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General chat about alcohol


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Alcohol

[ from 'Street Drugs' (1st edition, 1984 New English Library ISBN 0-450-05832) - Andrew Tyler ]


For anyone caught in possesion of a joint or, for that matter a wrap of heroin, the special, almosthalted place alcohol occupies in our society will be a perpetual irritant. What other drug can florafull-grown man within half an hour is so freely available, so freely advertised and dressed up nt s drug - with all the concomitant health implications - but as a happy social lubricant?

The case of alcohol is exceptional in regard to the hundreds of thousands of 'problem drinkers' - aod proportion of whom die early - and the thousands more who get mangled on the roads in drink-reltdaccidents. Yet it is not so easy to dismiss a drug that has been a good companion to people all ve te world for thousands of years, calming nerves, lifting spirits and conjoining groups in merryinsbrity.

When we speak of 'alcohol' we are referring to beverages that are for the most part concoctions of voured water, with the alcohol content of that water amounting to no more than 40 percent in whisk n as little as 3 percent in beer. Consumed in this way, alcohol inevitably gets rated by most peoleasless awesome a substance than it really is. This feeling is reinforced by the fact that neithe al no spirits lend themselves to comfortable injection; the pure undiluted stuff never has been tied ntraenously on a grand scale even by the most ardent users.

Alcohol gets its special place in society because of its particular intoxicant effect. In unshacklinormal social restraints of behaviour it causes an initial lift in spirits. But, fundamentally, iti stupefying drug. It provokes no contemplation or dreaming experiences as do LSD and certain 'maic mshrooms, and while there are other drugs that are equally unastounding and thus safe in their ercvedeffects, these either came along after Western society had drawn up its 'approved' drugs lis, orin erly times they were too closely identified with the diabolical pagans of the new world to e accpted.
Only the Moslems have decided to shun booze completely. Prohibition works - at some considerable co- in the Islamic world, but elsewhere temperance and prohibition movements have only modified the rg pattern of use. Accepting this fact, other societies create a fabric of rules and rituals that ak mss use of the drug more manageable. To further this process they also put the shutters up on oherstrng intoxicants, except when used in a medical context. The justification of such action come viaan eaborate mythology that says alcohol is less dangerous than it is, and other drugs much mor so. t proably doesn't need to be stated again that alcohol is potentially physically damaging, asaddictve andas hazardous to withdraw from as practically any other intoxicant substance.

Because a whole range of drugs have seeped out from the surgeries or from the Third World growers o the streets, it is becoming more and more difficult to sustain the lie that alcohol is the one masrcreational drug in use, and the new ones - illicit or not - on the market are merely a temporaryabertion. This is like pretending the motor car isn't really a major form of transport - that we'r stll iving in the horse age. For good or bad, alcohol is now only one part of the story.




2.1] What is it?

Alcohol is a hydrocarbon compound derived from fermented sugar. The chemical polite people drink ishyl alcohol, composed of the elements carbon, hydrogen and oxygen. More dispirited types resort tomtyl alcohol whose legitimate uses are as solvent in paint stripper and as an anti-freeze. The attacio of methylated spirits (a combination of methyl and ethyl alcohol) is that you can get drunk ceapr. ne drawback is that the intoxicant rating is lower than regular drinking alcohol. The methan in ethy alcohol (commonly called methanol) also upsets vision - sometimes in a total and permanen way.A thid option for alcohol fanciers is iso-propyl alcohol, found in after-shave preparations ad toilt wates. These are sometimes drunk straight like a shot of scotch, though this is consideredless sohisticaed than splashing it on one's face.

So it is ethyl alcohol (otherwise called ethanol) that is the intoxicant factor in the beers, winesd spirits, liqueurs, etc. that we consume so abundantly.

2.2] Beer

There are three main types of beer - the traditional English ale, the heartier stouts and the lightright lagers that are the premier choice in most other parts of the world, and increasingly so in rtin. The major raw material in all is malted barly, made by a process of germination during whichstre compounds are converted into fermentable materials. The germination is arrested by kilning ordryng,and the malt then extracted with a hot liquor to produce a sweet wort. This wort is now boild wih hos to produce typical bitter compounds and to precipitate unwanted protein. The hopped wortis net cooed and pitched with yeast. Fermentation is allowed to proceed and this produces a green eer whch awats conditioning. 'Real' ales are those that are left to condition in the cask and are till alve whenreaching the pub. The sanitised version is pasturised , filtered and chilled to deat in the rewerieswhere it will be packaged in kegs, bottles and cans. Lager is a variation on the ae theme, alling fo a different type of yeast and a longer, colder storage and conditioning period.Stout is ether made rom a more deeply coloured malt or from barley that is mot malted at all, but oasted. Guiess is an eample of the latter.

