Love Your Liver Month: Supporting People Through Alcohol-Related Hospital Care

By Annalise Johnson
Lead Alcohol Care Clinical Nurse Specialist
County Durham & Darlington NHS Foundation Trust

Why I Do This Work: Supporting People with Alcohol Issues in Hospital

When the role of Lead Alcohol Care Clinical Nurse Specialist was advertised around 3 years ago, I remember thinking: this feels like it’s been written for me.

The post wasn’t just about stepping into an existing service  –  it was about creating something entirely new. At the time, there was no inpatient alcohol care service within County Durham & Darlington NHS Foundation Trust. The idea was to build a dedicated team that could properly support people whose alcohol use was affecting their health, their lives, and their futures. I applied on the very last day, rushed the form in, and hoped for the best.

I’ve never looked back.

Finding my place in nursing

I qualified as a nurse in 2011 and, like many newly qualified nurses, went through a generic interview process and was placed where there was a vacancy.

My first job was on a gastro ward in Sunderland — and I loved it immediately.

A large proportion of the patients I worked with had alcohol or drug-related issues. Early on, I realised I felt a real connection with this group of people. I found it easy to talk to them, to listen without judgement, and to build trust. Where others sometimes struggled, I felt comfortable.

I don’t know exactly why that is, but I think part of it comes from where I grew up. I’m from Hendon in Sunderland – a close-knit community where alcohol problems were common and visible. It wasn’t something that felt threatening or unfamiliar to me. I’d grown up seeing that people struggling with alcohol weren’t “bad people” they were people dealing with difficult circumstances.

Over time, I also started to become very aware that this group is often forgotten. People with alcohol dependence can be labelled as “difficult”, “frequent attenders”, or “non-engagers”. I’ve always felt drawn to supporting the people others might shy away from – the ones who need help the most.

What an alcohol care team does

No 2 days are the same, but our work usually starts with referrals. Hospital wards can refer patients to us if alcohol is part of the picture – whether someone is drinking above recommended levels, experiencing withdrawal, or simply wants to talk. Sometimes people ask us for help not for themselves, but because they’re worried about a partner’s drinking. That matters too.

We’re also proactive. Every day, we review admissions data and identify patients who might benefit from our support – for example, someone admitted after self-harm or an overdose who was intoxicated at the time. Alcohol and mental health are often closely linked, and unless someone joins the dots, those underlying issues can be missed.

On a busy day, we might see anywhere between 10 and 20 patients. We carry out comprehensive assessments, but interestingly, alcohol use itself is often the smallest part of the conversation.

What matters most is why someone is drinking.

We ask about childhood experiences, family relationships, bereavement, work, money, housing, trauma, isolation – the whole picture. Alcohol doesn’t exist in a vacuum. If we can understand the root causes, we’re far better placed to support change.

For one person, drinking might be linked to losing a partner and feeling isolated. In that case, support might focus on tackling loneliness – linking them into befriending services or community groups – alongside health advice. For someone else, it may be linked to long-standing trauma that’s never been addressed.

Even if someone isn’t ready to change their drinking straight away, we always provide education and health information. Sometimes it’s the second, third, or fourth conversation that makes the difference.

 The moments that stay with you

One patient I’ll never forget was a woman in her thirties who was homeless, alcohol-dependent, and frequently admitted to hospital. When we first met her, she didn’t want to engage at all. She genuinely believed no one could help her.

Over time and through persistence, patience, and simply showing up –  she began to open-up. She’d lost both her parents as a teenager and had never received bereavement support. Alcohol became a way to survive. It’s helping people that makes my job worthwhile.