This study was carried-out across the whole of Scotland and assessed the availability of and the need for specialist alcohol treatment services.
The study identified a number of problems within Scotland’s alcohol treatment services. It was found that delays in access to detoxification were a significant issue. This was caused by a shortage of access to prescribing GPs, and lengthy waiting times for residential detox services. Limited access to psychiatrists was also mentioned.
The effect of delaying treatment and detox for an alcoholic, is that any initial motivation for treatment can rapidly fade. This was noted in the report – “staff struggle to keep service users motivated.”
Professor Jonathan Chick, Medical Director at Castle Craig Hospital, welcomed the report but noted the lack of any reference to the implementation of SIGN Guideline 74, or NICE guideline CG1115. These clinical guidelines both recommend that patients should actively be linked to mutual aid groups such as Alcoholics Anonymous.
In fact mutual aid is mentioned in passing in the introduction of this MESAS report, but not once thereafter. In one of the report’s case studies there is a section about “peer-led recovery” which makes a passing mention of SMART Recovery. Overall it would seem that the link between treatment and mutual-aid has been overlooked, and should be carefully reviewed in future reports.
One point that stood out for Peter McCann, Chairman of Castle Craig, was a reference made in the report to alcohol support workers “learning on the job”.
Peter McCann commented, “It would have been useful if this issue had been explored in greater depth. What are the qualifications of these staff members? Is this practice widespread? How are these workers supervised? How is it judged when the learning is complete? This gives rise to serious concerns about the quality of care being provided in some communities. I suspect that treatment is being provided on the cheap and I doubt if it is safe or effective.”