2.3] Cider and wine

Cider is made from fermented apple juice. Wines are fermented grape or other plant juice. Sparklingrts, such as champagne, undergo a secondary fermentation during which the by-product carbon dioxid sretained in the bottle under pressure.

Fortified wines like sherry, port, Madeira and vermouth combine wines with either brandy or neutralirits, as well as flavourings.

2.4] Spirits

The potency of spirits, as any adult from planet earth must know, is considerably greater than eithwine (which is about 10 to 12 percent alcohol) or beer ( 2.5 to 9 or so percent).

Spirits range from 35 percent of total volume to 75 percent in the case of certain highly inebriatirums. They are made by literal 'spiriting' away of the alcohol from the flavour base in which it st.Alcohol boils at a lower temperature than water, so if an already fermented liquid such as grapewie s heated in a vat, the alcohol spirit will be released before the solution that contains it ca evporte. The spirit is then trapped and cooled. Its character will depend on the style in which i is oile off. If done quickly in a continous process a neutral, featureless spirit will result, suh as in orvodka. Various flavourings can then be added to pep up the taste (juniper berries in gin or itcan besold straight as per vodka.

If the distiller wishes to preserve the special quality of the original fermented material (grape b for brandy, barley and corn for scotch) then the boiling up is done more slowly, and the result i noble' spirit. After distillation, the noble ones must be aged in wooden casks for several years MltWhiskey is at its best only after ten years, and the best cognac need fifty to peak. But sincesuc a iddlesome cannot produce a beverage within the price range of the world's masses the distillrs wll ee out the precious noble nectar by mixing it with cheaper, mass-produced 'neutrals'1. Frenh grae brady, for instance, is made by mixing noble cognac with industrial alcohol distilled from he EECs winelake, while blended scotch, like most Irish whiskys [ compilers note: this would seem contraiction n terms - scotch is Scottish whisky not Irish whisky (I have an Irish side to my famly and hve witnesed heated after dinner debates on the matter...) ] , takes the classier route of ixing potstilled mlt with grain whiskey that has been 'continuously' produced2. Also falling betwen the neutal and nobe traditions is bourbon whisky, popular in the States, which is continuously dstilled fro legally spcified grain and then aged in casks. Rum can be straight neutral, though thi too is someimes aged inwood.

2.5] Liqueurs

Liqueurs are spirits buoyed up with various and usually secret combinations of herbs. In some casese process starts with the fermentation of herbs in sugary water - a mixture which is then distille.Smetimes the herbs are added to the spirit after it has been extracted. Their origins lie in herbl edcines concocted in the Middle Ages.

2.6] Congeners

Congeners are chemicals vital in determining the taste, smell and appearance of an alcoholic bevera Present in tiny quantities in virtually all drinks, they are a natural part of the fermentation poes. Among the most omnipresent are tannic acid, fuse-oil, ethyl acetate, various sugars, salts, mneal and B group vitamins. While they play no part in getting you drunk they probably contribute t may o the typical hangover symptoms - headache, wobbly stomach, drowsiness. The amount of congenes ina gien drink depends on its base material as well as the manufacturing process. The drink withthe lwest ating is the neutral spirit vodka. Also low in congener ratings are gin and beer. Vastlymore cngenerloaded is bourbon, while wine falls somewhere in middle range. But contrary to the noton thatred wins hurt more in the morning than whites, it is the latter which contains the bigger qantity o an espeially noxious congener called acetaldehyde.

2.7] Potency

There are two popular methods of indicating the potency of drinks. The simplest is to specify a pertage of alcohol by volume. The one that is guaranteed to confuse is the proof system. This dates bc o the days when spirits were graded using gunpowder. Water and gunpowder will not ignite, but alohl nd gunpowder will. When mixtures of alcohol and water are soaked in gunpowder there is a pointat hic enough alcohol has been added to the solution to enable it to blow up. When it reaches the ointthe olution has 'proved' itself and is known as 100 degrees proof (100?). This has been found o be t 57.5 percent alcohol. However it is possible to produce spirit drinks in excess of 100? prof as wll as elow it. Typical British whisky is 70? proof (approx. 40% by volume). To compicate maters, th Americn proof system rates differently from the British. It has nothing to do with gunpwder; evry two dgrees proof equals one percent alcohol.

