The Responsibilisation Trap.
How people with alcohol problems are blamed twice.
Written by James Armstrong
We talk a lot about “responsibility” in relation to alcohol. Responsible drinking and responsible choices around alcohol use, but also being a responsible person who seeks support for alcohol issues. But responsibility, in the way it is used around alcohol, is rarely neutral. It's a way of deciding who is deserving of care and who must carry the burden of harm.
Responsibilisation is the process of placing responsibility for harm onto a person, rather than recognising the wider social, commercial, and structural factors that contribute to it. In the context of alcohol, this can mean people are told that alcohol-related harm is simply the result of poor personal choices, while the influence of marketing, availability, pricing, social norms, and industry practices is downplayed.
The “responsibilisation trap” emerges when this message comes from all directions, government policy, public discourse, media narratives, and the alcohol industry itself. People experiencing harm are expected to manage risk entirely on their own, while the systems and environments that shape alcohol use avoid accountability.
In short, people with alcohol problems are blamed for developing a problem, and then blamed again when they find it hard to recover.
This trap is not accidental. It is built into the way the alcohol industry frames harm, and it is embedded in the way treatment systems ration access to care.
The first trap: the alcohol industry’s responsibilisation approach
The alcohol industry has spent decades perfecting a narrative that shifts responsibility away from the product and onto the person. It works like this:
The industry normalises heavy drinking through branding, sponsorship, and cultural saturation
It reframes harm as a matter of individual misuse
It even positions itself as the guardian of “responsible drinking”
It avoids accountability for the predictable harms of its own business model
This is the first half of the trap: “You got yourself into this.”
It is a narrative that erases the wider determinants of harm such as poverty, trauma, mental health, social isolation, marketing saturation and advanced alcohol advertising and branding methods and replace them with a moral judgement about personal character.
Then there is the second trap, "you need to prove you are ‘worth’ treatment."
The same logic appears again when people try to access detox or rehab. Instead of being treated like the vast majority of people with a health need, people with an alcohol need are often treated as applicants who must demonstrate worthiness to enter an exclusive club.
Stigma determines people with a substance use need to be low moral character and low competence. To overcome this view people seeking more intensive care must repeatedly tell/sell their story and prove they are motivated.
A commissioner captured this dynamic with painful clarity in the recent RSDTG evaluation report when describing how increased funding removes stigma - Drug and alcohol support for people experiencing rough sleeping or at risk: what £262m achieved across 83 areas | Ipsos
“In the past we would have expected [service users] to get to a point where we felt it was - and this is going to sound wrong - worth investing that money in them… We were almost excluding them because they couldn’t get to that point of showing that commitment… What I think [RSDATG] has allowed us to do is to just allow people to go to detox and rehab without all of that process… They [still] have to demonstrate motivation by attending groups. And there have been some really good outcomes from people that we wouldn’t have funded detox and rehab before in the past.” - Commissioner
This quote is extraordinary, not because it is unusual, in my experience of working around residential care services for the last 20 years, it describes a common experience for people accessing residential care. It's only extraordinary because it's rarely ever openly talked about.
It exposes the underlying logic of responsibilisation in treatment:
You must prove you are motivated
You must show you are ready
You must demonstrate you are “worth” the investment
If you relapse, it is framed as personal failure, not system failure
Even when funding improves, the logic often remains that people must still “demonstrate motivation,” attend groups, perform readiness. The burden stays on the person.
So there is blame at both ends of the system
The alcohol industry and the treatment system are very different of course, but they produce a strikingly similar moral logic in order to avoid blame.
Together, they create a closed loop of stigma where harm is individualised, people internalise shame, shame delays help-seeking and delayed help is used as evidence of personal failure.
Responsibilistaion erases
Trauma and adverse childhood experiences
Poverty and deprivation
Mental health conditions
Social isolation
Saturation of alcohol marketing and availability
Advanced alcohol advertising techniques
Underfunded early intervention
Cuts to treatment budgets and workforce capacity
When these factors disappear from view, the individual becomes the only visible place to attribute blame.
It is time to dismantle the responsibilisation trap.
Our new toolkit looks at how to address professional and structural stigma, it's available here.