Alcohol misuse, abuse and dependence

Better minds better living with Dr. Yansie Rolston Monday, June 26 2017

I WOULD be very wealthy if I had a pound or dollar for every time someone has said that alcohol does not affect them, that they do not drink heavily, or that they can stop drinking anytime.

There are also those who genuinely do not realise that alcohol misuse/abuse (drinking excessively) and alcohol dependency (mental and physical addiction to alcohol) does not necessarily entail drinking copious amounts, or needing to have a drink first thing in the morning. But unfortunately, there are many who are aware and are in denial because of the particularly stigmatising mental health challenge that surrounds alcohol misuse, abuse and dependency.

By way of self-preservation there those whose preference is to carry around shame and guilty rather than admit to struggling with a mental health challenge.

If you are a person who drinks beers or a bottle of wine every day whether it is to cool down, unwind, or socialise there is a strong possibility that it could be affecting your health – which may not necessarily present itself now but could do so in later life.

However, before I get accused of being a killjoy let me clarify that I have nothing against those who choose to drink sensibly and in moderation, but the reality is that alcohol does in fact have considerable social, economic and health consequences. I have seen far too many lives lost, individuals mentally and physical disabled, families destroyed, and people struggling to claw their way out of the grips of emotional despair and financial ruin, and therefore witness first-hand just how damaging and harrowing it can be.

The burden of disease due to alcohol consumption is a massive public health problem, not just in Trinidad and Tobago but globally.

Furthermore, the World Health Organization 2014 report on Alcohol and Health has noted a link between alcohol consumption and at least 200 health conditions, which is quite alarming and should give cause for concern in a country with its overstretched and under-resourced health service.

Alcohol is psychoactive depressant substance with dependency producing qualities that affects thoughts and mood, which it does by altering brain chemicals. It is those very changes that are responsible for the loss of inhibition, the free-spiritedness, the increase in confidence, and the Dutch courage that so many people enjoy after having a drink or two. But those changes also modify perspective and slow down reflexes which can lead to risky, life-altering behaviours.

Alcohol use in Trinidad and Tobago is problematic because it is such a huge part of the cultural norm and it needs to be continually addressed within the wider context of mental health awareness. Those who are affected by mental ill health such as depression, alcohol can exacerbate those challenges for example it can increase the tendency towards suicidal ideation and self-harm.

Demographic studies show that alcohol is a major factor for death in males aged 15 to 59, and that drinking is increasing amongst females who are more vulnerable to alcohol-related harm including interpersonal violence and risky sexual behaviours.

Drinking amongst young people is also growing, and they are more prone to engage in risky behaviours resulting in increased numbers of accidents, disablement and other unintentional injuries. In terms of socio-economics, it should not surprise you to know that poorer people are more vulnerable to alcohol-related health outcomes.

Lower socio-economic populations are the ones who tend to purchase cheap or fake alcohol, often lack awareness of their own health and well-being and are therefore unaware of the ways in which alcohol could be affecting them, do not have ready access to quality health care, and are less likely to have strong support systems.

There is no disputing that people can enjoy the harmless pleasure of occasional tipples without any implications, but others are unable to be moderate in their intake, lending itself to psychological and physical dependency and long-term health consequences.

So, if you enjoy a drink I ask that you do so sensibly and moderate your intake. My granddad’s favourite mantra was “everything in moderation, nothing in excess”.

Cheers – to your good health.

Dr Yansie Rolston FRSA is a UKbased disability and mental health specialist advisor. She is a social strategist and trainer who works internationally at various levels of government, business and civil society. Contact her at

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