2.8] 'Standard' measures

If working that out gives you a headache, the British Health Education Council has devised a simpleethod of rating drink power. This establishes rough equivalents between different types of beverag,s allowing people to determine how much alcohol they are consuming. The comparisons are crude, bu teywork out as follows :-
one half pint of ordinary beer/lager =
a single mesure of spirits =
a medium glass of wine =
a small glass sherry, vermouth, etc.

The term used for any of these is One Standard Drink.

2.9] Sensations

Aldous Huxley had a high-minded angle on what drunkenness was all about when he wrote, 'Sobriety diishes, discriminates and says No. Drunkenness expands, unites and says Yes. It is in fact the grea xiter of the Yes function in man... The drunken consciousness is one bit of the mystic consciousnssan our total opinion of it must find its place in our opinion of the larger whole.'

Too true, although it helps to be sober when approaching that particular passage. It is also a factat while alcohol might excite the Yes function it also releases the No function, the Maybe functio n the Get-the-hell-out-of-my-way-or-I'll-stick-you-in-the-eye function. Inhibitions that normallycudl the belly jump out when drunk. It is because of this releasing action that alcohol is often clle a timulant when, physiologically, its effect is to depress the central nervous system (CNS). Dsinhbitin comes at low doses and most social drinking doesn't go beyond this point. In most cases he atosphee will be all the happier for having dispensed with the leg-irons of etiquette, but in crtain etting an inebriated group can perform the kind of mercilessly cruel acts that wouldn't be cuntenaned whensober. Its members become attracted to a certain course of action and little impressd by posible santions. Football gangs are a case in point.

From the very first drink there will be a deterioration of the mental and physical performance and, the dose is increased, these functions are progressively dulled. Death from respiratory collapse ol ultimately result. On the way, memory, body coordination, the senses, concentration and judgemet il all go.

Occaisionally drivers or machine operators insist that their performance is actually enhanced by a ple, but such claims are a product of their ailing judgement which ails all the more as they contiu rinking. The biggest boasts come from s/he who is most hammered.

Some people exhibit more obviously drunken symptoms than others. A lot depends on socisl setting anhe way the individual chooses to steer the experience. Someone sitting alone in a rented room is ulkly to get garrulous, witty and amourous. Similarly, a heavy drinker at work will do his/her besttococeal any signs of excess consumption. Saturday night down the pub is something else.



There we are more likely to see the traditional excitement, emotion and perhaps a little kick-fight if the stimulation - real or imagined - is present. Men who terrorise their wives after drinking oi some respects have a pharmacologically-based 'excuse' (disinhibition, lack of judgement etc.) bt n eality the violence wasn't put there by alcohol, it was simply let out.

2.10] Capacity

A person's level of drunkenness depends on the concentration of alcohol in the body. Sobriety is reered when the alcohol is discharged. It follows therefore that people will get more drunk if they aein high levels quickly. It also follows that they will sooner be able to walk the white line agan f hey can hurry the alcohol out of their body. In terms of alcohol absorbtion we don't all startoutequl. Women absorb it faster than men, as do lean individuals against the obese or muscular. Thre ae oter factors that affect the rate: food slows it down, especially carbohydrates like bread ad pottoes.Milk does, too. But while getting drunk can be slowed or quickened, sobering up works ata steay, unvrying rate. Generally speaking, the average-sized male takes approximately one hour torecoverfrom On Standard Drink. This time scale relates to the work rate of the liver, the organ whch metablises 90percent of alcohol. The balance is peed out unchanged or excreeted in breath and i sweat. I emergenc cases hospitals have been known to inject fructose - a simple fruit sugar - to peed up th metabolisng, but this is risky unless done by trained personnel. Coffee has some merit n stunning eople awake but it won't improve coordination or judgement, so driving is still hazardos.

2.11] Health effects

It need hardly be stated that the majority of people handle their drink well enough, causing no inj to themselves or to others. This illustrates the comparatively mature attitude we have towards th rg. But when things go wrong, then the implications for health are serious.

2.12] Hangovers

There is some debate about the part congeners play in laying on the traditional head-thumping sympt. Some believe congeners are most of the problem, but it seems clear enough that dehydration also ly a large part. Alcohol is a powerful diuretic, prompting water to vacate the body cells and accuultein the blood. As to hangover cure, the best one is to avoid further irritating the stomach wit moe dink or explosive foods. A cup of hot water (already boiled) sometimes helps. Otherwise, rela andin fve to ten hours you'll be on the up.

