This book, coincidentally, acts as an ‘aide-memoir’ to the UK
Government in its decision to develop a National Alcohol Strategy.The prologue reads: ' This book starts from the premise that,
however great the changes which have taken place, alcohol policy
today is embedded in the past. In examining evolution and change
in policy formation and implementation in the alcohol field, the
intention is to enhance understanding of current approaches to
dealing with the adverse effects of alcohol consumption'.
At the same time, this account of alcohol policy provides a case
study which will be useful to those who have an interest in how
social policies emerge, change and develop. How do issues move
on and off policy agendas? Why do some policy statements fail
to be implemented? What is the role of civil servants, professional
leaders, or pressure groups in policy formation? How do inter-departmental
tensions or the conflicting interests of different social groups
influence policy objectives and policy outcomes? To what extent
is policy ‘evidence based’? These are some of the questions which
are raised and illustrated through an examination of alcohol policy
over the past fifty years.
The book tracks the fundamental change in the treatment and management
of alcohol problems, mainly in the post war period, with excellent
earlier historic references. The chapter on ‘The Case Study of
Women and Alcohol’ is particularly interesting as the following
extracts reveal;
'Academic and medical papers written at the turn of the century
claimed ‘strong evidence' to show that alcoholism is spreading
at an alarming rate among females. Typically, no figures were
offered in support of the contention; rather observations of changing
patterns of social behaviour were provided as evidence. Young
girls were alleged to be indulging in drinking and smoking and
there was a continuing outcry over the employment of young women
as barmaids and the subsequent decline of many into alcoholism.
Women were regarded as being particularly at risk of succumbing
to temptation and of drinking immoderately because they suffered
from ‘an inherent vulnerability of the nervous tissues’ which
lowered their resistance to alcohol. By the late 1950's the female
alcoholic, as she emerges from the clinical literature of the
period, is a stereo-typical figure suffering from greater pathology
than the male alcoholic and having a poorer prognosis. For example,
writing in the 1950s, Lincoln Williams described the "Immature female psychopathic addict, often emotionally labile
and a possible suicide risk, perhaps sexually frigid, perverse
or promiscuous ... the woman patient, so vulnerable to emotional
disturbances, finds it more difficult to readjust her life and
to make a successful recovery than the male".
It was not until the mid 1970s that the ‘female alcoholic’, as
a subject of research and treatment concern, was rediscovered
in the UK. For instance, one of the few policy statements in the
early 1980s regarding women and alcohol was a statement in 1983
concerned with drinking during pregnancy. Certainly, women involved
in the early ‘activist’ group felt that interest in foetal health
gained greater policy attention than the treatment needs of women
alcoholics. Comments from Shirley Otto, a research psychologist,
give some insight into their thinking at that time: "We drew our ideas from feminist thought and from the work on
homeless women. We were guilty of ending up taking about ‘empty
nest’ syndrome and such like but it was all we knew at the time
... We were also caught up fighting off the foetal alcohol stuff.
That just gave the boys such fun. As soon as they got hold of
it they ran with it. Because it was such a lovely stick to beat
women with. But it didn’t come off - it hasn’t come off. They
were less interested in women, more interested in foetal alcohol
syndrome. At first it was not too difficult to stave it off, because
it was unclear what it was and how it applied. And people were
using very different definitions of it. But it’s something that
gets money. It implied the idea of the degeneration of the race
although they did not use these terms. Very, very occasionally
they could think of providing provision for mothers and babies
which was an acknowledgement that women had children, but they
wouldn’t provide creches that gave women fuller lives".'
There is much, much more to recommend in this book to all those
who need to understand the historic, professional and political
background leading up to the UK Government's review of alcohol
strategy.
Dealing with Drink by Betsy Thom is published by FA Free Association
Books, 57 Warren Street, London W1P 5PA @ £15.95. Email fab@melmoth.demon.co.uk, phone 020 7388 3182.
