On the eve of Alcohol Awareness Week, Health Editor Barry Nelson meets one of only three hospital-based alcohol intervention workers in the country

GEOFF Anderson talks to lots of people who don't think they have a drink problem. Unfortunately, Geoff then has to ask them why they keep coming back to the accident and emergency department at Sunderland Royal Hospital needing treatment for injuries which happened when they were drunk.

He also talks to patients admitted to hospital with medical problems because they are simply drinking too much booze for their own good.

Geoff, who works for the charity Turning Point, is one of the first hospitalbased alcohol intervention workers in the country. Jointly funded by the charity and the NHS, his mission is to point out the perils of excessive drinking to people who are already experiencing the dark side of Britain's love affair with alcohol and get them the help they need.

Not everybody responds, but those that do are referred to treatment services.

"I was speaking to a guy recently who didn't consider himself much of a drinker. He ended up in hospital with an inflamed pancreas caused by alcohol,"

says Geoff, who has worked as an alcohol outreach worker at the Wearside hospital since November last year.

"He said I know lots of people who drink more than me who don't have problems'," recalls Geoff.

CONSULTANTS are not the only ones who do ward rounds at Sunderland Royal Hospital. Every weekday morning Geoff talks to staff at the A & E department to see what the previous night has brought in. Apart from people who have come in because of alcohol-related injuries, fights, falls and other mishaps, Geoff is also alerted to patients admitted to medical wards for emergencies.

The doctors and nurses are now used to having an alcohol intervention worker on the premises and if individual patients are agreeable, their names are passed to Geoff. Staff now look out for what some call A&E "frequent flyers", regular patients who are either worse the wear for drink or recovering from drink-related injuries. Geoff will take a note of their details and try to see them.

Even if it is just passing on his card and having a quiet word, Geoff makes it clear that he is there to help.

"I sometimes feel like a door-to-door salesman," laughs Geoff, who has worked in the field of alcohol harm reduction for years.

Many people have a mental image of a problem drinker as the tramp in the shop doorway with the can of super-strength lager, but Geoff says it is more complicated than that. Chillingly, for those of us who regularly exceed the Government's recommended maximum weekly limits for alcohol consumption (21 units for men and 14 for women), some of Geoff's clients are men and women who have been kidding themselves that drinking way over the recommended limits is not a problem.

"Quite often people don't understand how many units they are having and what regular drinking can do to them.

Unfortunately, it is a drip-drip effect.

"You don't see the effects at first, it is in the future when you see the same people in their 40s and 50s with severe liver damage."

Geoff's clients come from every age group. "It can literally be from late teens to pensioners. The oldest client I have seen was 75. I would say about 60 per cent are men."

Apart from people who have medical problems caused by excessive drinking, Geoff's main client group is people who have come into accident and emergency after being involved in an accident or a fight after they have been drinking.

Broadly, there are three types of drinkers that Geoff is interested in helping: the binge drinker, the hazardous and harmful drinker and the dependent drinker. Clients who agree to be assessed by the Turning Point worker can either be seen at the hospital there and then, or - more commonly - make an appointment to see Geoff at a later stage.

ALOT of the thinking behind the way Turning Point works with problem drinkers originated in the United States. The essence is to provide enough persuasive information to convince the client that it is in their interests to turn their backs on their heavy-drinking lifestyle.

"There is this idea that there is a moment when you can change people who have experienced some kind of trauma because of alcohol abuses," says Geoff, who gives the client what is known in the trade as harm reduction advice.

"Studies have shown that if this is done properly it can have a pretty good effect on people who are misusing acohol."

The selection of potential clients is carried out by hospital staff using a special questionaire. "People are asked four questions. If they score more than two on the list they are offered an appointment with me."

He stresses that there is no compulsion at any time and to have any chance of working, the advice has to be given to someone who wants to change.

"It is all about motivating people to change their behaviour. You can't make people change."

Even if patients sign up it doesn't mean they will take the advice. "We present people with the evidence, we give them the facts about the links between excessive drinking and health problems, basically we give them good reasons to make their own choices. But sometimes you work with people you know simply haven't got the motivation to stop. You don't always get a result. Sometimes I feel like I am hitting my head against a brick wall."

CLIENTS who agree to take part in the scheme are often advised to keep a drinks diary to chart exactly how much they are consuming.

"We also try to get them to consider the reasons why they are using alcohol in this way. It is often stress relief or other problems in their life."

If they need further support, Geoff can refer them to a number of North- East agencies which provide rehabilitation, everything from a full medical detoxication to long-term counselling.

Geoff sees around 30 people a month, but some will spurn his advice and help.

"Some people will say to me that they haven't got a problem and they don't want to speak to them. All I can do is leave them my card and hope they ring.

A lot of the time it is just planting the idea in their heads."

* A unit of alcohol is a small glass of wine, or half a pint of beer

10:30am Friday 11th April 2008

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