WHAT is the image that pops into your head when you think of alcoholism? Well, for many people alcohol dependence conjures up a profile from the more severe end of the spectrum of this illness.

I certainly remember studying about it at medical school, often seeing it as a problem mainly affecting middle-aged men and mostly associated with poorer social backgrounds, drugs, violence, homelessness to mention a few of the stereotypical profiles associated with alcoholism.

Whilst some of these may be true, it does not represent all of those people who are struggling with alcohol dependence in 2021, especially as we review the impact of alcohol on people during the pandemic. This has become a serious problem and we need to tackle it head on.

Alcohol dependence is a disease and people suffering from this are in urgent need of compassion, understanding and support. No longer can we assume that if it does not affect you directly, it is not your issue. Alcoholism is a societal problem and one that is increasing at a rapid pace.

This week we learnt that deaths directly related to alcohol have risen to their highest in Scotland in more than a decade. How worrying is this? Sadly I am not surprised by this data as I have first-hand seen the number of patients who have presented with problems with alcohol over the last 18 months and they are far from the stereotypical profiles we are used to imagining.

There were 1190 alcohol-specific deaths last year in Scotland which is the highest number registered since 2008 and this is heartbreaking because these are deaths that could have been prevented. I have lost patients and I have even lost two close friends to alcohol dependence syndrome but had they been able to come forward and know that they would receive the help and support they needed, they would still be here today. We can do better. We must do better.

Over the pandemic we all experienced unprecedented stress. Whether it was the uncertainties, anxieties, isolation, job losses, financial strains, boredom…everyone has had their share of challenges. Being forced to socialise virtually made it more and more acceptable for people to celebrate “wine 0’clock” or “gin-time,” often drinking at home alone. The Tik Tok trends seeing mums portray the comedic home-schooling scenes armed with bottles of booze to see them through – we are starting the see the effects of this in our surgeries. What starts off in cases as an occasional drink can quickly in the, face of adversity, become a more frequent indulgence or coping mechanism.

I have had patients using alcohol to help them sleep or to help with their mental health whilst others have been managing their high levels of stress with alcohol but didn’t see the problem as they have remained functional.

Alcohol is creeping into people’s everyday lives, into normal behaviours and becoming a silent killer and the data is backing this up.

In Scotland, we have made some progress in times gone by but sadly any progress and interventions previously placed did not hold up to the challenges of the pandemic and the latest figures must be a wake up call for urgent intervention.

Proposals to further raise the minimum pricing per unit of alcohol or narrowing the price gap of alcohol in supermarkets to those in pubs are welcome suggestions but they do not address the acute issue; the huge number of people currently in crisis.

We need to do better in educating society about the way we view those struggling and raise awareness of the scale of the issue so early recognition of red flags takes place. Often people can struggle alone in silence and not seek support or help by which point it can be too late.

Primary care services need to have more access to allied healthcare workers as a matter of priority to be able to refer patients for early intervention rather than have them waiting for months for reviews by secondary care services.

I believe we have not yet seen the true extent of the fallout of the pandemic with regards to dependence and addiction issues. I can also say that there are many people struggling but functioning with alcohol dependence and feel they cannot come forward for help which worries me.

So, I write this in an attempt to evoke some reflection on how you interpret alcohol? What is your own relationship with it? Do you suspect it is an issue for someone you care for? Is it something you hold judgement for, or do you view people with alcohol dependence as suffering from an illness in desperate need of help?

How can we change the narrative and conversation to be more compassionate and supportive to those struggling and lastly for the government, what are you going to do to help these people now?