Letter to the Editor TREATMENT OF ALCOHOLICS Dear Sir, The article in your current issue dealing with the absence of adequate scope in England and Wales for the treatment of the sick alcoholic, admirably sets out, inter alia, a case for an increase in both in-patient and

out-patient hospital facilities. Any assumption, however, that restorative therapy can be successfully applied extra-murally to an unspecified section of alcoholics should, I submit, be supported by something rather less nebulous than the concupiscent claim that "the sobering up process can, of course, be carried out at an out-patient clinic ..." albeit with the added qualification that "admission to hospital may in the long run prove the quicker way to final success." I was conscious of the need for emphasis stressing the immeasurable advantages that intra-mural treatment has over that available to an outpatient. In "A.A.", I have met many who have experienced both, as I myself have, and I would accordingly urge that the current efforts to have the necessity for expansion officially recognised should be concentrated primarily on securing additional intra-mural facilities. It cannot be contested, surely, that when an alcoholic reaches the stage where hospital treatment is required, some form of control over the patient is essential, at least in the initial stages of the re-adjustment. Moreover,

determinative step towards recovery that the alcoholic is to be the realization that he is "powerless over alcohol", then indeed the chances of his achieving this are infinitely greater inside a hospital than by casual attendance at an out-patient clinic. The violence of the threshold impact, the realization by the alcoholic (who has hitherto regarded himself as being normal) that he is a patient in a mental institution solely through alcoholism, transcends in value many I would go further by stating that efforts to other factors aiding recovery. secure the segregation of the alcoholic from other mental patients should be tempered with a recognition of the inestimable worth of that initial shock?the shock that has, to my own knowledge, inspired a surrender of the alcoholic ego and eventually induced a willingness, and even eagerness, to yield to the varied forms of therapy now available inside a hospital. Yours faithfully, "Bill (L.)" if it is

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Treatment of Alcoholics.

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