Heavy drinkers
... and alcoholics
It happened in September. Paul Hill’s wife had left him, and in due course the divorce came through. He moved out of the house they shared, and rented a room overlooking Shepherd’s Bush Green in west London.
Hill, 31, worked in publishing but the job didn’t interest him. On leaving work, he went straight to the pub. One Friday, shortly after his birthday, Hill didn’t go home.
It was a mild night, and after the pubs closed he carried a bag containing about a dozen cans of beer onto the Green. Sitting among trees, he avoided the attention of other drinkers, mostly teenagers, who were fighting and running among the traffic.
In the morning he returned home to change his clothes, and lay on the floor for a while. Then he got up for a slice of toast – and a beer. By 11 o’clock, he was ready for a few drinks at the pub before the Premier League match for which, as a season ticket holder, he had a reserved seat.
Not long after the match kicked off, at 3pm, Hill phoned a friend. Not just any friend, but someone he’d known as long as he could remember – me.
After little preamble, Hill told me he’d had enough. He mentioned the divorce, and spending his birthday alone. Then, at the top of his voice – shouting to be heard over the din of the football crowd – he said he was going to kill himself.
I suspect that many readers of this newspaper have had to deal with similarly desperate phone calls, if only because excessive drinking, in Britain, is so widespread. According to figures released this week by the Department of Health, some eight million people among us are problem drinkers. That’s one adult in six.
Not all of them threaten to kill themselves, of course. But nor do they all get into fights, urinate on a stranger’s doorstep, engage in drunken sex in town centres, or beat their spouses. Many lead respectable middle-class lives.
They might very reasonably be described, as one commentator put it this week, as “middle-aged, middle-class people who sit smugly at home with their bottles of wine watching TV programmes about Britain’s booze culture and shaking their heads in disgust”.
On the phone to Paul, I begged him not to do anything rash and after hanging up I found a phone number for the Priory. But the kind of rehabilitation provided to celebs was too expensive, I discovered. I was advised to call Alcoholics Anonymous.
I had never imagined that the AA could have anything to offer people in my own close circle. I thought of it as an organization at once comic and desperate. But I had recently come to know a recovering alcoholic, a successful man who seemed to have overcome his problems after being dry for many years.
This colleague joked about the AA as a kind of “parallel universe”, much like the Freemasons, whose members can be found in every walk of British life.
He’d told me there were smart meetings full of prosperous middle-class people meeting at lunchtimes in the City. Celebrities tend to attend meetings in Chelsea, he said. And in Notting Hill there are meetings dominated by trustafarians.
So I phoned the AA’s main London number and told the woman who answered what had happened. She told me Paul must call the AA himself.
I drove to see him. I was shocked by the squalor of his home, and the powerful odour of alcohol he gave off – but I tried to hide these feelings. Over the next hour or two, I assured him that I, for one, cared for him and couldn’t bear the idea of his suicide – and that I was sure many other friends felt the same way. That was only half-true. That fact is that his behaviour, over the years, had reduced those “many other” friends to just a few.
I urged him to call the AA, and summarized what my colleague had told me about it. As I left, I pressed into Paul’s hand the AA’s phone number, scribbled on a Post-It note. I doubted that he would call.
Drinkers such as Paul Hill have usually been left out of government drives to tackle Booze Britain. Not any more.
A 10-year plan to change Britain’s drinking culture, announced this week, identifies three groups of problem drinkers – children, 18- to 24-year-old bingers, and “harmful” older drinkers who consume alcohol at home.
Many of them don’t seem to realise how much they are drinking. When the Office for National Statistics surveyed how much people drank, responses indicated an average of 10.8 units a week – equivalent to 5.6 litres of alcohol a year. But HM Revenue and Customs data shows that the average annual amount bought by each adult is nearly twice as high.
Professor Ian Gilmore, director of the Royal College of Physicians, says: “Many of us drink more than we care to admit.”
Drinking to excess is classified as regular drinking of at least eight units a day for men or six units for women. A unit is half a pint of beer or a small glass of wine. Successful people who routinely down a bottle of wine – or more – every night, may think this sounds paltry. Many will resent ministerial interference.
One who does is Janet Street-Porter: “There is a huge difference between an alcoholic and a heavy drinker,” she said this week. “Heavy drinkers don’t expect the government to intrude into their lives.”
Addressing this concern, the health minister Caroline Flint said: “This isn’t a crackdown on middle-class wine drinkers per se. It’s about saying if you are drinking over the limit on a daily basis, you could be storing up problems for yourself down the road.”
It’s no use pretending that nothing needs to be done. Cirrhosis of the liver has increased 700 per cent in men and 800 per cent in women over the last 30 years. And there are other grave health risks. Thousands of people die every year from alcohol-related heart disease, strokes and cancer.
“The problems are getting worse,” says professor Roger Williams, who treated the late footballer George Best.
