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I believe that some alcoholics are mentally unwell and they use alcohol to dampen their emotional pain…as some have suggested on this site before:-
“until such time as the pharmaceutical industry come up with a pill that helps like alcohol does, it will continue to be my coping mechanism of choice”.
Lets first make clear what i mean by ‘mentally unwell’…by that i mean a person that does not function normally in society, or a person that has inadequate coping strategies when dealing with either mental or emotional turmoil/torment.
I believe that once a person is an alcoholic, it is inherent in that, that they will at some point behave in a selfish way.
Either way, how do we treat them? With difficulty and barriers is the answer!
Unfortunately it has been my experience of late that patients entering the services with dual diagnosis become very political, in terms of whose budget are they going to consume. Hearing many phrases like
‘their primary problem is alcohol, if they didn’t drink they wouldn’t be suicidal’
‘no, no, they wouldn’t be drinking if they weren’t so suicidal and mentally unstable, that needs treating before we can tackle the alcohol’
Meanwhile the poor patient is in the midst of all of this cafuffle being tossed from one to tuther like a frisbee!
Similar to my previous post, we are not collaborative with patients that want to have the freedom to smoke, we are not collaborative with those clients who want to sleep all day and wake at night, we don’t tend to be accommodating and collaborative with patients who like to sleep until midday, as it doesn’t fit with our view of what is deemed acceptable. we might collaborate with them in terms of sitting with them and writing a care plan, but is that care plan a product of what we want it to look like, or do we really write what the patient thinks is important, and in their own language.



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