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Alcohol services

To find your nearest alcohol service, go to our online services directory.

Specialist alcohol services are provided by the statutory, independent and private sectors throughout England and Wales.  However provision is patchy and services offer very different types of support.  Many alcohol services, especially residential services, also offer help for people with drug problems.

Below is a brief summary of some of the different types of treatment available.  For a review see a 'Review of the effectiveness of treatment for alcohol problems', published in 2006 by the National Treatment Agency for Substance Misuse.

Advice, information and counselling services: often the first point of contact for someone concerned about their own or someone else's drinking.  People can usually ring or call in for information or advice.  Some of these services may be small agencies where volunteers mainly provide the counselling, although many are larger agencies with paid workers.  Many advice and counselling agencies describe their treatment approach as eclectic, meaning that they do not adhere to any one treatment philosophy but borrow from a range of approaches appropriate to the needs of the client.  Cognitive and behavioural models are often referred to together with a client-centered approach.  The cognitive model recognises that problem drinking is a learnt activity and therefore people can learn alternative ways of responding to problems and drinking cues.  Behavioural models recognise the individual as being able to take responsibility for their own actions rather than being controlled by alcohol.  This is in contrast to the disease model where drinking problems are seen as inevitable in those with a pre-disposition to alcohol problems or addiction.

Community Alcohol Teams (CATs): provide a wide range of support services including home-based and community detoxification programmes, counselling and group work.  Most CATs are managed by the health service and often have a multi-disciplinary staff team often including link-workers, health-care workers and social workers.  Some CATs will accept self-referrals although others only deal with clients referred by GPs or other professionals. 

Day programmes: provide a structured, full-time programme for clients and can last for anything from six weeks to nine months.  Programmes are typically provided by a range of non-residentail alcohol support agencies and counselling services.  Some residential services take clients on a non-residential basis and offer day programmes.

Residential services: may be provided in hospital, within nursing homes, registered care homes or in hostel accommodation.

Residential services vary in the approach they take to alcohol problems, addiction and recovery.  However, as with advice and counselling agencies, many use a combination of models.  Residential services fall into a number of categories:

• Abstinence-based residential services - these used to be known as 'dry houses' but now are mostly just described as residential services.  They aim to maintain an alcohol-free living environment for their residents.  They usually offer a combination of individual counselling, group work, social skills training and practical help to encourage the use of local community resources
• Christian philosophy houses - provide rehabilitation within a Christian ethos of care. Care is usually taken not to pressure any resident to adopt Christian beliefs and the style will be similar to abstinence-based residential services (see above)
• Therapeutic communities - serve a range of people and have diverse and independent origins, so their approaches vary - but to build a sense of community, members work alongside each other and with staff to take control of their situation. TC principles are based upon a collaborative, democratic and deinstitutionalised approach to staff-patient interaction.
• Heavy drinkers' houses - also known as 'wet hostels' these provide support and care for long-term alcohol misusers who are unable or unwilling to use other forms of supported rehabilitation. The goal for most is a gradual improvement in health and quality of life.

Self-help groups: Alcoholics Anonymous is the best-known network of self-help groups with over 3,000 local groups in the UK.  AA views alcohol dependency as a disease where total abstinence is required.  There is a belief in a power greater than the individual through which, along with the support of other alcoholics who share with each other their experience, common problems can be resolved and individuals can recover.  Al-Anon is a similar network for relatives and friends of problem drinkers

SMART Recovery UK also operates a meetings structure which is run by volunteers who have first-hand experience of addiction.  Smart Recovery UK is working with Alcohol Concern to develop a UK-wide network of groups which will aim to help people gain independence from addictive behaviours. 

Online resources: there are a number of web-based services for people worried about their drinking.  These include sites that offer online tools to assess how much you are drinking and then provide support and/or information and advice.

Independent alcohol counsellors: can provide independent, fee-charging services as sole practitioners or small companies.  Local alcohol agencies or GPs may be able to provide details of these services in their areas.