The danger when alcohol becomes your best friend

Alcohol dependence is not the stigmatised image of someone slumped over a bar counter drowning their sorrows, nor is it the rock star smashing everything in sight in a drunken rage.

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Behind the stereotypes is a far more complex addiction that can be triggered by trauma, grief, mental illness, major life changes and years of using alcohol to cope with emotional pain.

Many of the people now seeking treatment do not fit the picture, either. They are professionals with successful careers, parents raising families and South Africans who have always believed they had a healthy relationship with alcohol. Yet not.

Graeme Hart, an addiction counsellor at Netcare Akeso Stepping Stones who has been sober for almost 12 years, said he is seeing more people over the age of 40 reaching out for help.

“I think we came from a generation where you kept a stiff upper lip and dealt with your problems on your own,” Hart said. “Psychologists and therapists were for rich people and Americans on TV.”

Hart said many people had spent years believing alcohol was helping them cope, until they realised it had become part of the problem.

“Like me, their best friend of many years, has now become toxic,” he said.

A toxic best friend

“People have often covered up their dependency for years, and under the surface they may be struggling with anxiety or depression.”

He said many believed they had always been social drinkers until something happened that accelerated their drinking. This could be funnelled to major life events like divorce, bereavement, job loss and other instances of similar ilk.

Do you need a drink to chill? Picture iStock

Social worker Ingrid Pollak of Inner Essence said the underlying problem was often not alcohol at all, but unresolved emotional pain.

“Whatever you perceive as trauma, that triggers you, that is a trauma,” Pollak said. She said what one person dismissed as insignificant could have a profound emotional impact on someone else, making alcohol an easy escape if those emotions remained unresolved.

South Africa’s drinking culture also makes it harder for people to recognise when their relationship with alcohol becomes unhealthy. Alcohol remains part of celebrations, sporting events, braais and social gatherings, making excessive drinking appear normal.

Hart said the warning signs were often found not in how much someone drank, but in why they drank.

“Whether someone needs help is not always so much about the type of substance or quantities used. It is more about the relationship the person has with the substance or behaviour,” he said.

“The desire to use substances in times of distress for emotional regulation or comfort can often be an indication that a person has lost connection with themselves and others.”

As alcohol becomes more important in a person’s life, behaviour often changes. “Over time, addiction shapes the person’s behaviour and they often become secretive, self-sabotaging and avoidant, further alienating themselves,” Hart said.

Alienation and self-sabotage

The impact is not really confined to the person doing the drinking. Pollak said families often carry the consequences well before the person dependent on alcohol recognises they need help.

“They end up carrying the alcoholic and their lives instead of them actually carrying themselves,” she said.

Pollak noted that there were generally two broad patterns. Functional alcoholics could continue going to work, caring for children and meeting their responsibilities despite drinking every day. Dysfunctional alcoholics gradually neglect their families, responsibilities and themselves as alcohol becomes the centre of their lives.

South Africa has a drinking culture. Picture iStock

Children often pay the highest price, she said.

“A lot of the time, those children either become parentified in families where alcohol dependence reigns. They become very responsible and take on adult responsibility, like looking after themselves, making their own lunches and looking after their younger siblings.”

Others grow up, she said, believing heavy drinking is simply part of adulthood. “If my daddy and my mummy drink, well this is what adults do,” she said.

Hart said alcohol dependence frequently exists alongside anxiety disorders, depression, bipolar disorder and attention deficit hyperactivity disorder. He said one of the biggest challenges in recovery was not always the physical craving for alcohol.

“When people try to stop drinking, it is often the emotional attachment that they find the hardest to deal with and not the craving for alcohol itself,” Hart said. “This is why people who want to recover have to follow a lifelong programme of maintenance to remain sober.”

Mixed signals about drinking

Returning to South Africa’s drinking culture, Pollak said society often sends mixed messages about alcohol.

“You are expected to drink to be social,” she said. “But then it becomes a stigma if you become drunk or if you become an addict.”

Hart said reducing the stigma starts with improving understanding of mental health. “There is still stigma, and we need more awareness about mental health,” he said.

“More understanding at a younger age could help prevent dependence from developing.”

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