Alcoholism and Drug Dependence: A Multidisciplinary Approach

470 Pages·1977·15.59 MB·English

by  M. J. Akhtar (auth.)

ALCOHOLISM AND
DRUG DEPENDENCE
A Multidisciplinary Approach
ALCOHOLISM AND
DRUG DEPENDENCE
A Multidisciplinary Approach
Edited by
]. S. Madden
Mersey Regional Addiction Unit
Chester, England
Robin Walker
Walton Hospital and Fazakerley Hospital
Liverpool, England
and
W. H. Kenyon
Merseyside Lancashire & Cheshire Council on Alcoholism
Liverpool, England
PLENUM PRESS· NEW YORK AND LONDON
Library of Congress Cataloging in Publication Data
International Conference on Alcoholism and Drug Dependence, 3d, Liverpool, 1976.
Alcoholism and drug dependence.
"Proceedings of the third International Conference on Alcoholism and Drug De
pendence held in Liverpool, England, April 4-9, 1976."
Includes index.
1. Alcoholism-Congresses. 2. Drug abuse-Congresses. I. Madden, John Spencer.
II. Walker, Robin. III. Kenyon, W. H. IV. Title. [DNLM: 1. Alcoholism-Congresses.
2. Drug abuse-Congresses. 3. Drug dependence-Congresses. W3 IN166 1976a/
WM274 16123 1976al
HV5009.158 1976 362.2'9 76-30574
ISBN-13: 978-1-4684-2339-6 e-ISBN-13: 978-1-4684-2337-2
001: 10.1007/978-1-4684-2337-2
Proceedings of the Third International Conference on Alcoholism
and Drug Dependence held in Liverpool, England, April 4-9, 1976
© 1977 Plenum Press, New York
Softcover reprint of the hardcover 15t edition 1977
A Division of Plenum Publishing Corporation
227 West 17th Street, New York, N. Y. 10011
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted,
in any form or by any means, electronic, mechanical, photocopying, microfilming,
record ing, or otherwise, without written permission from the Publisher
FOREWORD
It is for me, as President of the Merseyside Lancashire &
Cheshire Council on Alcoholism, a signal privilege to write a brief
foreword to these Proceedings of the Third International Conference
on Alcoholism and Drug Dependence.
During the week experts, from the world over, in all those
disciplines which have a contribution to make to the solution of the
problems of alcoholism and drug dependence, surveyed recent advances
in our knowledge of the aetiology, epidemiology, early recognition,
management, and the social and industrial implications of these
twin scourges of the contemporary scene. The discussions were most
helpful and enlightening even when a wide spectrum of conflicting
views and experiences were revealed.
The justification for adding yet another volume to the growing
literature in this field is two-fold; first, that those taking part
in the conference can study at leisure and in depth the
transactions of the conference; and secondly, that those who were
unable to attend might benefit from the most recent views of
international experts in the diverse facets of one of the major
current problems in world health.
LORD COHEN OF BIRKENBEAD
CH, PRSH, MD, DSc, ScD,
LLD, DCL, FRCP, DL, JPo
CONTENTS
Introduction . . • . . . . . . . . . . . . xiii
J.S. Madden, R. Walker, and W.H. Kenyon
Opening Address to the Conference
M. Meacher
SECTION I
GENERAL
Sexual Disorders in Male Alcoholics 3
M.J. Akhtar
Vitamin B12 and Folic Acid in Chronic Alcoholics . . . . .. 15
E. Heilmann
Porphyria Cutanea Tarda in Chronic Alcoholics 19
E. Heilmann
Physical Complications of Alcohol Excess-Metabolism
of Alcohol . . . • . . . . . . . . . . • 23
D. Owens
Is Illegal Drugtaking a Problem? . . . . . . . . . • • . .. 35
M.A. Plant
Alcoholism and Drug Dependence - A Multidisciplinary
Problem: The Sociologist's Viewpoint •.•.
D. Robinson
Alcohol and the General Physician 57
R. Walker
Denial of the Hidden Alcoholic in General Practice . . . .. 63
R.H. Wilkins
vii
viii CONTENTS
SECTION II
AETIOLOGY AND EPIDEMIOLOGY
The Validity of Per Capita Alcohol Consumption as an
Indicator of the Prevalence of Alcohol Related
Problems: An Evaluation Based on National
Statistics and Survey Data ••.•••• 71
A.K.J. Cartwright, S.J. Shaw, and T.A. Spratley
On the Need to Reconcile the Aetiologies of
Drug Abuse . . •• . • . . • • 85
C. Fazey
Drinking Patterns of Young People 95
A. Hawker
Alcoholism and Psychology - Some Recent Trends
and Methods • • • • • . . • • • . . . • • • • . . • • • 105
G. Lowe
A Psychiatric View of Substance Dependency • . • • • . . . • • 115
J.S. Madden
How Important is Alcohol in "Alcoholism"? • . . . . . . . . . 123
R.J. McKechnie
Social Circumstances of Non-Convicted vs Convicted
Drug Users ...••. 139
C.E. Reeves
The Pathological and the Subcultural Model of
Drug Use - A Test of Two Contrasting Explanations . . . 151
K.H. Reuband
Unemployment and Sickness Absenteeism in Alcoholics ..•.. 171
E.S.M. Saad
Alcohol Problems in Women . • . . . . . • . . . . . . . . . • 181
A.B. Sclare
The Aetiology of Dependency . . . • • • • • . • • . . . • • . 189
F.A. Seixas
CONTENTS ix
