How well is the UK doing at getting people who need this help into treatment for their drinking problems? It’s a statistic which matters, because the more of the in-need population we treat, the smaller the alcohol-dependent population and the less the related harm. We can get an idea of how much better the UK could feasibly be doing by comparing countries within the UK, where Scotland seems to be doing much better than England (at least three times better) at meeting treatment need (1 2). An estimate for Leeds in northern England is that trebling access to treatment to the level in Scotland would over five years cut the alcohol-dependent population by just under a fifth and save a further 65 lives. In 2004, UK-wide there would have been an estimated 794 fewer deaths had one in five dependent drinkers been treated with medications versus if none had. Numbers avoiding illness would have been considerably greater.

The aim is to present a ball-park indication not of absolute numbers and proportions needing treatment, but of the degree to which these figures alter under different criteria for what counts as ‘needing treatment’. Our analysis focuses on England and the year 2014 because this is where the data and estimates are most complete. Most pertinently, this was the year and England was the country addressed by the key source for these estimates panel.

As we’ll see, depending on where you draw the line, England’s performance in ensuring needy drinkers enter treatment can look anywhere from a poor 7.5% to an excellent 43% or even more. Line-drawing is a matter of judgement, and perhaps too of motivation – of how you want to portray performance, and in turn whether you want to advocate for more services, or to reassure that need can already largely be met. But as a basis for these judgements, we should be as clear as possible about the relevant facts and uncertainties.