay for detox, there is a fair chance that it will fail and they will start drinking again."

On the drugs side, one of the biggest problems is addiction to diazepam tranquillisers, or 'blues'.

"It is easier to get them off heroin than drugs like diazepam," says Jeanette.

Many drug clients are addicted to alcohol and a string of other drugs and have to be weaned off one drug at a time.

Despite the physical toll drink takes on people, Jeanette marvels at how quickly clients can feel and look much better.

"Alcohol clients can look better within three or four days. After a week, they can be different people," says Jeanette.

But only about 20 per cent of those who come in for alcohol detox - which includes giving clients diazepam to prevent fitting and reduces anxiety while they are coming off booze - stay on for rehabilitation because of lack of funding.

Christmas is always a difficult time for some drinkers and quite a few of those who are currently undergoing rehab at the Huntercombe have opted to stay in.

Kev is looking forward to enjoying a Christmas party without having to cope with the hangover from hell.

"It doesn't bother me that I am in for Christmas. A lot of people are staying here. We can have our own party. You can be daft and have a laugh without having a drink," he says.

Marilyn, a 54-year-old publican from the Durham area who is undergoing alcohol rehab, has opted to spend Christmas Day with her daughters but is happy to spend the rest of the festive season at the Huntercombe Centre.

"I was apprehensive about coming here but it is lovely," she says. "Everybody has been so supprtive. I feel like I have had a big bag of potatoes taken off my shoulders."

Kev is also planning to see in the New Year at the centre.

"Christmas is bad enough for people like me," he says.

"But I'm afraid the New Year is just too much of a temptation."