Alcohol Use Disorders (104) Do people understand the harms of alcohol? (18)

27 February, 2024

Dear All,

The discussion, points, angles, questions ... are coming thick and fast it is difficult to keep up.

Many thanks for the summaries; and of course the discussion which archived also acts as a resource - repository.

I wonder whether the question: "Do people understand the harms of alcohol?" must always be placed in context?

It is radically different when asked of the tee-total, dry, safe drinker; and someone (still) actually in their alcohol drinking?

It occurs to me that alcohol, even more so than 'other' substance misuse (heroin...) represents what must be *the* contradiction, paradox in healthcare - except the tragic loss that is suicide.

Contrast substance misuse inc. alcohol, with 'help-seeking' and 'The Sick role'

Decision to consult and how in mental health, the mental capacity act is actually being misapplied policy-drift):

Previously, I highlighted how as a Community Psychiatric Nurse 1985-1995 (adult) .. if a patient/client was not working to control/reduce their alcohol consumption they may be 'counselled' re a pending discharge and referral back to their GP - family physician. In supervision with the team's manager they would want to know what is 'happening'. It being important not to create (social) dependency, or worse support someone in their alcohol misuse.

There was a sense, still is(?) that in substance misuse (across forms) - the individual has to reach 'rock-bottom', literally the 'gutter' that is the point they decide (really?)* to live, or carry on to die.

Is this is trope/myth?

What is the current strategy?

In terms of 'HIFA' - and the person that counts*, not only do they not have the 'information'; they do not have the EXISTENTIAL INFORMATION as it relates to them: 'Health Information for YOU'! 

-----Again in Hodges' model we can contrast the dichotomy/polarisation of INDIVIDUAL :: GROUP.

The model's being situated; and able to encompass data, information, knowledge (facts, for example, and their delivery) - wisdom (Multi-contextual / transdisciplinary..).-----

I admire people who work in these services (learning disability and palliative care); as they must be severely tested as they retain an ability - the humanity to 'see' the person whatever the patient's situation and their lack of awareness (capacity..?) of its critical salience.

(RTs greatly appreciated here too TY.)

Peter Jones

Community Mental Health Nurse and Researcher Blogging at "Welcome to the QUAD" h2cmng at

HIFA profile: Peter Jones is a Community Mental Health Nurse with the NHS in NW England and a a part-time tutor at Bolton University. Peter champions a conceptual framework - Hodges' model - that can be used to facilitate personal and group reflection and holistic / integrated care. A bibliography is provided at the blog 'Welcome to the QUAD' ( h2cmuk AT