The mentality and behaviour of drug addicts and alcoholics is wholly irrational until you understand that they are completely powerless over their addiction and unless they have structured help, they have no hope” – Russell Brand
Last week, for my first foray into the clinical side of psychiatry, I had to sit-in and observe patient-counselling in the substance-abuse clinics.
For most of the patients, the addiction they were struggling with was alcoholism, but there were a few marijuana addicts sprinkled into the mix. Now, for these patients to have been referred to this clinic, they had to have been admitted to the hospital because they were having serious problems. Some of them tried to quit alcohol, but because of the copious amounts they were accustomed to drinking, ended up with severe withdrawal symptoms. Some of them were admitted because of severe drug-induced psychoses. Some of them were admitted because they tried to seriously injure themselves while under the influence.
But at least these were the patients who decided to take a step towards recovery by actually showing up for their appointment. Unfortunately, there are so many patients who default on their appointments, and they never get the help that they need. And there are so many others that haven’t even recognised that they have a problem. The latter two cohorts far outnumber the first. Our challenge is to reverse them.
Right here at home in Guyana, alcoholism is a huge problem. A 2014 WHO report stated that the average Guyanese, aged 15 or older, consumed more than 8L daily of pure alcohol, in 2010 – the global average is 6.2L. Like in suicide, I don’t think this is an area in which we should be aspiring to be world leaders.
Back in 2011, when I was in high school, I wrote about the cultural influences that promote this sort of alcohol use, specifically chutney songs like ‘Rum till I die’. There’s the question as to whether such songs are simply describing a reality, rather than promoting the act. Alcohol has become so ingrained in our society – starting on the sugar plantations. For young males especially, they’re expected to drink once they’re a certain age – it’s what “men” do. It’s a rite of passage. Unfortunately girls, who had often seen their mothers become the object of male alcoholic rages, are increasingly picking up the habit.
But the problem isn’t the drinking. The problem is the quantity they’re drinking. The reasons they’re drinking and what they are culturally conditioned to do once they get “high”. Some cultures, such as Italians, allow consumption of large quantities of wine – especially with meals. But they don’t have the level of alcoholism as we do, nor do they get as violent as we do. Culture is a key variable in alcoholism prevalence. Some drunks “open up” and others get violent.
The quantities of alcohol the patients in clinic admit to consuming, are staggering – and that’s just the amount they’re admitting: most patients like to lowball the number. One patient said that he had to keep drinking more and more and more because it wasn’t having an effect anymore.
For many people, for their drinking to reach that point, it’s because there’s an underlying problem. For some its marriage problems, work-related stress, or all of the million other problems they’re dealing with that day. But they’ve been conditioned to believe the answer can be found at the bottom of a bottle.
I’m still a medical student, but in the time I have spent at the hospital, I have seen patients admitted with serious injuries from falling down drunk, from getting into fights while drunk and from trying to hurt themselves. I’ve seen patients in liver failure after years of alcohol abuse.
There are serious consequences of alcohol abuse and on reflection I am amazed there aren’t more centres to deal with those consequences in Guyana.
