Alcoholics Known or Unknown to Agencies: Epidemiological Studies in a London Suburb

(1) Two parallel epidemiological investigations into prevalence of abnormal drinking were conducted in the same London borough. The first enquired of a wide spectrum of `reporting agencies' the number of cases coming to their notice over a 12-month period, while the second study involved house-to-house interviewing and elicitation of subjects' own report of troubles experienced with drinking during the previous 12 months. (2) The reporting agency survey revealed a \`labelling' prevalence per 1,000 adults aged over 16 of 8.6 for men, 1.3 for women, and 4.7 overall. About half these cases were known to a medical agency. The sample survey gave a prevalence of \`problem drinking' per 1,000 adults aged 18 or over of 61.3 for men, 7.7 for women, and 31.3 overall. (3) The likely ratio of \`needful cases' to cases in contact with an \`apposite agency' probably lies between 4 : 1 and 9 : 1. (4) The relevance of these findings to the planning of society's response is discussed. It is argued that mere expansion of treatment services designed within terms of the usual present model cannot adequately meet the problem.