An estimated 13,000 people have severe alcohol dependency problems in Malta, according to Sedqa’s care manager services sector Manuel Mangani.
The figure is based on global research which suggests that fewer than one in four alcoholics seek help. In fact, 4,000 alcoholics have sought help from Sedqa, the government agency for substance abuse in the past 22 years.
Sedqa, Oasi and Mount Carmel Hospital work closely with Alcoholics Anonymous, a self-help group for people who wish to stop drinking, and recommend its programme to their clients.
In this context, the number of members in the national AA, standing at only 120, appears low. This may partly be due to the smallness of the island and the fear of being ‘found out’, despite the fact that members of the fellowship are bound by the strictest rules of anonymity.
AA was set up in Malta in 1966. It is part of an international self-help fellowship which developed ad hoc in 1935 in the US when two alcoholics, a stockbroker Bill W and a surgeon Bob S met and realised that by talking about their disease they could stay sober. Today AA has 2,000,000 members and time has shown it works worldwide, although nobody knows exactly how.
Scientific research points to two main reasons for its success – the effects of the group on the individual, more specifically the act of sharing stories, and the central place of a ‘higher power’ in its programme.
The programme is tough and radical, requiring total abstinence from alcohol. It is structured around 12 steps, based on the conviction that the alcoholic has no power over alcohol, where members agree to abandon personal power to a higher power/God. They then have to admit to God, themselves and one other person the nature of their wrongs and make amends to those wronged. Not easy. In exchange, they get total support. Each member has his/her own sponsor and 24/7 access to a member of their group when in difficulty.
Culturally, alcohol enjoys widespread acceptance, backed up by a strong alcohol lobby. Malta is still the only country in Europe without a National Alcohol Policy, though a draft policy was finally presented for public consultation last November. But it has yet to become law.
Moreover, Mr Mangani feels that the government should state more clearly that alcohol is a dangerous substance, even in small amounts, significantly contributing to many illnesses, including cancer.
Unfortunately, few alcoholics are referred to AA by GPs, who are arguably the first people in a position to diagnose the disease. GPs are always invited to open AA meetings at conventions, according to one longstanding AA member.
What is the profile of the alcoholic who seeks help in Malta? Mr Mangani says that those calling on Sedqa are normally over 40. This is also true of AA. There is the tendency in the alcoholic to postpone asking for help and find his or her own solutions that do not involve cutting alcohol out altogether, until he or she reaches rock bottom. According to an AA member: “An alcoholic is a megalomaniac with low self-esteem, living a false life,” he says wryly.
The programme is tough and radical, requiring total abstinence from alcohol
The Maltese AA has very few young members, although it is known that heavy drinking among young people is high compared to other European countries. There may be need to set up a ‘Young People’ in AA group branch, as some other fellowships overseas have done, dedicated to people between 16 and 35.
New trends in alcoholism in Malta include a significant rise in the number of women seeking help for alcohol dependence. Sedqa reports that the number of women seeking help has risen from 16 per cent in the past 15 years to 25 per cent.
According to both Mr Mangani and the chairman of Mental Health Services, psychiatrist Anton Grech, the rise could show lower diffidence by a more empowered gender to open up, rather than an actual rise in the number of female alcoholics. However, more research is needed in this area.
Multiple substance abuse is also on the rise. Many drink heavily and take cocaine to keep awake and function better, says Mr Mangani.
The AA Malta 11th International Convention will be held from Friday to next Sunday at the Seashells Resort, Suncrest Hotel, Qawra Coast Road, Qawra. A number of sessions on all days are open to the public. For more information e-mail convention@aamalta.org.mt. To contact AA, e-mail help@aamalta.org.mt or call 2123 9264 or 7923 9264.
The story of a recovering woman alcoholic
“It was customary when my father came home from work every evening for us all to gather around the kitchen table, a half-gallon of Scotch in the centre and drink as we chatted about our day, waiting for his permission to go out in the evening.
Ironically, I did not like alcohol in my teens and drank a glass of sweet liqueur or wine just to belong. But I soon acquired a taste for it and began to drink a great deal like the rest of my family and friends – we never thought of it as alcohol abuse.
At the weekend, I would go out with my friends and they would get tipsy while I got drunk. I started a serious relationship and things ran smoothly at first. I only got drunk at weddings, parties and social events – and I thought that made my drinking okay, because it was only on occasions.
Slowly I started to increase my intake, drinking as soon as I returned from work, pouring myself a stiff Scotch as I stirred the soup or baked a pie. My relationship suffered and this made me drink more. I stopped working for a while and started drinking from the morning.
Still I was in denial, worrying instead about another family member who I thought was drinking too much. I let myself be persuaded to attend an open AA meeting, where I finally confronted the fact that I was an alcoholic. I left full of good intentions to avoid that first drink, but I succumbed almost immediately.
In the following years I would go for months without a drink but lapse over and over again. I lost good friends who were embarrassed to be seen with me. My own family avoided me.
Finally, I went back to AA. Everyone seemed to be telling my story - the gradual increase of alcohol intake, the loss of husbands and wives, the brushes with the law…
I attended meetings every day at first, which gave me the strength to spend the next 24 hours without a drink and the next. If I am having a bad moment I have telephone numbers of people in the fellowship whom I can call any time, day and night, to help me over that temporary hurdle.
I take one day at a time… my task is simply not to drink that day. I don’t think about tomorrow.
Using this method I have managed to have eight years of sobriety. Yesterday, has gone and tomorrow may never come. But today I am alive and free from the chains that bound me in my active alcoholism.
I am hugely grateful to my friends in the fellowship who have helped me to stay sober and will continue to do so for each new day I choose to stay away from that first drink.”