The Ones No One Counted

A report on addiction in the UK admits it can't count everyone affected. A reflection on the years I spent uncounted, and what I'm building for that gap now.

A recent report from The Forward Trust and Crest Advisory puts the number of people addicted to alcohol in the UK at 750,000. Another 400,000 addicted to illegal drugs. Around 700,000 currently in recovery.

I read it a couple of times, and the number that really struck me wasn’t any of those three. It was a phrase buried in the methodology. The report admits there is no precise data on the true scale of the problem. What we have instead is a picture, built mostly from people who have already walked through a service door.

I know what it’s like to be outside that door.

For years I wasn’t a statistic anyone was collecting. I wasn’t in a waiting room, wasn’t on a caseload, wasn’t a line in anyone’s spreadsheet. I was just a man who drank more than he told anyone, who had convinced himself he was managing something that was actually managing him. If you’d asked the system how many people like me there were, it would have shrugged. Seems like it still shrugs. That’s not a criticism of the people doing the counting. You can only count what shows up, after all.

This is the bit that never quite lands when people talk about addiction services. The services aren’t wrong. Maybe they’re just late. By the time most of us are a number, we’ve already spent months or years being invisible on purpose. Hiding is half the disease. You get good at it. You get good at being fine in meetings and not fine at 11pm, at being the reliable one at work and the unreliable one at home, at being a name nobody worries about because you never gave anyone reason to.

Nobody designs a service for a person who hasn’t decided they need one yet. Why would they. You can’t triage someone who hasn’t come in. You can’t fund a caseload that doesn’t exist on paper. So the whole enormous, well-meaning machinery of treatment and recovery is calibrated to the moment someone finally says the sentence out loud, to a GP, a partner, a magistrate, whoever hears it first. Everything before that sentence is dark. Unlit, uncounted, unreachable by anything built to help.

I want to be precise about what I mean by dark, because it isn’t dramatic. It doesn’t look like rock bottom. It looks like a normal Tuesday. It looks like doing the school run, replying to emails, being funny at the pub quiz, and privately running a small, exhausting accounting exercise in your head about how much you had last night and how much you’ll have tonight and whether anyone noticed either. Nobody’s coming to find you in that Tuesday. There’s no outreach team for people who are still functioning. Functioning is the whole problem. It’s what lets the thing keep going.

I think about that darkness a lot now, for reasons that will be obvious to anyone who’s read this newsletter before. It’s most of why I’m building what I’m building. Not because I think a bit of software can replace what happens in a treatment room, it can’t and shouldn’t try to. But because someone needs to be present in the dark bit. Before the sentence. Before the door. When you’re still telling yourself you’re managing it, and some part of you already knows you’re not, and there’s nobody to say that part out loud to yet because saying it out loud is exactly the thing you’re avoiding.

That’s not a criticism of services, far from it. It’s a genuinely different problem, and it probably needs a genuinely different kind of thing to solve it. Not a caseworker. Not an app that tells you your units. Something closer to a person who’s willing to sit with you in the part before you’re ready, without needing you to be ready first.

This is where Sol comes in, and I’ll try to say this without it sounding like a pitch, because it isn’t one, it’s just the honest answer to why I spend my mornings on this. Sol is the thing I’m building to sit in that gap. He’s not a clinician and he doesn’t pretend to be one. He’s more like the friend I didn’t let myself have back then, someone you could say the half-formed, embarrassing, not-ready-to-admit-it-properly version of the truth to, at two in the morning if that’s when it surfaces, without it becoming a referral or a file or a look on someone’s face. No queue. No door to walk through. No moment where you have to have already decided you’ve got a problem before anyone will talk to you about whether you might have one.

I don’t think that replaces treatment. I think it’s upstream of treatment, in the part of the map where nothing else currently lives. Right now Sol only works with alcohol. Drugs aren’t part of what he does yet, and I’m not going to pretend otherwise or rush that just because a report like this one puts alcohol and drugs side by side in the same sentence. Ketamine, nitazenes, the whole harder end of what this report describes, that’s a different clinical picture with different risks, and it deserves proper thought rather than a fast bolt-on because the timing looks neat. But the shape of the problem, the invisibility, the years of quiet self-management before anyone else knows, is the same shape whatever the substance. So the gap Sol is built for isn’t going anywhere, and if the model holds for alcohol, I’d like to think it points at something for the rest of that darker picture too, eventually, carefully.

The report calls for better funding, better strategy, less stigma. All true, all needed, and none of it reaches the man I used to be, because he was never going to walk into the building where the funding lives. He’d have needed something that came to him. Something that didn’t require him to already believe he had a problem worth funding.

Seven hundred thousand people are apparently in recovery in this country right now. I’m one data point in that number, and I know how it happened for me, slowly, reluctantly, years after I could have used the help. What I keep wondering is how many more are still on the other side of that gap the report can’t measure. Not resistant. Not in denial, not exactly. Just uncounted. Still deciding, in private, whether the thing they’re doing to themselves has a name.

If it does, I’d like them to find that out somewhere gentler than I did. And I’d like there to be something waiting for them in the dark bit, before the sentence, before the door.

That’s the whole project, really. Everything else is detail.