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parts of the country the numbers of alcoholics being admitted to
mental hospitals is mounting. This, despite the well-known fact
that we have an "iceberg" situation where the alcoholics coming
forward for treatment represent but a section of the nation's total.
For prevention and control of alcoholism we need to know (a)
what the problem is, (b) the percentage of population at risk and
(c) its prevalence. Unfortunately, there are several reasons why
accurate assessment of the problem, both locally and nationally, is
difficult. No definition of alcoholism is universally recognised, thus
enabling standardised registration to be effective statistically, although
that offered by the W.H.O. is the most acceptable so far
and, at present, no machinery exists whereby such information,
were it obtainable, could be collated and consolidated.
What do we know of alcoholism in this country? Very little.
Studies of and researches into this problem are remarkable for
their paucity. Since Dr. D. Parr's valuable survey carried out in
1956 in co-operation with the College of General Practitioners
there have been few systematic investigations of note.
In accordance with the late Professor Jellinek's formula, it is
estimated that 300,000 or 1.1% of all the population over the age
of 20 years in England and Wales are alcoholics of which a quarter
suffer from complications. It is universally accepted that this illness
affects more men than women and the ratio for this country is
considered to be 2: 1. The problem is to be found in all socioeconomic
classes although more patients in the higher groups tend
to seek treatment. Presuming that this statement holds good for
Greenwich, then we could expect to have some 1,716 adult alcoholics
in the Borough, 1,144 males and 572 females, of whom 429
would be of the chronic type. These figures are approximately ten
times greater than those which would have been produced had the
calculations been made according to Dr. Parr's findings, the discrepancy
being attributable to the different bases upon which the
original surveys were conducted. However, even if the true position
for the Borough lies somewhere between these two assessments
then our problem, seemingly very well hidden at present, could be
of some moment. In this respect, general practitioners are likely to
be sources of reliable information and cases will be revealed
following police court proceedings and patients' recourse to hospital
treatment or their application to voluntary or local authority
welfare organisations.
Because the aetiology of alcoholism is complex, prevention is
not simple. In endeavouring to reduce its incidence the struggle
becomes one against tradition and long-standing customs, against
financial interests and human irresponsibility, against the loosening
morals and greater permissiveness of a modern society.