ne frequently hears discussion
about the deadly effects of illegal drugs on the people of the federation, and
on our society. But what about alcoholour legal drug of choice? Is it a serious
problem here? If so, what is the nature of its negative effects?Health Problems
"Alcoholism is our number one public health problem," declared Dr. Izben Williams emphatically. A 1994 study he conducted revealed that, "30-35% of general hospital admissions are directly or indirectly related to alcohol." These results are supported by other doctors anecdotal reports that up to 50% of hospital patients are alcohol related. "Alcoholism ranks almost with chronic admissions such as diabetes and hypertension," stated Dr. LeRoy Richardson of the Mary Charles Hospital. He noted that many accidents and injuries are also linked to alcohol abuse.
Dr. Clavelle Hobson expressed concern about the "terrible drain on our medical system," which is caused by alcohol, noting that there are already enough limitations from other sources. She emphasised that at JNF alcoholic patients often stay a week, or sometimes up to three weeks to go through detoxification. Some of them quickly return to the bottle, and subsequently to the hospital, in a short period of time.
While the effects of alcohol abuse are more readily apparent in poor people because they are visible on the streets, health educator Jefferson Wallace revealed that "alcohol is just as problematic in the middle class as the lower stratum," noting that their abuse is usually hidden at home until it becomes impossible to conceal. Dr. Williams referred to studies carried out elsewhere in the Caribbean which "show a particularly high percentage of alcoholism among expatriates."
Wallace said that alcoholism "appears to be more deep-seated in some rural areas," a perspective which was expressed by others. The production of "Hammond," illegal rum, remains strong, particularly in Conaree, Saddlers, Tabernacle and Molineux. The low-cost of this home brew, makes it easier to abuse. Dr. Williams noted that Hammond often has "many impurities in it," continuing that there is "more illness from that rum than the commercial product."
Nasty Social Effects Too
A teacher from Basseterre High School called alcohol "one of our leading social problems," saying that she sees its effects in terms of child abuse and neglect. Dr. Williams agreed, saying "it's related to a lot of our social ills." One of the organisers of the Alcoholics Anonymous group discussed its long-term affect on families, saying that "people use the family's money for alcohol instead of basic needs," such as food and clothing. She continued, "people aren't present to their family when they're drinking. They're out partying, sleeping or in some cases abusive. It sometimes leads to both physical and sexual abuse, destroying marriages and relationships and negatively affecting children." Most chronic alcoholics are also unable to hold down a job.
Almost every healthworker with whom we spoke recounted recent stories about the extent of the problem.
"The other day, two ambulances arrived at JNF from different directions, both bringing patients with alcohol-related problems," mentioned one. Dr. Williams related that "it is not unusual for me to encounter young men in their 20's who are having problems which you expect to meet in men in their 60's, because they began drinking alcohol at the age of 9 or 10."
Dr. Richardson reported that several days earlier a 50 year-old man had come to Mary Charles Hospital vomiting and very sick. He was transferred to JNF where he quickly died. The next day Dr. Richardson saw two of the deceased man's drinking buddies who were "drinking for him." The man's death was connected to his long-term abuse of alcohol.
Why and What is Being Done?
"We have not yet decided to give due cognizance to the damage of alcohol," noted Dr. Williams. Dr. Richardson described drinking as "part of the culture, inherited in our history" and "socially acceptable." Dr. Hobson theorized that the roots of alcohol abuse "go way back to the time when it wa perhaps the only form of release from poverty." Another doctor said, "we have not come to grips with the excesses." The fact that drinking alcohol is so widely accepted by the general public makes it more difficult for effective programs to be put into place.
Education about the negative effects of drinking is "a significant component of the DARE Program," which was introduced in the schools in September, according to Constable Junie Hodge, coordinator of the program. Eight police officers have been trained to conduct the educational work in St. Kitts and Nevis. They describe the health and social effects of drinking to the young people and seek to teach them the tools needed to resist alcohol and other drugs.
Hodge cites his own personal experiences to back up the factual information. "I am a victim of alcohol abuse," he tells the young people. "I lost my father to alcohol." His father was killed in an auto accident while he was driving drunk. Hodge was only five years-old at the time.
DARE is active in primary schools and will expand into secondary schools where they will lecture on the harmful effects of drugs in the new year. "The Commissioner gives priority to this work because it prevents crime," Hodge noted.
