Reviewing guidance on alcohol misuse disorders, I see that UK National Institute for Clinical Excellence (NICE) has 3 documents on this topic. All are worth reading. One focuses on alcohol-related disorders, one on harmful use and dependence itself, and one on public health approaches including screening. The most striking point is how common alcohol harmful use is in UK, with figures in excess of 20 of adults. The term harmful use itself is defined here by the World Health Organization in ICD-10:
A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (e.g. hepatitis following injection of drugs) or mental (e.g. depressive episodes secondary to heavy alcohol intake). Harmful use commonly, but not invariably, has adverse social consequences; social consequences in themselves, however, are not sufficient to justify a diagnosis of harmful use.Another striking feature is both the prevalence of depression and anxiety symptoms among those who are dependent on alcohol, and how most people find these symptoms resolve within a month of stopping the alcohol use. NICE has clear guidance on screening and management. I would like to see more done to help people with these disorders.
