It’s sobering, in the sense of making you stop and think, when you hear reports from the frontline of alcohol treatment. Often these people are much more worth listening to than those who comment and policy-wrangle at a safe distance.

The Guardian at the weekend carried a “secret alcohol liaison nurse’s diary”, a revealing glimpse of people with drink problems and those who try to help them.

There’s the man who fell over while drunk and didn’t go into A&E with his serious head injury for three days, because he feared they’d keep him in and he wouldn’t be able to drink his daily bottle of vodka. He dies.

As does a 36-year-old woman who continues to drink despite the support she’s had over the previous two years.

These people know that if they carry on drinking they’ll kill themselves. Yet they carry on doing it.

The nurse sounds surprised when another client has actually taken the advice and given up her two bottles of wine a night. It makes a heart-breaking job worthwhile.

There is huge frustration, though, that overspills in the diary.

The nurse is supported by a team of volunteers, recovering alcoholics rather than professionals. They are passionate about helping others in a similar plight, but it shouldn’t be like this.

“Why don’t we have an all-singing, all-dancing NHS alcohol service? Cuts are having a devastating impact,” says the nurse, against which her other plea, “Why don’t we have a minimum alcohol unit price?” sounds slightly odd.

More expensive alcohol will surely not help people who are undeterred by the certainty that if they carry on drinking they’ll die.

There is a barely sketched out narrative, of course, that the people who turn up at A&E as a result of a chronic drink problem might not have got that way if alcohol had been made less available to them – which means less available to everyone.

And perhaps price does play its part, but it is a part in a complex drama with many players that we understand very little about – why is it that a small minority of people get into such serious difficulty with drink?

Looking upstream towards the causes of alcohol problems is the right thing to do, but we need to go further upstream than price and availability to the dark source of despair.