The cultural attitude to alcohol in this country has moved from one of ambivalence to permissiveness, with many people simply accepting drunkeness as the norm, an addiction counsellor has claimed.

According to Rolande Anderson, who practices in Dublin, today in Ireland, public and private drunkenness 'are apparently acceptable and many of the excesses associated with alcohol and their related consequences are permeating all areas of life'.

He noted that addiction counsellors nationwide offer services to people of all ages with various alcohol-related problems, but certain trends are now emerging.

Women in their 50s and older, and young people in their 20s and 30s, are now attending 'in large numbers'. Many of these also suffer with depression or anxiety and some have other addictions as well. Many are also 'battling financial and domestic difficulties'.

He described the statistics on alcohol consumption as 'pretty damning'. In 2010, the average Irish adult consumed almost 12 litres of pure alcohol - this is equivalent to almost 500 pints of lager, 125 bottles of wine or 45 bottles of vodka.

Mr Anderson said that while some doctors 'fear uncovering an alcohol problem because 'Pandora's box' is then opened', GPs have an important role to play in reducing alcohol misuse.

"They should be more vociferous in relation to what they see in their daily work. They should lobby local TDs to try to ensure that better services are available," he insisted.

However, he acknowledged that in many cases, a GP's hands are tied by a lack of services and resources. For example, beds for alcohol dependence 'are at a premium' unless you are fortunate enough to have financial resources or appropriate health insurance to be able to avail of private facilities.

"GPs report that it is almost impossible to get a public patient admitted for basic 'detox' and so they often have to refer patients to emergency departments, which are already hard pressed to cope with service demands," he explained.

He insisted that primary care (GP) staff need 'active support' if alcohol misuse is to be tackled properly.

Mr Anderson noted that while postgraduate training for GPs in this area has improved in recent years, undergraduate training is 'woefully inadequate' for lifestyle problems in general, including alcohol addiction.

He added that alcohol problems need to be picked up in patients 'as early as possible', as the longer the problem exists, the harder it is to offer effective help and treatment.

Mr Anderson made his comments in the journal of the Irish College of General Practitioners, Forum: Clinical Focus.