Two reports released recently in Scotland and Ireland show that there is an immense lack of treatment services for people and families with alcohol use problems.
People needing services have had to wait for a long time to receive support and even then those receiving support are significantly fewer than the number of affected people suffering from alcohol use disorders in the family.
But the reports and WHO as well as OECD analysis provide solutions.

Affected families report vast treatment gap

A partnership of Scottish family support organizations conducted a study called “Ask the Family”. It examined experiences of those suffering from alcohol and other drug problems and the impact on their families.

The national “Ask the Family” survey ran online for three weeks earlier this year and collected data from those over 16 years of age. Additionally, a number of creative activities and events were also used for data collection.

The report of the study found the following:

  • Family members had been affected by their own or someone else’s alcohol or other drug use problem for an average of 16 years.
  • It took them eight years to obtain any form of support for their own/family alcohol or other drug use problems.
    • Only one in eight (13%) reached support within a year.
    • Over a third had to wait for up to five years (36% waited 1-5 years).
    • About another third had to wait up to 15 years (34% waited 6-15 years).
    • The longest wait was 35 years.
8 years
average waiting time in Scotland to obtain support for alcohol or other drug use problems
The ‘Ask the Family!’ study reports it took family members an average eight years to obtain any form of support for their own/ family alcohol or other drug use problems
  • The survey respondents said that every single type of relationship was harmed by the alcohol or other drug use, including parents, partners, children (including adult children), siblings, extended family, friends, neighbours and work colleagues.
  • An individual’s alcohol or other drug use negatively affected about 11 people around them.
  • Most of the respondents (81%) were in favor of ‘Whole Family Support’. This is a type of service where everyone in the family who needs support gets a different kind of support based on their needs.

The family members who engaged with the study were clear that it had taken too long to find support, and that there is not enough support available for families harmed by alcohol and other drugs.

There are good examples of high quality family support in Scotland but, as families have told us directly, there is nowhere near enough of it to go around to meet the need,” said Justina Murray, CEO of Scottish Families Affected by Alcohol and Drugs (SFAD), as per their website.

We are calling for significant, sustained and strategic investment in high quality family support for children, young people and adult family members harmed by Scotland’s longstanding relationship with alcohol and drugs. This must reach right across the country so all families can get the support they need as soon as they need it.”

Justina Murray, CEO, Scottish Families Affected by Alcohol and Drugs (SFAD)

Snapshot of alcohol treatment shortfall in Ireland

Alcohol Action Ireland recently published the report “Alcohol Treatment Services: A snapshot survey. 2021” which explores some of the prevailing issues related to services in Ireland. Data was gathered from service providers who were interviewed over a period in 2020. The report finds four central themes regarding alcohol treatment services in Ireland:

  1. Mental Health and Trauma
    Many people seeking treatment experience problems with getting adequate treatment for both mental health and alcohol/ other drug use issues.
  2. Reducing the impact on children and families
    Trauma, as result of adverse childhood experience, was recognized by many of the service providers.
  3. Gaps in Services
    Children often go unnoticed in the programs of those seeking treatment. 50% of those in treatment are fathers or mothers, with children having to share the journey to recovery.
  4. Barriers to treatment
    Societal stigma, inadequate provision of detoxification services, better aftercare supports and services were highlighted by service providers.
Less than 10%
gain access to support and treatment for alcohol problems in Ireland
The latest data show only 3,500 of a potential 250,000 people (1.4%) needing support for alcohol problems gain access to some form of treatment program.

Research shows that Ireland has potentially 250,000 people who are dependent alcohol users, and while international norms suggest 10% (25,000) are actively seeking support or treatment, in Ireland the latest data show only 3,500 people needing support gain access to some form of treatment program.

Meanwhile the COVID-19 pandemic has made the situation worse for those with alcohol or other drug use problems and those in recovery.

Alcohol Action Ireland makes the following four recommendations in their report:

  • Develop a trauma-informed national strategy regarding delivery of the best possible treatment to people accessing alcohol treatment services, including aspects such as models of care and integrated mental health.
  • A HIQA type inspection regime is established for all residential treatment services providing uniform outcome measurements and monitoring of services.
  • An investment is made to ensure services have the capacity to adequately address alcohol dependency and unmet mental health needs.
  • Urgent action is required to address their needs of children affected by parental substance use disorder. Over 50% of those in residential treatment services have children; investment is required to ensure their needs are met.

Alcohol use disorder treatment gap – a global issue

The problem of inadequate treatment services for those suffering from alcohol and other drug use problems is not specific to Scotland or Ireland. It’s experienced worldwide. A recent report from the Organization for Economic Cooperation and Development (OECD), “Preventing Harmful Alcohol Use” states that currently, less than 10% of people suffering from alcohol problems receive the healthcare they need.

The OECD’s analysis of national efforts to prevent and reduce alcohol harm finds gaps exist in the development and implementation of proven policies. They recommend a package of policy solutions to fill this gap.

OECD estimates that, for every US$ 1 invested in high-impact alcohol policy solutions, up to US$ 16 is returned in economic benefit.

Improving treatment for alcohol problems is one of their policy recommendations. These recommendations called the 4P package include the following:

  1. Pricing – limit the affordability of alcohol, especially by eliminating ultra-cheap alcohol,
  2. Promotion – ban alcohol advertising, especially to protect children and including online alcohol advertising,
  3. Policing – improve law enforcement, for instance of driving under the influence counter-measures, and provide better services to victims of alcohol violence, and
  4. Primary care – invest to support people experiencing alcohol problems and alcohol use disorder.

Already in the 2018 Global Alcohol Status Report, the World Health Organization indicated that the estimated treatment coverage for alcohol use disorders is low across the world.

Despite the effectiveness of brief psychosocial interventions in primary care settings, scaling them up continues to be a challenge in most countries given the limited resources for capacity building and monitoring of health systems.  and global standardised indicators are being developed to measure treatment coverage for alcohol and other substance use disorders.


SFAD: “Families harmed by alcohol and drugs waiting 8 years for support