There are other costs. Hospitals annually treat around a million people who have been injured after drinking excessively. And some 17 million working days are lost each year to hangovers and drink-related illness, representing a loss to employers of around £6.4bn.
Then there’s alcohol-related crime: that’s officially reckoned to cost between £7bn and £12bn a year. Half of all violent crime is alcohol-related.
We have a puzzlingly contradictory attitude towards alcohol in Britain, and move seamlessly from cheering heroic drinkers to tutting and pouting our disapproval. After England won the Ashes, everybody seemed to think it admirable and funny that the star of the team – my distant cousin Andrew Flintoff – went on an epic bender. But this week the same player was primly accused by the team captain of irreparably damaging team spirit, during the World Cup, by capsizing a pedalo while drunk.
One reason for our inconsistency may be that – despite Street-Porter’s contention – there’s little evidence of a clear difference between alcoholics and heavy drinkers.
“Most experts have rejected the ‘disease’ concept of alcholism,” says Professor Nick Heather, emeritus professor of alcohol and other drug studies at Northumbria University. Instead, they take the old-fashioned view that drinking excessively is merely a bad habit.
The disease theory has been promoted, these critics say, by profit-making alcohol treatment-centres and drug manufacturers. The lifelong-disease theory, says another, “excuses alcoholics for their past, present and future irresponsibility.”
The argument about whether excessive drinking is a genuine illness isn’t merely hypothetical. If alcoholism is not a disease, and so-called “alcoholics” are to blame for the state they get into, should the NHS withhold treatment from them? If so, does that mean also withholding it from people who would never consider themselves alcoholics but merely wine buffs, connoisseurs of the single malt, or as Street-Porter put it, “heavy drinkers”?
Setting aside the question of disease, it’s clear that drinking habits are also cultural. In Japan, it’s common to see salarymen getting smashed and sobbing into each others arms. That’s less common, obviously, in Islamic states where alcohol is forbidden by strict laws. Germans and Scandinavians drink heavily, but the French and the Italians are not believed to do so.
The “culture” that determines these differences consists of many small details. As a matter of policy, British pubs overheat their premises to make people thirsty; provide salty snacks, for the same reason; and play music too loud for conversation, so that drinking becomes a way to conceal conversational awkwardness. By ceasing to promote drinking that way, the industry could reduce drinking levels.
Two years ago, the government argued that getting rid of the old 11pm closing time would stop people drinking up in a hurry. Drinkers would no longer mass on the streets all at once, ministers said, and town centres would become civilized again.
Many people opposed 24-hour drinking, including Professor Heather. “British drinking habits have been built up over centuries,” he told me at the time, “and are not likely to be affected much by a few media campaigns. The fact is that making alcohol more available by increasing opening hours will inevitably lead to a higher level of consumption which will in turn lead to an increase in alcohol-related harm, which is already at an unacceptably high level in this country.”
But the evidence suggests that the reforms have helped – a bit. Mark Hastings, of the British Beer and Pub Association, points out that the amount we drink has fallen for the last two years. In the last 12 months, it fell by more than 4% – the largest fall for 30 years. So maybe the new plan, to interfere with older drinkers, will be more successful than critics suggest.
And there are lots of critics. Some such as Street-Porter resent the plan. Others such as the British Medical Association think it doesn’t go far enough. The alcohol treatment charity, Addaction, warns that problem drinkers in some parts of the country may need to wait up to a year for support through programmes funded by primary care trusts. “We have waiting lists of up to four months just for an initial assessment,” says a spokeswoman.
But official programmes aren’t the only option, so why wait? For a week after I visited Paul Hill at home, he didn’t call the AA. But then, for reasons I’ll probably never understand, he did.
He went to one meeting, then another. Suddenly he was going every day, and talking at length about the AA and its celebrated 12-step programme. With support from strangers who have been through much the same experience, he stayed sober for a week, then a month, and now nearly five years.
I called him this week to ask if he minded me writing about what he went through. He agreed, because like most heavy drinkers he used to deny he had a problem, and he’s keen to pass on how the AA helped him.
“People who drink say they can quit any time, but how will they know until they try? I tried to stop drinking about four times, and never managed more than three weeks. The last time I did it my ex-wife said she preferred me drinking.
“Being an alcoholic and not drinking is difficult on your own. Without AA I would be either dead, in jail or in a mental hospital. I have no doubt about that. I had a clear choice between suicide and getting help.”
10 June 07
A big well done for your article “ just one bottle away”.
I am a member of A.A. and found your article most uplifting in that it shows A.A. in the true light of it’s life saving but completely free service !!
— steve edwards · 12 June 07 · #
Thanks v much Steve. I remain v close to Paul Hill (not his real name) and feel incredibly grateful to the AA, or rather its many members, for helping him to transform his life. PS. this story appeared in the Sunday Times under the headline “Just One Bottle Away.”
— john-paul · 14 June 07 · #