Living on cloud wine

Alcohol is the only hard drug British society insists you take – “go on, one drink won’t hurt you”. Alcoholics are the only addicts British society refuses to take seriously – “an alcoholic is someone you dislike who drinks as much as you do” – said Dylan Thomas, before the booze killed him at 39. And alcoholism is the only sickness British society pretends doesn’t exist – “I’m a drinker not a drunk,” said my friend Christopher Hitchens as he reached for the whisky bottle again.

You cannot expect effective treatment for a sickness society chooses to ignore. Health provision for alcoholics has become a pitiful thing under the one-party rule of Tories in Westminster and Scottish nationalists in Edinburgh. I accept that treatment is pitiful for all types of drug addicts: at a huge cost to them, their friends, their families, the victims of crime, the health and police services, and the taxpayer.

Alcoholics are different because the state doesn’t treat their dealers as criminals

But alcoholics are different because the state doesn’t treat their dealers as criminals. The government does not invite the Sinaloa Cartel into Whitehall to advise it, any more than Fifa invites heroin manufacturers to sponsor the World Cup. All other hard drugs are either illegal or, in the case of tobacco, taxed to high heaven and shunned by the middle class. I have never heard a host or hostess spit: I am so sorry but if you insist on dosing yourself with wine you must take your filthy habit into the garden.

Until I went clean in the 2010s, I was what the old Fleet Street called “a big drinker”, which meant that, if I was not an alcoholic – the British maintain that no one is until they are sleeping on a park bench – then at least an alcohol addict. As are you, if you cannot go a day without a drink or binge until you are insensible.

Tory and SNP indifference is scandalous precisely because I know from experience that addiction raises two formidably difficult questions that require professional help to tackle.

I doubt the ten million or so people in the UK who drink more than the recommended guidelines think of themselves as addicts

Why do some people become addicts when others can enjoy hard drugs in moderation? And why can some go clean when others cannot?

Under relentless lobbying from the alcohol industry the government has tacitly agreed with the drink industry’s answer that addiction is the addict’s fault. Like a shabby squaddie on the parade ground, they must smarten up and pull themselves together. Until they do, they’ve no one to blame but themselves.

Today’s alcohol and indeed gambling companies follow the tactics of big tobacco in the twentieth century. The Institute of Alcohol Studies showed in September 2022 how the drinks industry persuaded government to put “the onus on individuals to act ‘responsibly’,” and shifted blame for addiction onto consumers.

I doubt the ten million or so people in the UK who drink more than the Chief Medical Officer’s guidelines think of themselves as addicts, and I expect most believe they have the strength of character to give up any time they choose.

They don’t choose to do so now because alcohol is such a cheap and easy drug to acquire. The Labour Government of 1997-2010 applied a “duty escalator” – a commitment to increase alcohol duty rates each year in real terms. The Coalition Government stopped the escalator in 2013, and to widespread applause cut or froze duty on cider, beer, wine, and spirits year after year until 2021. As the cost of beer fell by a fifth, our government spent a decade in power floating on a sea of cheap booze. Perhaps Conservatives thought that keeping the electorate pickled was an effective means of reconciling the populace to their rule. I certainly found them harder to take after I sobered up.

No one really knows why some alcoholics break free and others stay imprisoned

In 2013, the year it began to cut duties, the government also passed responsibility for public health from the NHS to local authorities. NHS spending was ringfenced. It kept pace with inflation, if not with rising medical costs and the rising demands of the elderly population. Ministers promised they would keep the ringfence on public health spending on alcohol and drug treatment once it moved to local control.

They lied.

Although overall alcohol consumption has fallen in the 21st century, as the young decide not to imitate their parents, the number of deaths specifically caused by alcohol hit its highest recorded level in 2021.

As the suffering has grown, the Local Government Association reports that ministers have cut public health budgets by 24 per cent on a real-terms per capita basis.

Of course, if you believe that addiction is a matter of personal choice, the loss of counsellors and psychiatrists is no loss at all. But then if you think that, I suggest in all politeness that you have never been an addict yourself.

Let’s not glamorise alcoholism with stories of Raymond Chandler, Dylan Thomas and Ernest Hemingway. Most addicts are poor people leading desperate lives. They drink too much for the same reason others eat too much, or smoke or inject too much. They want an escape. The dirty secret of the alcohol industry is that it makes its money from the poor addicts (and if you are not poor when you begin your addiction, you are likely to be by the time it takes hold). All the glossy adverts for Tennessee bourbon, all the high-class wine columns in prestige newspapers hide the fact that, as surely as drug dealers on the streets of Glasgow, alcohol manufacturers’ best customers are addicted customers who need to buy their product continuously.

Alcoholism is not only a blight on the poor. Alcohol relaxes drinkers and overcomes their inhibitions, which is why so many insecure people of all classes have turned to it, writers especially it seems. Perhaps it is just addicts’ fault for lacking the will to go clean.

The alternative disease theory of alcohol is an offshoot of the most extraordinary self-help organisation of the 20th century. Founded in 1935 by Christian revivalists in the US, my atheist soul revolts at AA’s appeals to alcoholics to submit to a “higher power”. The enterprise reeks of Bible Belt piety. Yet at least AA is there for alcoholics, when the public health authorities are often absent without leave. And at least its creed that alcoholics can find a cure helped develop the idea that alcohol was a disease that could be treated. By removing stigma, AA encouraged people to admit they had an addiction.

I didn’t always believe in the disease theory. My worst side, my harrumphing and, well, saloon-bar side, dismissed it as self-serving drivel. Now I am not so sure. Supporters of the disease theory can point to the undoubted fact that alcohol changes the structure of the brain. Doctors I have interviewed speak of patients who are in agony yet still cannot give up. They are as helpless as patients in the final stage of cancer.

If the causes of alcoholism are controversial, arguments about possible cures are worse. No one really knows why some break free and others stay imprisoned. Helping addicts is hard work. Most addicts relapse after the first attempt. They need personal attention from voluntary or state-employed counsellors. This is why the decline of public health provision is so disastrous.

One manager for a local authority substance abuse team, speaking on condition of anonymity, told me that even Whitehall knew how badly it had behaved and was now offering a little more money. “Counsellors and managers are burnt out, massively burnt out,” he said. “There’s no such thing as a caseload cap in addiction services. We have people with caseloads of 100-plus. There’s no way they can provide a personal service.”

The next time newsreaders tell you with conspiratorial smirks that the government has frozen alcohol duties yet again, ask yourself how many crimes cheap booze will cause, how many road deaths, cancers, wrecked lives and relationships, and wonder why this country still smirks along with them.

Nick Cohen writes for the Spectator and the Critic. “Writing from London” by Nick Cohen can be found at nickcohen.substack.com