THE problem of alcohol abuse still plagues many people. Although there is, at times, increased focus on cannabis in Jamaica, it is important to remember that alcohol-related disorders still contribute significantly to disease burden, both locally and worldwide.

Because alcohol is a legal drug and widely used in social settings, there is often the misconception that it is safe.

In the realm of psychiatry, alcohol-related disorders are currently classified as:

1. Alcohol use disorder;

2. Alcohol intoxication; and

3. Alcohol withdrawal.

Alcohol affects the cells in the body and the most immediate impact is to the brain. It is a depressant that causes brain functions to slow down. This can result in: Slurred speech; poor muscle control and judgement; confusion; slowed reaction time; poor vision; lack of coordination; and sleep disruption.

Seizures may occur during alcohol withdrawal in severe cases.

MANAGEMENT

A biopsychosocial approach to managing alcohol-related disorders is necessary. People often believe that a short-term inpatient stay at a rehabilitation facility will serve the purpose of “flushing out” the system of alcohol and prevent the person from ever drinking again. However, this could not be further from the truth. In fact, there is still a high possibility of relapsing after a period of alcohol cessation.

ADDICTION TREATMENT SERVICES UNIT

This facility, located on the compound of the University Hospital of the West Indies, provides an excellent short-term (three to four weeks) inpatient option for acute detoxification and rehabilitation.

Treatment is aimed at managing the acute withdrawal symptoms by the use of medication and psychotherapy. One-to-one and group psychological sessions are aimed at psychoeducation and teaching patients ways to cope with life stressors and be better at identifying and eliminating cues that lead to relapse.

Any co-occurring mental health issues are also identified and treated. The key thing to remember about this facility is that it is voluntary, and the patients must have reached a stage of motivation and prepare themselves for a period of inpatient stay. Addiction Treatment Services Unit is open to both adolescents and adults.

ALCOHOLICS ANONYMOUS

Located at the Stella Maris Church in Kingston, an Alcoholics Anonymous (AA) meeting is a support group for alcoholics who are breaking their addiction. Members will often meet to share experiences on problems with their lives, recent developments, and how long they have been sober.

TEEN CHALLENGE

Teen Challenge Jamaica is a non-profit organisation dedicated to helping individuals suffering from drug and alcohol addiction. The nearly 40-bed programme helps various teens during a 12-18-month period.

This is accomplished by:

• Counselling: Resolving past issues;

• Mentoring: Applying biblical principles to every aspect of life;

• Teaching: Learning new ways to deal with life issues;

• Training: Job-readiness and vocational skills;

• Structure: Learning good disciplines through work, recreation and rest;

• Love and acceptance: Life-learning in a family atmosphere.

RICHMOND FELLOWSHIP (PATRICIA HOUSE)

This is a 24-bed residential facility for Jamaicans as well as non-nationals who have lived in the country for more than five years.

The service model embraces the therapeutic community approach to substance abuse that focuses on individual and group counselling. The facility accepts patients 18 years and older with a history of out of control drug use, willingness to seek help, who have no active psychiatric illness and no other medical attention that requires more attention than the drug addiction.

The mission of the programme include:

1. Mental health training and education, rights advocacy for the mentally ill, training in prisons.

2. Provide detoxification and rehabilitation for drug abusers who cannot afford the private sector services.

3. Psychosocial training and retraining.

Many private psychiatrists islandwide also provide assessments and treatment for alcohol-related disorders and can make appropriate referrals to any of the above mentioned facilities as necessary.

FOUR WAYS TO HELP PREVENT ALCOHOL AFFECTING YOUR MOOD

1. Use exercise and relaxation to tackle stress instead of alcohol.

2. Learn breathing techniques to try when you feel anxious.

3. Talk to someone about your worries. Don’t try and mask them with alcohol.

4. Always be aware of why you’re drinking. Don’t assume it will make a bad feeling go away; it’s more likely to exaggerate it.

Dr Ashish Sarangi MBBS is a resident in psychiatry at the University Hospital of the West Indies. He may be contacted via email at aks_sarangi@hotmail.com