SECTION III
TREATMENT
A Pilot Controlled Drinking Out-Patient Group . . . . . . . . 199
D. Cameron
Programming Alcoholism Treatment:
Historical Trends . . . . . . . . . . . . . . . . . . . 209
R.M. Costello
A Young Problem Drinkers Programme as a
Means of Establishing and Maintaining
Treatment Contact .................. 227
B. Coyle and J. Fischer
Family Focused Treatment and Management:
A Multi-Discipline Training Approach . . . . . . . . . . 239
J.P. Flanzer and G.M.St.L.O'Brien
The Young Alcoholic - Approaches to Treatment . . . . . . . . 263
P.D.V. Gwinner
Detoxification - The First Step . . . . . . . . . . . . . . . 271
J.R. Hamilton
The Treatment of Drug Dependence -
A Taxonomy of Approaches. .............. 277
I. Hindmarch
Aims of Treatment . . . . . . . . . . . . . . . . . . . . . .. 293
B.D. Hore
Controlled Drinking in the Alcoholic -
A Search for Common Features. ............ 297
T. Levinson
A Programme of Group Counselling for Alcoholics . . . . . . . 309
J. S. Madden
The Ontario Detoxication System: An Evaluation
of its Effectiveness 321
R.G. Smart
x CONTENTS
SECTION IV
REHABILITATION
The Role of the Probation Service in the
Treatment of Alcoholism . . . . . . . . . . . 331
T. Crolley
An Analysis of Clients Using Alcoholic Agencies
within One Community Service • . . . . . . . . . . . . . 335
S.D. Delahaye
Co-ordination and Co-operation . . . . . . . . . . . . . . . . 351
B.D. Hore
The Problem - Its Magnitude and a Suggested
Community Based Answer to Alcoholism . . . . . . . . . . 355
W.H. Kenyon
Methodological Problems in Evaluating Drug Misuse
Intervention Programmes .. . . . . . . . . . . . . . . 369
M.A. Lavenhar
Planning for the Future - Developing a Comprehensive
Response to Alcohol Abuse in an English Health
District . . . . . . . . . .. .......... 379
T.A. Spratley, A.K.J. Cartwright, and S.J. Shaw
The Featherstone Lodge Project - Phoenix House.
One Method of Rehabilitation . . . . . . . . . . 387
D. Warren-Holland and S. Warren-Holland
The Co-ordination of Care in the Field of Alcoholism . . . . . 395
E. Wilkes
SECTION V
PREVENTION AND EDUCATION
The Role of Legislation in Diminishing the
Misuse of Alcohol ...... .......... 401
C. Clayson
The Need for and Some Results of Evaluation of
English Drug Education . . . . . . . . . . . . . . . . . 409
N. Dorn
CONTENTS xi
Developing a Co-ordinated Approach to
Interprofessional Education ...•........ 417
M. Grant
Alcohol Control Policy as a Strategy of
Prevention: A Critical Examination
of the Evidence . • . . • . • . • • . . • • . . . . . . 425
J. de Lint
Parents, Children and Learning to Drink . . . • . . . . . . . 451
R.J. McKechnie
Alcohol and Education . . . . . . . . . . . • • . . . . . . . 457
E.B. Ritson
Chairmen . . 465
Contributors 467
Index 471
INTRODroTION
The allied conditions of alcoholism and drug misuse are
attracting increasing attention in an expanding number of
countries. In Liverpool a tradition has been established of
holding conferences on these subjects at local, national and
international level. The list of sponsoring organisations for the
larger conferences includes the International Council on Alcohol
and Addictions, Lausanne and Liverpool University Department of
Psychiatry and was strengthened for the third international
conference held in 1976, by the Alcohol Education Centre, London.
This conference drew participants from 18 countries. Its
theme centred on the importance of a multidisciplinary approach,
and so allowed a wide spread of subjects to be covered by lecturers
from ma;ny professional backgrounds, who sometimes held
challengingly diverse points of view. The speakers included a
legislator, psychiatrists, specialists in internal medicine,
general medical practitioners, psychologists, social workers,
sociologists and an anthropologist. Their topics were ranged
from causation and prevention, education, and prevalence patterns
of alcohol and drug usage, to treatment and rehabilitation.
The reader will find much evidence to support the view that
the per capita rate of alcohol consumption of a nation intimately
affects its incidence of alcohol problems. The hopeful corollaxy
of this concept is that the amount of beverage alcohol consumed
wi thin a state is amenable to government intervent ion by legal and
fiscal measures. But the situation is not clear cut; contributors
from Scotland point out that their country has a distinctly more
extensive alcoholism problem than neighbouring England and Wales,
yet Scotland has more restrictive licensing laws and only a
marginally higher level of alcohol consumption. Different
attitudes and culturally determined reactions to the taking of
alcohol contribute to the differing incidences of alcoholism
between communities, and must not be overlooked in the search for
preventative devices.
xiii