Tuesday, May 27, 2008

Local authorities shirk responsibility in treatment of alcoholics

Public health officials say that people seeking treatment for alcohol abuse are clearly in worse shape than a few years ago. There are queues for long-term treatment, even though there is no actual shortage of available treatment facilities.
One problem is that municipalities are cutting costs by refusing to sign vouchers for alcohol treatment, even though doctors see an urgent need for the treatment.
Finnish drinking habits are also changing. Near teetotalers are becoming “moderate drinkers”, while former moderate drinkers are becoming heavy consumers.
“As the number of heavy consumers grows, the damage caused by alcohol accumulates on that group”, says Kalervo Kiianmaa, research professor at the National Public Health Institute. This is seen in increased pressure on public health clinics and treatment centres.
“The quantity is decisive”, Kiianmaa says. “Some have wanted to believe that by encouraging the consumption of mild drinks rather than spirits, it might be possible to reduce the harm that is caused, but in spite of this development, the damage has just increased.”

The growth in problems has also been noted by the National Research and Development Centre for Welfare and Health (STAKES), which makes an annual survey of visits to health centres in which intoxicants were involved in one way or another.
Last October's survey showed more than 12,000 such visits. In about 90% of the cases, alcohol was the drug that was used.
In the previous such assay, in 2003, the number was 10,946.
Pressure is also on home services. With older people, the use of alcohol, which might have been problem-free previously, can prove to cause problems later. The body becomes more frail, and medicines can bring surprises.

The need for longer-term treatment has increased, and there are queues for treatment.
“The shortage of money in municipalities is also a problem”, says Pekka Puska, Director-General of the National Public Health Institute. “Occasionally, existing vacancies for treatment are not utilised.”
“When a problem has emerged over years, even decades, it requires long and repeated courses of treatment”, says STAKES development chief Airi Partanen. “Unfortunately, local authorities call them into question.”
Pekka Heinälä, head physician at the A-Clinic Foundation, says that he has seen situations recently in which doctors say that the need for treatment is clear, but the municipality rejects the idea.
“Sometimes it can happen that the customer does not want any dealings with the local authorities, because the lady next door works at the municipal office.”

The threshold for seeking treatment has risen, and it can also be seen. “Those seeking help today are in much worse shape than a few years ago”, Partanen notes.
Private treatment facilities are available for those with enough money. “Their share will undoubtedly grow”, Heinälä predicts.
Now local authorities deal with more than half of the treatments of alcohol addicts. The A-Clinic Foundation handles about 40%, and private care takes care of 10%.

Failure to intervene in time can lead to cirrhosis of the liver. For researchers, cirrhosis mortality is a key indicator of the prevalence of alcohol problems in a society.
Nobody gets cirrhosis without being an alcoholic”, says Kalervo Kiianmaa.
In 1970 there were 200 deaths of the liver disease in Finland. Now the annual death rate is about 1,000.
Not all alcoholics succumb to cirrhosis - only about one third. Nevertheless, the figures suggest that the number of alcoholics has increased at least fivefold.
In 2006, 3,049 people in Finland died of alcohol-related causes. About 2,000 deaths were attributed to diseases and accidents caused by drinking.

Alcoholism radiates to a very wide area”, Kiianmaa says. “It also often causes a chain reaction of social problems. Drinking causes problems at work; a person is fired, which leads to economic problems, which cause marginalisation.”
“Alcoholics are also a burden on the health care system. Intoxicated people are prone to accidents, and drinking causes diseases. About 11,000 people are on disability pension because of ailments caused by alcohol”, Kiianmaa says.
He sees only one way to reduce the harm caused by alcohol: consumption needs to be reduced.

Kiianmaa proposes immediate and tough measures against youth drinking. “Now it is too easy to acquire drinks that are favoured by the young. Beer and cider are available anywhere and at any time, and young people consume them a great deal.”
source: www.helsinginsanomat.fi