
Harish Rao is a specialist registrar and honorary consultant at the South Essex Partnership NHS Foundation Trust. He works as a higher specialist trainee in addictions in East London. He has published research on stigma and additive disorders. Jason Luty is a consultant psychiatrist in addictions at the South Essex Partnership NHS Foundation Trust. He has an honorary contract with the Cambridgeshire and Peterborough Mental Health Partnership NHS Trust. His research is based on the effects of adult attention-deficit hyperactivity disorder and stigma in people with substance-use disorders.
Correspondence: Correspondence Dr Jason Luty, The Taylor Centre, Queensway House, Essex Street, Southend-on-Sea, Essex SS1 4RB, UK. Email: sl006h3607{at}blueyonder.co.uk
Around 7.1 million people in England drink hazardously or harmfully and a further 1.1 million are dependent on alcohol. Motivational interviewing is widely used to treat people with alcohol problems and is probably the best described example of a brief intervention. However, some recent trials have been disappointing. Specialised alcohol treatment services have also suffered from weakness in the evidence base. Investment in treating alcohol misuse has fallen far behind that for drug misuse. The Department of Healths Alcohol Harm Reduction Strategy for England embraces policies that are high-profile and cheap but are ineffective and ignore many effective measures. It recommends stepped care for alcohol treatment, but unlike the equivalent for drugs treatment, it sets no targets and leaves the small (7%) increase in funding to the discretion of local purchasers. UK spending on specialised treatment for drug misuse is estimated to be around £600 million for 2007 – around three times the estimated cost of treatment for alcohol misuse.
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