Accessing timely, effective treatment
Studies by the Health Research Board (HRB) have found 14.8% of the population in Ireland – 578,000 people, show evidence of an alcohol use disorder (AUD), with 90,000 of those having a severe AUD problem.
International evidence suggests that at any one time, 10% of those in need may seek treatment. The most recent data from the HRB (2021) shows that in 2021 there were only 3,017 new cases treated for alcohol use problems. The total number of cases receiving treatment was 6,859. These figures are staggeringly low for a country where so many people are drinking problematically.
Clearly, given the scale of the problem, alcohol treatment is not getting the resources required for a problem that causes so much harm not only to the individual, but to families and communities.
Addiction services (drugs, alcohol, gambling) are currently funded at a level of approximately €103 million annually while the wider costs of alcohol to the State are estimated at least at €3.6 billion.
Research shows that people who access treatment for alcohol have likely experienced trauma at some point in their lives and have some sort of mental health need. Issues can include domestic violence, abuse, parental problem substance use, poverty and bereavement/ loss, all of which contribute to poor mental health.
Accessing timely, effective treatment for problem alcohol use is crucial for recovery, but very many barriers to accessing treatment too often stand in the way of getting help.
Barriers people face are on a spectrum from simply not knowing what’s available in terms of help and how to access it, to the lack of timely provision of services across all stages of recovery such as detox facilities and aftercare. For women there are also very specific issues such as childcare and the fear of having children taken away because of their alcohol problem.
On top of all of this, they may be experiencing issues such as domestic abuse, financial struggles and grief, not to mention stigma for having the problem in the first place. Research shows that women with a drug or alcohol dependence disorder report significantly higher levels of stigma than men. Indeed, fear of stigmatising experiences is one of the most reported factors hindering women from accessing substance use treatment.
AAI advocates that a national strategy should set out the types of interventions that constitute best practice and develop national standards against which services can be evaluated and monitored. In particular residential treatment services, like all other residential health-care services in Ireland, should be monitored by HIQA. Person-centred trauma-informed services would ensure that people’s rights are at the centre of policies and practices.
The need for specialist services for at risk populations must be investigated without delay, as set out in the national drug and alcohol strategy, for example, international research makes a case for specialist services for older people.
Some of these issues were discussed at an AAI webinar, Access to Alcohol Treatment: Removing Barriers to Healthcare.
For information on support services contact HSE Drugs and Alcohol Helpline.
Freephone 1800 459 459 for confidential information and support.