[ compilers note: my favorite hangover cure is to drink 2-3 pints of cold water and the soak in a hoath for an hour or so, but the list of ideas is probably endless... :-) ]

2.13] Alcohol with other drugs

Doctors warn against taking alcohol in conjunction with most other CNS depressants such as barbitua, tranquillisers and the opiates, scince the action of one is accentuated by the other. Alcohol tae ith heroin is especially dangerous: there is a possibility of vomiting while in a coma. Alcohol ls racts adversly with MAOI drugs (see appropriate chapter), and anti-histamines.


Cannabis is fine with alcohol, although the dehydrating action of both drugs (as well as the awesomevels of stupidity obtainable when using both) casts doubt on the worth of taking the drugs togethr-'Smoking grass and drinking beer is like pissing into the wind... '- Freewheelin' Franklin ( Th Fbuous Furry Freak Brothers ? G Sheldon/Knockabout Comics).

2.14] Pregnancy

Babies, being a product of their parents and everything they consume, run a risk of damage when one both of those parents indulges in heavy drinking.

So far practically all measurements and research have been done on women, but if the child can haves father's nose it can also bear the scars of its father's alcohol habit. The most carefully examie onsequence of parental drinking is what is known as Fetal Alcohol Syndrome. This term was coinedinth 1970's, although the condition has been recognised for centuries. Generally the baby when delverd wll be small and light, and a year later will still be under par. Facial features are also ditincive:including a broad, flat midface, low nasal bridge, short upturned nose, and 'mongolian' fods atthe iner corners of the eyes. Mental impairment is the most serious outcome of the full syndrme. Alhough he link with alcohol is proven, the risk is believed to be small. Large numbers of hevy driners delver entirely normal babies.

2.15] Drinking and driving

A word of warning to drivers about the creeping-up syndrome. The legally permitted amount of alcoho driver can have in his/her bloodstream is 80mg per 100ml. This will be accumulated from about fiv tndard Drinks (although it can be as low as three) fairly smartly consumed. If such an amount is akn t lunchtime a residue will still be present in the blood at going-home time. If, before gettin beindthe wheel, the driver should take a top-up it could send him/her over the legal limit. More mporantl, it could get an innocent person injured or killed. Blood alcohol levels can be worked ou by lokingat amounts consumed at a given time, set against the work rate of the liver. (Bear in mid thatit is ossible to be registered drunk while driving to work the morning after a heavy session.

2.16] Body heat

Alcohol causes the blood vessels near the surface of the body to widen, leading to heat loss. For sone falling down drunk out of doors on a cold night this can prove fatal. The elderly who drink ar lo much more prone to hypothermia.

2.17] Long term heavy drinking

In regard to longer-term effects, alcohol intrudes into numerous illnesses either as the actual cauor as a complicating factor.

The DHSS (this is the British 'Department of Health and Social Security') notes3 that up to thirty cent of men currently admitted to hospitals are either 'problem drinkers' or physically dependant nacohol. Among the dependant ones the death rate on a comparative age basis is twice as high as th rstof the population. Nutritional and digestive troubles may be the first signs of illness arisin frm polonged heavy drinking, for although alcoholic drinks do contain small amounts of iron and mgnesum ad some of the B vitamins, their principal food value is sugar, i.e. empty calories. Consumd on op ofnormal eating, drink will deliver excess flab. Taken instead of food - which is the styl of may serius drinkers - malnutrition will follow. This can be aggravated by further loss of appeite as resultof inflammation of the stomach lining (gastritis) together with sub-normal absorptio from th gut caued by irritation of the bowels. Vomiting, nausea, loss of appetite and diarrhea ar common wrning sigs of damage.

The best known consequence of heavy, long-term drinking is cirrhosis of the liver. It usually takesom 10 to 15 years to develop and presently (1984) kills about 2,500 people each yer in the UK. Altog this is a low rate compared to, say, France, since 1970 the number has been climbing fast. Cirross s a progressive and potentially lethal condition in which changes in the fat content of the lier amaes its cells, which are then replaced by scar tissue. The problem with the scarring is that t cus of the blood supply to those areas responsible for producing and storing nutrients. Alcohol s notthe sle cause of liver cirrhosis. Indeed, some researchers prefer to blame it on malnutrition pointng to high incidence among prisoners of war. Nonetheless, as with smoking and lung cancer, hile th relatinship isn't exclusive, it's a close one.

Other parts of the body suffer from prolonged heavy drinking. Bron-chitis, pneumonia, tuberculosis diseases of the heart may all occur more frequently.