DARE encourages children not to drink at all. "It is illegal for a minor under age 16 to drink, sell or carry alcoholic beverages," Hodge asserted. However, "what Police usually do is to ask him or her to get rid of the alcohol, and talk to a parent or teacher." They don't want to arrest the young people, he said. However, he pointed out that "if the parent is involved, we deal with them according to the law."
Health educator Jefferson Wallace has almost completed designing a "Health Promotion Exercise" to be used in primary and secondary schools, as well as with the general public. It focuses on lifestyle-related diseases, including alcohol and drugs.
Helping Hands
Few services are available to assist those who have alcohol problems. There is no detox center or other residential programme for people who want to stop drinking. The nearest treatment center is currently located in St. Lucia, and one is being established in St. Maarten. There are active Alcoholics Anonymous (AA) groups on both Nevis and St. Kitts (see page 5 for contact information). They are the only organised programmes available.
"The biggest factor is breaking through the denial," said the AA organiser. Each person must first admit to him/herself that he/she has a problem and needs help before any change can be made. AA is a peer fellowship based on the idea that people support one another to change their lives, and that the help of a "Higher Power" (whether one defines that as God or in some other way) is necessary in order to overcome the addiction.
The fellowship, which meets three times weekly, is based on a 12 step programme which has been used by hundreds of thousands of people throughout the world to overcome their drinking problems. (See accompanying piece for "John's" personal story.) The St. Kitts group regularly includes approximately a dozen people, an increase from only a few several years ago. One of the group's fundamental principles is "living one day at a time."
Several doctors mentioned the importance of creating stronger links between inpatient services at the hospital and available support services, in particular the AA group. Dr. Hobson suggested that perhaps alcoholic patients should be accompanied to an initial AA meeting before they're released from the hospitalto help them make the first contact which may motivate them to continue participating in the group.
It is clear that much work is needed to reduce the devastating social and health effects of alcohol abuse. "Efforts must come from outside government," according to Dr. Williams. However, government can play an important role by using its powerful platform to discourage alcohol consumption and to legislate its responsible use.
"Peace of Mind I'd Never Known"
It took a nine-day drinking spree for "John" (not his real name) to make a firm decision to stop drinking. "It really shook me up," that I didn't come home for that entire time, he recalled, "I could have died." Although he had been aware of his drinking problem for several years, this was the first time he hadn't come home.
"The last time I had an alcoholic drink was 11 May 1993," he said with pride. Several weeks later he hooked up with Alcoholics Anonymous through a friend who had given him literature about the programme. "When I read the materials I felt like I was reading my own story," he said. Today, John continues to regularly attend AA meetings. "I will always remain an alcoholic," he noted, "I have arrested the disease, but I'm just one drink away from a drunk. I cannot be complacent."
"I started out as a moderate drinker at age 18. But, over the years, my drinking got progressively worse without my realising it. I always felt that I could conquer alcohol. I would always tell myself, `I drank the wrong kind of alcohol or I didn't have enough to eat.' I made many excuses and felt I didn't have a drinking problem," John told The Observer.
He became more concerned "when it started to interfere with my job and family life. I started to miss days of work. I promised to take my kids out and couldn't follow through. I was warned at my job and eventually suspended." He remembered "trying many times to stop drinking on self-will and determination, but each time I stopped, I drank twice as hard when I began again."
"Because of believing in this higher power, which is God to me, I have achieved three and a half years of sobriety," he emphasised. "I have prayed and meditated a lot and followed the 12 steps of AA. The group support has been a tremendous help. I found true friendship and real love there. The group is so supportive of one another. It takes an alcoholic to have an impact on another alcoholic."
"AA has given me a peace of mind which I had never known. I was always frustrated or depressed. When I used to drink I was existing; now I'm living. I've become more loving. I now do things with my family that I had never done beforegoing shopping and to the beach. I am more understanding and honest, and I have much more self-confidence. These days I am in charge of my life."
"In AA we look for spiritual progress rather than spiritual perfection. We don't promote the programme, but we hope it attracts people."
When asked about how he would respond to someone who asked him about how to quit drinking, he replied, "you have to be very honest with yourself. You must want it for yourself, not because of anyone else. The very first drink is the dangerous drink. That is where I need help from the Allmighty."
