26/10/2025
Families Left Out: Why England’s Alcohol Services Lock out the families of those suffering with alcohol use disorder - and How to Fix It
Executive Summary
Across England, families affected by alcohol dependence are routinely excluded from the very services designed to help. Despite the rhetoric of ‘whole-family approaches’, current commissioning structures and funding models leave families unsupported, unrepresented and often in crisis. This briefing draws on evidence from OHID and PHE, alongside lived experience shared by families in Shropshire, to show why reform is urgently needed.
Key Messages
• Families bear the greatest burden of alcohol harm but are almost entirely excluded from support.
• The official definition of ‘treatment’ no longer reflects what families experience on the ground.
• National data shows declining completion rates for alcohol clients and limited family involvement.
• Local examples, such as Shropshire, reveal that ‘treatment’ often means minimal contact, no clinical input and no family inclusion.
• Reform requires national leadership: family-inclusive standards, ring-fenced funding, and accountability.
Amy’s Story
Amy was a bright, creative young woman whose struggle with alcohol gradually overwhelmed her life. Her family reached out repeatedly for help but were told that, without Amy’s consent, they could not be involved. When she did seek help, the local service offered brief sessions and little medical support. Her family were left alone to cope with fear, exhaustion and grief. Amy’s death left unanswered questions that no family should ever face.
What ‘Treatment’ Should Mean — and What It Too Often Means in England
According to OHID, alcohol treatment should be a structured, evidence-based package of care that includes assessment, psychosocial interventions, medical detoxification if required, and recovery support. However, since responsibility shifted to local authorities in 2013, provision has become inconsistent and underfunded. In Shropshire, for example, the commissioned ‘treatment’ service offers limited contact, little or no clinical input, and minimal family involvement. Many families report feeling that there is effectively no treatment available for severe alcohol dependence.
What ‘Successful Completion’ Really Means — and What It Doesn’t
In national statistics, a ‘successful completion’ means that someone has finished a planned course of treatment and is judged no longer dependent on alcohol. For example, if 100 people enter treatment and 45 finish successfully, the completion rate is 45%. However, this measure does not track long-term recovery or relapse, and excludes family wellbeing. High completion rates may mask the fact that many families continue to struggle without support.
The Evidence
• National OHID data (2023–24) shows that only around 30% of people in alcohol treatment in England complete successfully, with wide variation between local authorities.�• Family support is not a statutory part of alcohol service contracts.�• Between 2013 and 2020, public health funding for substance misuse fell by around 40%.�• Fewer than 5% of recorded alcohol clients in treatment have family involvement noted in their case records.�• In Shropshire, local data shows declining completion rates and limited access to alcohol-specific interventions.
How to Fix It — Five Practical Reforms
1. Establish **national minimum standards** for alcohol treatment, requiring clinical input, family inclusion, and clear care pathways.
2. Introduce **family-specific funding streams** within the Public Health Grant, ensuring support for relatives even when the drinker refuses treatment.
3. Mandate **family-inclusive commissioning**, with measurable KPIs on engagement and wellbeing outcomes.
4. Create a **national network of Alcohol and Family Support Hubs**, combining peer support, counselling and practical help.
5. Require **local transparency**, publishing alcohol treatment and family-support data quarterly by local authority.
Conclusion
Families are the invisible casualties of England’s alcohol crisis. They carry the trauma, the cost, and the care when the system looks away. In Shropshire and across the country, ‘treatment’ too often means a brief encounter, not a recovery journey. Reform is both a moral and practical necessity: helping families helps recovery. It is time to build an alcohol treatment system that includes, supports, and heals entire families.
Prepared by Jane Mackenzie, Founder of Share Shrewsbury
