THE QUESTION OF COMPULSION OF ALCOHOLICS

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Regularly the question of compulsory treatment of alcoholics is aired. This is in spite of evidence that where acceptable services are provided alcoholics use them voluntarily. Few psychiatrists are satisfied by the results achieved when patients are compelled into their care. Patient and doctor regard each other with antipathy and it is not possible to provide more than custodial treatment. But even today their general medical colleagues seem unable to relinquish a groundless belief in the benefits of treatment by compulsion. The way they formulate this indicates that such compulsory detention in hospital also serves a punishing role: ‘We feel that in some very bad cases, compulsory detention in hospital offers the only hope of successful treatment.’ ‘We believe that some alcoholics would welcome compulsory removal and detention in hospital until treatment is completed.’1

I. British Medical Association (Scottish Office). Memorandum of Evidence to the Standing Medical Advisory Committee’s Special Sub-committee on Alcoholism, May 1964.

The same report continues: ‘ Unfortunately, very few alco-hoHcs really want to be “ cured It is seldom the alcoholic that makes the original approach to his general practitioner for treatment; it is almost always his relatives.’ The opinion was given that the majority of alcoholics ‘and even potential alcoholics’ require hospital in-patient treatment for at least several months. ‘For psychological and social reasons, the unit should be as far from the patient’s home as possible.’ We have quoted these views not just to show that opinions rendered obsolete by research are still firmly put forward, but to indicate the sort of treatment services that, all too possibly, might be set up if administrative decisions were based on such opinions rather than on ascertained facts.

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