More research is also being done into alcohol's effect on the brain. It is now understood that the at organ shrinks from imprudent drinking, causing intellectual impairment. Evidence for an increasdrsk of certain cancers is also turning up. The parts most vulnerable are the tounge, mouth, throa, oie box and liver.

The other major physical ailment resulting from heavy use is called peripheral neutritis. This is tcondition that has alcoholics missing their step and crashing to the ground. Basically it's about ev fibres being starved of vitamins and, as a result, failing to perform properly. The condition miny ffects the toes, feet, fingers and hands. It starts with tingling and progresses to numbness. reamen is by rest an vitamin B therapy.

Apart from this catalogue of physical hazzards, alcoholism also inspires a range of maladies that acts the emotional life of the user and those closest to him/her. Typically, the can be anxiety, dersion, guilt, paranoia, memory blackouts, agitation and, quite often, violence visited upon the spus. t is not an exaggeration to say that the impact on the home life of a heavy drinker is the heaies ofall.

2.18] Alcoholism

Alcohol is much like any other potent mind-altering drug in that a proportion of those who use it w return to it too often and with too much relish so that a tolerance to the desired effects develos f this attachment isn't controlled the tendancy is to keep on increasing the dose, which strengten te bond and weakens the mind and body. A point is reached where to be without the drug is to suferdepivation. This syndrome can be called dependance or addiction, but in the case of alcohol it as mre uually been called alcoholism. An equivalent term would be heroinism or benzodiazepinism. Snce te 196s alcoholism has been thought of and treated as a disease - one that could be defined inmedica terms

The disease idea was a reaction against older notions that said heavy drinkers were weak or bad peo, but the notion is now falling from fashion. 'Disease', it is being argued, is a rigid concept thtpomotes rigid systems for dealing with it. It suggests some alien factor eating away at the passie icim, whereas 'alcoholism' allows for a host of psychological and physical moving parts that var frm prson to person and over which the 'victim' can and does have control. More contentiously,it i nowbeing stressed that total abstinence may not be advisable for some chronic drinkers, unles theyhave xtensive liver damage; it would be better to get the dose down and steady. This coincide with he intllectual drift among workers dealing with other drug problems. With it goes the demystfying o the meical apparatus: the 'treatment' centres, the detox units, perhaps even the rehabilittion houes. And s those balloons are pricked the hope is that all kinds of people in society will nderstandmore full the causes of dependence, and how it can be handled. A government-commisioned rport in 199 was follwing just this line when it stated: 'Treatment is not an answer to alcohol prolems. Servies cannot cpe now and are never likely to be able to. And not all those who are offeredtreatment wil benifit. Hlp can be given to alcoholics by people in a wide range of different capacties and not ust by those n the medical profession... The main task is to develop services so thatawareness of acohol problemsamongst those coming into contact with alcoholics is enhanced, and thespectrum of faclities is brougt to bear on those who may benefit from them as early as possible.

Platitudes? The translation into something tangible depends on how serious 'society' intends to be. the exisiting treatment modules are rubbished to the extent that the government has an excuse to ulout the fiscal plug then we could be left with nothing but platitudes to offer the problem drinkr.

2.19] Sudden deaths

As with other CNS depressant drugs, an extremely high dose of alcohol quickly consumed can kill. Ag there is no amount you can point a finger at and say: this much is lethal. It depends on constituinand how much tolerance has been built up. However, anything in excess of one bottle of spirits i oe out and death is a possibility. Alcohol has other ways of despatching people in a hurry. It isoftn afactor behind murders, suicides and accidental deaths. Drownings and alcohol are a common du, asare rink and road casualties. One-fifth of all road deaths are related to excessive drinking, nd th youn male, above all, is frequently disposed of in this way. Alcohol plays a part in about hlf theroad acidents involving males aged 15 to 24.

2.20] Withdrawal

Once a person is physically dependant on alcohol the problems incurred by suddenly withdrawing suppare as severe as from any other drug. They are almost identical to the results of barbituate withdaa, including the risk of convulsion, hallucination, and delirium. The first symptoms can occur a ewhors after the last drink, typically with the morning shakes. A drink will steady these. If one s nt frthcoming the alcohol dependant will get increasingly jumpy or agitated, unable to hold a cu or ie alace. While in the throes of the shakes something like a quarter4 will suffer accompanyinghalluinatins. They'll probably be short lived and take the form of distorted shapes, moving shadow, snathes ofmusic or shouted remarks. In this state, note Kessel and Walton in their classic littl volume Alcohoism5 the sufferer will be prone to reading threats into the most casual glance or reark frominnocentbystanders. More awesome still is the condition known as delirium tremens. This, tey say, 's one of he most dramatic conditions in the whole calender of medicine.' Kessel and Waltos own desciption canot be bettered.

