SINGAPORE: At the birthday parties and family celebrations Nigel* used to attend, alcohol was freely available. He was then in his early teens.
“It was just there, and the uncles would say, come here and have a drink young man, and we would just pick it up, no permission needed,” he recalled. “It was all about being funny and jovial.
"I just gulped it down, and that was it, but over the years I started to like it.”
But this early introduction to the pleasures of alcohol was the start of his journey down the road of addiction: At his peak, Nigel was drinking about 36 to 40 cans of beer a day.
ALCOHOL ADDICTION ‘NO DIFFERENT’ FROM DRUG ADDICTION
Although it is socially acceptable to drink alcohol, addiction specialists Channel NewsAsia spoke to say it can be a lethal drug.
“Because alcohol is so easily available and part of our culture, many people may be drinking at dangerous levels without seeking help, as it has already become part of their lifestyle,” said Dr Gomathinayagam Kandasami, chief of the Addiction Medicine Department of the National Addictions Management Service (NAMS).
“As a doctor, I can say that whether you develop a drug addiction or alcohol addiction, there is no difference,” he added. “Addiction destroys you and your family, and increases the risk of dying early.”
He also cited statistics from the 2010 Singapore Mental Health Study, which showed that 96.2 per cent of those affected by alcohol abuse did not seek help. According to the study, which are the only local statistics available on the issue at a national level, alcohol abuse is also one of the three most common mental health disorders in Singapore.
The abuse usually begins in a social setting, said Dr Thomas Lee, consultant psychiatrist at the Resilienz Clinic.
“I very rarely find patients who start their drinking alone,” he noted. “Sometimes, they are also introduced to alcohol by their parents or family members, and they find they like the taste of it.”
But when their drinking starts to interfere with their daily life, where they may not be able to go to work without having a drink first ... that’s when it starts to become a problem.”
Dr Kandasami added that drinking large amounts of alcohol in a short span of time – for example, four or five drinks in half an hour – is one precursor to problem drinking. If left unchecked, he said, problem drinking can develop into addiction.
“If they don’t drink, they will develop a lot of withdrawal symptoms,” he explained. “They could get shakes or sweats when they wake up in the morning, so they end up drinking a can of beer to start their day.”
And, because it takes time for the addiction to develop, both doctors said the patients they usually see have been drinking heavily for many years before they are compelled – usually by family members, or when they hit a crisis – to seek help.
They noted that the patients they see are typically older – between the mid-thirties to their fifties – and most had started drinking in their teens or early twenties.
“By that time,” said Dr Lee, “they would already have damaged their liver, or their memory has started failing.”
NIPPING THE PROBLEM IN THE BUD
This is why nightspots, bars and liquor importers hope to address problem drinking where it all begins: In social settings.
The Singapore Nightlife Business Association (SNBA) has teamed up with the European Chamber of Commerce’s (EuroCham) wine, spirits and beer committee to form an alliance aimed at promoting responsible drinking.
“We want to make sure that Singapore is perceived as a safe place to go out at night, that people don’t find an environment where others are drinking more than they should,” said general manager of Moet Hennessy Diageo Singapore David White.
The company imports and distributes premium wines and spirits, and is on the EuroCham wine, spirits and beer committee.
“As suppliers, it’s also the right thing to do, because we want to make sure we are self-regulating the industry and that in the long term, we are not impacted negatively in any way,” he added.
The alliance, named the Singapore Alliance for Responsible Drinking, plans to help nip problem drinking in the bud by training bar staff to recognise signs so they can handle the situation appropriately.
The alliance also hopes to roll out a standardised training programme across the industry, taking the best of overseas training programmes and adapting them to the Singapore context.
One programme they are looking at is the Training for Intervention Procedures (TIPS) from the US, which is a skills-based programme designed to prevent intoxication, underage drinking and drunk driving.
SNBA's vice president Edward Chia explained that even while some establishments may already have in-house training programmes for their staff, the training can be “highly inconsistent”.
“Different companies would have different approaches, different policies, but to me, that creates an inconsistency in the nightlife industry in Singapore. So we hope to have a standard programme that is executed and delivered to almost the majority of operators in Singapore who have a liquor or a public entertainment license,” he said.
A TIPS pilot was also carried out in 2015 for nightspots in Clarke Quay, to great effect.
“Since we did the TIPS training, our statistics showed that over-intoxication-related incidents fell by 30 per cent in our clubs,” noted Mr Gordon Foo, managing director of Shanghai Dolly, adding that previously, his staff learnt from on-the-job experience and by asking more senior staff for advice.
“I think TIPS training provides standardised, formalised guidelines for everybody to follow, so they know what to do at the same time.”
Shanghai Dolly security staff Mohd Fairuz has about 10 years of experience in the industry. His job involves patrolling the premises looking out for rowdy drinkers, or small groups drinking large amounts of alcohol.
"There was no training given previously and l learnt everything from my seniors," he said.
“Previously, we hesitated to confront customers who were rowdy, because I thought if a bouncer approaches a customer, it looks bad for them, like they are doing something wrong.
"But after TIPS training, I realised that it’s all about our body language and how we approach them. If we approach them smiling, it shouldn’t be a problem,” he added.
He added: “I’ve learnt to engage rather than confront customers, get to know them, and now, some of us are friends.”
MORE AWARENESS NEEDED
It took almost four decades for Nigel, who is now in his fifties, to kick the habit. Late last year, he voluntarily checked himself into the inpatient detox programme at NAMS at the urging of his wife and a good friend.
“I realised that after so long drinking, something is wrong,” he said. “I’d always thought life was good to me, but then why would I need to keep going to get a beer just to calm myself?
“I was basically drinking away all my money, not meeting up with appointments, not seeing friends, just being reclusive and always looking for money to buy beer ... And when I was sitting alone gulping beer after beer, I started thinking about jumping and ending my life ... but I never had the courage to do that.”
He is grateful that his wife realised there was a problem and called a good friend for help. “I was in a stupor, and he literally dragged me out of bed, and got me showered and shaved,” he recalled.
After treatment at NAMS, Nigel is still on medication, but has been sober for the last seven months.
He noted that it will definitely be helpful for nightspots to give their staff formal training on spotting the signs of problem drinking. “The impact will be there, slowly and gradually.”
But he added that outside the drinking establishments, there also needs to be more awareness about the dangers of alcohol abuse in the community.
“The families should be educated, and the community as well,” he said. “We talk about gambling, about drugs ... but alcoholism is a big problem in Singapore.”
Both doctors concurred, with Dr Lee adding that this education should start from young.
“At the school level, children are more aware of sex education, and they don’t know as much about the harms of alcohol,” he said, adding that even children as young as 12 can start drinking.
He also suggested that existing messaging about drinking in moderation be tweaked, noting that currently, the focus appears to be on drink driving. “We don’t see messages outside of this, for example, the health hazards of drinking too much.”
Dr Kandasami noted that much has already done by the Government to restrict the sale and use of alcohol in public places. But more could be done, he said, particularly in the messaging towards young people.
“The messaging for drug abuse is very strong, where you go to prison and ruin your life, but when it comes to alcohol, I’m not sure the messaging is strong enough, particularly for binge drinking or underage drinking,” he said. “Maybe the Government can make it clearer – that your drinking problem will not be tolerated.”
*Nigel's name has been changed.