Alcohol, whilst utilised as a social beverage for personal enjoyment and relieving the pressures of a hard day's work, is a depressant which one can be dependent on. Its effects can be debilitating, not only on one's health, but also on one's social life, as someone with alcohol addiction issues may alienate family and friends in pursuit of the next drink.
Interestingly, risk assessment for Alcohol problems is usually not something I am used to doing, as normally it is difficult to engage client with such issues, for the very reason that they may alienate themselves from the family members.
In working with aftercare issues for ex-inmates and their families, there has been raised awareness of how problems of alcoholism play crucial roles in family adaptability with their environment. However too often a time, families suffer serious stress and anxiety in coping and caring for a member who has an addiction problem to Alcohol. Being something readily available and relatively cheap, working towards addressing alcoholism in Singapore is an onerous process.
Pamela Askham (1997) discusses important issues that probably need to be explored when identifying Alcohol related problems in clients and their families.
1. What are the reasons for drinking?
2. How does drinking effect client's relationship with family members?
3. How does drinking effect client's relationship with society and the environment? (includes employment, relationship with other systems, etc)
4. Does the client come from a family of heavy drinkers?
5. Do social groups attended by the client include heavy drinkers?
6. Past attempts at reducing or stopping drinking? What were the effects?
7. What does client hope to do about his current drinking?
8. What support does client have when he is trying to cut down or stop? (explore informal social support)
9. How much is currently being consumed?
10. What are the risks for client and the environment (E.g. Potentially put himself in a situation of violence where he can hurt himself or others.Potentially put himself in a situation where he may get arrested)
1. Exploring client motivation and level of support for change
- Reasons for client making decision to stop drinking
- Family members who may be present to assist in supporting this desire to stop
- What would be the substitute for alchohol for the client?
- How can client chart and observe progress over the next few weeks?
- What are the rewards for this change in behaviour?
2. Identifying emotional states that may increase risk of drinking too much and possible ways to address them without use of alcohol.
- Negative emotional states (e.g. feeling angry, depressed, anxious or tense)
- Social Pressure (when introduced to a celebratory environment such as a friend's party)
- Personal Control (in being able to say no when someone offers him to buy a drink)
3. Practical ways of dealing with alchoholism
- Having a drinkers' diary to take note of how much drunk and how much money spent.
- Reducing progressively instead of stopping all at once
- Finding excuses that can be used in situations where drinks are offered.
Resources available in Singapore
1. The National Addictions Management Service Singapore (NAMS), where residential detoxification, medical assessment and treatment, as well as addictions-based counselling can be provided. The social worker would benefit from working collaboratively with the NAMS counsellor to address alcohol related problems in concordance to family based intervention.
2. Halfway houses also provide residential, group work, counselling, spiritual support and employment support for clients struggling with addiction related issues which include alcoholism.
3. Alcoholics Anonymous Singapore: A free service provided by a fellowship of individuals who organised secular open and closed meetings to talk about Alcohol related problems and their struggles and successes in addressing them.
Askham, P. (1997). Alcohol: The Effects and Risks for Individuals. in Kemshall, H & Pritchard, J: Good Practice in Risk Assessment and Risk Management 2: Protection, Rights and Responsibilities. London and Bristol, Pennsylvania.