Introduction

In this chapter I first explain the limitations of previous understanding of, and responses to, women's alcohol use. I also describe a piece of service user-controlled research, which indicates alternative ways in which women could receive help and support. Such support would better reflect the meaning of alcohol use for women and would be based on a ‘social model’ as described below. Finally, I reflect on the political dimensions of how women's alcohol use is seen and in consequence ‘treated’ and consider the extent to which human rights may be involved.

A social model of alcohol use, like a social model of mental health, is one that seeks to contextualise the need to use alcohol alongside such social factors as poverty, domestic abuse, loneliness, depression and anxiety (Staddon, 2009). It has been suggested in this book by Beresford (Chapter One) and by Staddon (Introduction) that a ‘social model’ may offer a more appropriate and effective approach for women with alcohol issues. Some of the ways in which society understands and attempts to deal with alcohol use may be based on misunderstandings as to its meaning for different groups.

Women's alcohol use and its treatment

Over the last decade there has been something of a shift in understandings of alcohol use, at least at an academic level, and to a certain extent at the treatment commissioning level. Although alcoholism may still be seen by some as a lifelong disease of the will, whereby, paradoxically, one is both immoral and ill (Willenbring, 2010; Perryman et al, 2011), it has now been shown that most people appear to recover without treatment, due to changes in the lifecourse (Penberthy, 2007; White, 2008; Willenbring, 2010), with full recovery from an addiction being well documented (Raistrick, 2005; Heather et al, 2006; White, 2008; Willenbring, 2010; Perryman et al, 2011). There is consequently a need to challenge traditional views of alcoholism, such as it being a chronic, lifelong condition. These views are, however, widely and generally held by the public (Ettorre, 2007; White, 2008) and in consequence may well affect the kinds of treatment chosen for funding by commissioners. Commissioners, including general practitioners (GPs), are naturally affected by the weight of what we call ‘common knowledge’.