In denial about the human cost of alcohol

About a month ago there was a documentary broadcast on BBC2 which should have been compulsory viewing. Did you see it? Probably not. Hardly anyone did. BBC2 routinely gets only 8% of the TV audience and we are long past the era when last night's viewing constituted the next day's topic of conversation; when children greeted each other in the playground every morning with "Did you see . . .?"

Rain in My Heart, despite its critical acclaim, disappeared into the maw of shows, good, bad and indifferent, transmitted every night. We were far too busy to notice its passing.

Perhaps, though, we didn't want to notice. Perhaps the significance of Paul Watson's dark film, which I can unhesitatingly say is the most unsparing depiction of alcohol abuse ever made, is that collectively we didn't want to see it. It was broadcast on a minority, elite channel. It did not receive much publicity. After transmission, it rapidly achieved the kind of invisibility which characterises alcoholism itself.

How symbolic that the inhabitants of one of the most alcohol-blighted societies in the developed world hastily put their heads back in the sand and said: "Phew! Thank God no-one noticed and decided to act on it."

The theme of Rain in My Heart was brutally simple: the fate of alcoholics in hospital. Only one hospital was brave enough to let Paul Watson in: Medway Maritime, in Kent, but one watched, transfixed, in the sure knowledge that in hospitals all around the country the same scenes were being repeated, over and over again, in a mundane cycle of horror.

Under the care of the weary, ever-tolerant Dr Smith-Laing ("Everything we do here is too late; we've missed the boat by miles") were four patients. We were spared nothing of the yellowing, suppurating, bleeding-from-every-orifice reality in the lives of Mark, Vanda, Toni and Nigel. Toni, 26, a binge drinker who was once a lovely-looking young woman, died during the film. Nigel, in his 50s, died on camera from cirrhosis, although he had stopped drinking 10 years earlier. Mark, 29, and Vanda, 43, existed in a purgatory of denial, chronic ill-health and slow-motion suicide.

It was shocking, heart-breaking, riveting stuff, filmed with aching beauty; and it put its cold hand on the shoulder of each and every one of us. This is the logical continuum; the people for whom happy social drinking – fun – became first dependence, then living death. They are people who are familiar to us: if not now, then in a few years' time.

As the alcoholics were, so we are, too, in absolute denial about the damage alcohol is doing to us: to our children; to the taxpayer; to families; to employers; to the balance of payments; to the whole sum of human happiness. It's our poison of choice; our anaesthetic. We happily re-elect a government that has failed quite catastrophically to curtail the growth in drinking with fiscal policies; and now simply tries to pretend that any problem which exists is not its fault.

There exists today a moral crisis about alcohol misuse, coupled with an almost total reluctance to acknowledge the issues. In Scotland, our politicians have devised a policy to tackle unacceptable behaviour by young people, not to tackle the cause of the behaviour, which is binge drinking. Alcohol, a powerful, dangerous drug, now costs less than bottled water and is as freely available. Asbos are but a metaphor for misplaced blame; a focus on the symptoms.

At the root of this institutionalised blindness is institutionalised hypocrisy: the acceptance that revenue to the Exchequer from alcohol is too important to forgo. And how easy this is to camouflage by draping the cloak of liberalism across it; saying we have to de-regulate alcohol because to do otherwise is unprogressive. How do we chattering classes argue against that?

Elsewhere Scottish doctors, as terminally weary as Dr Smith-Laing, call for a rise in alcohol prices to combat the daily wash of alcohol-related hospital admissions. They link the comparative fall in price to the increase in violence and illness. Inevitably, they live the consequences, in sickeningly graphic detail, every day.

On the surface, the executive makes the right noises. It has a current campaign, Don't Push It, calling for people to take responsibility for their own behaviour. Still pursuing a liberal line, in other words, when patently such things are ineffectual. Why, despite the statement last month from Harry Burns, the country's chief medical officer, on the frightening scale of alcohol abuse, are no radical moves similar to the smoking ban being made? Alcohol abuse has to be a political responsibility. Of course tax is a reserved matter, but Holyrood could restrict drinks licences, for example, or ban two-for-one offers in supermarkets.

The deeper reason, I suspect, is that politicians to some extent use alcohol as a form of social control. Give the masses their cheap fire-water; they'll stay on the reservation and harm only themselves. Oh, appoint czars to fret and strut about illegal street drugs. But do nothing radical to address the advance of this ubiquitous legal narcotic.

Now when it comes to figures for alcohol misuse, dear reader, you probably glaze over. But please take heed of these. Alcohol consumption has increased by 50% since 1970. Promotional spending on booze has risen by 125% in real terms since 1980. Drink became 54% more affordable between 1980-2003, while numbers of licensed premises rose by 25%. And the results? The cost of alcohol misuse to Scotland, in terms of the NHS, social work, police, emergency services, and the wider economic and human costs, is put at £1.7bn a year. Since 1997 there has been a 45% increase in alcohol-related liver-disease admissions to hospital. About one million people visit A&E departments each year because of alcohol. It reduces GNP by 5% and costs employers £404.5m annually in sickness, absenteeism, accidents and crime. Alcohol-related deaths in Scotland last year were 1513, nearly double a decade ago.

By 2012, it is estimated 48% of men and 53% of women in the UK will exceed daily recommended limits for alcohol units. More than half of today's teenagers, in other words, are heading for an adulthood to some degree impaired by alcohol.

Those staggering young people in the park or on the street corner, regularly fuelled on fortified wines and beer, are sleepwalking into mortal danger. They drink it because they can afford to; because they have access (fake ID being easy to buy off the internet); and because our poor, benighted culture implicitly condones drunkenness – legitimising it by the one figure I haven't yet mentioned, the most important sum of all: £11.5bn a year in duty and VAT the Treasury takes from the industry.

Tell that to the wretched people with the yellow eyes and the blood-filled buckets in the hospital wards for alcohol abusers. Tell them it's their own fault; tell them the nation needs the money. I will confess: I begged a DVD of Rain in My Heart from the BBC and asked my teenage son to watch it. He was reluctant; 90 minutes later, as the credits rolled, he was still gripped, silent, deeply affected. He told me later he had no idea what alcohol could do. Perhaps, as a start, Paul Watson's film could be shown to every teenager in the country.

The Herald