'The symptoms are florid. There is great restlessness and agitation. In the hospital ward the patie weak as he is, may have to be restrained by two or more people before he can be got into bed. He snver still, tossing and turning restlessly, constantly engaged in conversation, switching from peso t person, from subject to subject at the smallest stimulus and frequently shouting salutations nd arnngs to distant passers-by. His hands, grossly tremulous, clutch at the bedclothes; continuouly h tris to pluck from them imaginary objects, shining silver coins, burning cigarettes, playing ards r bedbugs. He is prey to ever-changing visual hallucinations and may shield his face from meaacing r attaking objects, animal or man. He is completely disorientated. He may not know where he s, the ime of ay, the date or the month.

'No words can do justice to the picture of fully developed delirium tremens during the hours or dayefore the patient falls exhausted into a deep sleep. He generally emerges from this little worse adwth his memory for the recent events mercifully blunted.'

Left to run their course, the DT's can generally take three to four days, but drugs can ease the suring. The main dangers arise from other illnesses that might be present at the same time, and fro osible convulsions. They can prove fatal if unattended. Also, a frequently registered cause of dethisthe inhalation of vomit.

2.21] Earliest use

To trace the history of alcohol consumtion is to trace the origins of human history itself... There reasonable evidence to show beer and berry wine being drunk as far back as 6,500 B.C. (some say 900B.C.)6 while the first historical account of alcohol production is an Egyptian papyrus dated 3,50 .C The distillation of spirit is thought to be merely a thousand years old...

2.22] Help

Bad drinking habits derive from a dangerous spiral. They could have their roots in social ritual thgot out of hand, or in pain. Good drinking habits derive from understanding - understanding what achl is and its potential for good and for harm. Good habits also derive from self-awareness and th dtemination to confront problems and overcome them in a healthy way.

There is a range of statutory services to help in this regard, financed by central as well as localvernment. There is also an important voluntary sector that - as in the non-alcoholic drug field - osantly walks the fiscal tight-rope. The main plank of the government's response are the AlcoholicTratent Units (ATUs) which are usually sited in the psychiatric departments of major hospitals. Thy nrmaly include a detoxification unit, and although the tradition has been to hospitalise patient, may ar developing out-patients services in an effort to 'go into the community'. ATUs have neversucceded i serving the whole of their designated catchment areas or so other hospitals sometimes tke it pon thmselves to service the problem drinker either in the phsychiatric or general wards. GP also ly on a ervice of sorts but, like social workers, they tend to be a less able to recognise dink-relaed problms and/or unwilling to get involved when they are spotted. Probation officers are ore sharpsighted ad the probation service does get involved in the running of special hostels. Butit is thorugh the vountary sector - that part which is neither securely funded nor responsible undr statute -that the maor facilities are laid on. There are, for instance, about forty local Councis On Alcoholsm which proide information, advice and counselling as well as refferal to special car facilities. person may smply show up with or without a doctor's letter. Then there are several rsidential 'dry houses where roblem drinkers can live-in for six months to a year and grapple with heir problems. ome, like Turnig Point and Aquarius, run units in different parts of the country. Acoholics Anonymos is a mutual hep group that is entierly self-funded and organises small local gaterings which meetall over the counry, usually weekly but sometimes more often. It works on the Tweve Steps to Recovey principal - emplying a certain amount of spiritual deep-thinking and the unshaeable belief that lcoholism is a 'disase' rather than a simple indulgance. AA's kith and kin are l-Anon - for the famlies of problem driners, and Al-Ateen - another mutual support fellowship for een drinkers.

The other important services are the handful of detoxification units used by single homeless to dryt in, and by the authorities as an alternative to prison. There are just three in the whole countr U).

2.23] Footnotes

1 Nicholas Faith, 'Gentlemen's War: A survey of the world's trade in distilled spirits', from Economist 22/12/1984

2 Ibid

3 'Drinking Sensibly', Dept. Health and Social Security, HMSO Books, London, 1981, pg.12

4 N.Kessel & H.Walton, 'Alcoholism', Penguin, 1965, pg.34

5 Ibid

6 'High Times Encyclopedia of Recreational Drugs', Stonehill Press, New York, 1978, pg.91
 
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