Drinking nation: have we had enough?BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e2634 (Published 17 April 2012) Cite this as: BMJ 2012;344:e2634
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For the past 14 years, I have managed a clinical catchment area where, during the late 1990s, up to 20% of my community team referrals and up to 50% of my in-patient beds being occupied by older people with dual diagnosis. It was then that I thought that enough was enough. Following the acquisition of new clinical competencies from a largely self funded MSc in addictions and the subsequent development of a Trust dual diagnosis strategy for older people , the outcomes speak for themselves.
Between 2005/06  and 2008/09 , Southwark had the second lowest percentage increase in alcohol related admissions of all London boroughs for people aged 65 and over, with a 6% increase over this time frame, compared with whole sample (mean 36%, s.e.m. 5%, 95% CI 37%-45%).
Although economic interventions to reduce demand will undoubtedly have an impact on alcohol related admissions, the provision of specialist skills within mainstream clinical teams can also be effective and have equally significant outcomes
 Rao R, Shanks A. Development and implementation of a dual diagnosis strategy for older people in south
east London. Adv Dual Diag 2011;4:28-35
 House of Commons Hansard Written Answers for 26 Feb 2009. http://www.publications.parliament.uk/pa/cm200809/cmhansrd/cm090226/text.... Last accessed 19.04.12
 Southwark Primary Care Trust 2011 (personal communication)
Competing interests: No competing interests