Slowing the epidemic of alcoholism in Ghana
“O thou invisible spirit of wine! If thou hast no name to be known by, let us call thee devil!”
I suspect most of us have known someone who probably drunk a bit too much and wondered if that may have been a reason why they died long before their time. Most people drink reasonable amounts of alcohol on occasion. However, for some, knowing what is enough when it comes to drinking is impossible. Such people may as well agree that alcohol can be the devil of some sort.
I have thought a lot about writing this piece. The loss of several young people I know, friends and acquaintances, who have probably died from alcohol abuse recently, motivated me to speak up. I concluded that in its totality, what I have to say might help somebody even if it causes me some discomfort. Perhaps someone who reads this will share it with his or her loved one struggling with this disease we call alcoholism. If sharing this helps someone, even one person, then it would all be worth it.
I also know that I may be speaking for many other people who have been affected by alcoholism. Mothers who have buried their sons and daughters lost to the curse of the bottle when the children should have buried them someday when they passed on. Children, whose education may have been cut short because a parent had problems with drinking and spent the money that should have gone towards school fees, a child who went to bed hungry because his/her parent had spent the money for food on alcohol and mothers whose husbands become nightmares when they drink.
More important, I am writing this for those who may be struggling now with alcoholism. My intention is not to judge anyone, for that is not what he or she need or deserve. I cannot offer anyone advice, for I am unqualified to. Rather, I wish to share my thoughts on the subject and hope that it brings some awareness to the problem in general. My hope is that what I write resonates with someone and that as a nation, we begin to address the silent epidemic that is robbing us of our loved ones.
Medical science classifies alcoholism as a disease and someone who drinks excessively is an alcoholic. Alcoholism may affect every person: from the educated, professional, the rich to the poor. People who suffer from this disease often have an uncontrollable urge to drink. These individuals are often unable to resist the urge to get a drink even if it is causing them serious problems at home, work, financially and is adversely affecting their health and wellbeing. The US National Institute of Alcohol Abuse and Alcoholism defines what excessive drinking is by the number of drinks someone has per day, based on their gender.
Alcoholism costs us in many ways. When there is someone drinking excessively in the family, it affects the whole family. It is worse if that person is the breadwinner, a father, seldom a mother. Our parents are the first role models we know. They teach us a lot without saying a word. One stern look may tell us to behave. One quiet look of approval may signal us to us to strive more to achieve. Now, if the person drinking is supposed to be the breadwinner and role model and they are spending all their money on drinking, then everyone suffers. Even putting food on the table becomes a problem. Perhaps the kids go hungry some days because there is nothing to eat. Under these conditions, the mother has to work and struggle to become the provider. School fees may go unpaid. The drinking often socially embarrasses the family, especially the kids, and that can make kids angry and depressed.
Economically speaking, a lot of productivity is lost because of alcoholism. Professional people may absent themselves from work because they drank too much the day before. I do not want to start naming groups but we all know that some professions in Ghana have more problems with alcoholism than others are. For example, its common knowledge that a number of classrooms are empty across the country every day because the teachers who are supposed to be teaching are drunk. The fact is there is a great loss of productivity in the professions because of drinking.
The health consequences of alcoholism are many and serious. Cirrhosis of the liver, other cancers, alcohol poisoning, drunken driving and accidents, mental issues, violence, and premature death are very serious consequences of alcoholism. The World Health Organization estimates that over 3 million people died from alcohol in 2016. That figure is probably higher. I do not intend to waste much time on the causes and effects of alcoholism. Instead, I like to put forth several suggestions.
One of the most important levers we can use to control excessive drinking and alcoholism is the law. Four things are important here: (1) We need to know who is allowed to sell alcohol; (2) We must clearly specify where alcohol can be legally sold (3) Knowing the age limit for buying and drinking alcohol and (4) What times alcohol can be sold. On all these four items, the law ought to be the best lever, not just its promulgation, but more important, its enforcement across the board, everywhere in the country.
I know there are laws on the books covering all the above. Like everything else, we do not enforce our laws. No one in Ghana feels a compulsion to respect the law. There certainly are statutes on who can sell alcohol. Only places and individuals licensed to sell alcohol should be allowed to sell it. The last time I counted, there were at least five people selling alcohol in my village. Clearly, these are all in violation of the law. When you walk around our cities, you can see small joints where people freely buy alcohol. I cannot say if these places are licensed, I doubt if they are looking at what they look like. Second, the sale of alcohol has to be regulated. We cannot sell alcohol 24-hours a day. Even bars in hotels close after a while. Today, you can go to any village in Ghana and buy akpeteshie 24 hours a day. You probably can wake some of the sellers up at 3 am and they would sell you alcohol if need be.
I have lived in both Canada and the US. In the province of Quebec, only the provincial government is allowed to sell hard liquor and wine in its own government-owned stores. It was not until last year that the state of Connecticut passed a law allowing alcohol to be sold on weekends (Saturdays and Sundays). On weekdays, all sales of alcohol, including beer have to stop at exactly 9 pm. If you are in line to pay for your beer, you must pay for it before its time; otherwise, you had to leave without it. All supermarkets must pull a curtain to cover the shelves with beer after 9 pm. It is the law and people respect the law. It is about time we start respecting our laws in Ghana and stop this wanton lawlessness.
Getting a license to sell alcohol, or yet open a wine and alcohol store is the state of Connecticut and most states in the US is not an easy task. You will have to apply to the town, the notice has to be publicized and the community has to raise objections if they want to. I have witnessed at least two instances in which applications were rejected because people who lived in those neighborhoods successfully argued against them.
My point is that laws on who can sell alcohol need to be enforced. Local and District Assemblies must enforce the law. They must move to license anyone who sells alcohol and these individuals must renew their licenses yearly. The certificates allowing them to sell alcohol must be prominently displayed in their shops. This means no individual must be allowed to sell alcohol from his or her places of residence and alcohol should only be sold in designated bars/stores. Unless we are prepared to enforce our laws, there is no reason to have them to start with. We simply cannot continue to ignore own laws and act with impunity.
Now to who can buy and consume alcohol. I am not so young, and my grey hair betrays my age. Yet, without showing my driver’s license, I cannot buy a bottle of beer in a supermarket in Connecticut if I wanted to. No one assumes I am 21. The cashier or clerk has to verify your age on your license. For the most part, my assumption is that not a lot of young people are drinking excessively in Ghana. Maybe I am wrong. Be as it may, it is important to enforce laws on who can buy alcohol. Those who are licensed to sell alcohol must be educated and sensitized not to sell to underage drinkers. Those who violate this law should immediately lose their licenses. Doing these things may take a while to take root. However, like most aspects of our individual and collective life, discipline and commitment are required.
It will be a great thing for us to declare a National Alcohol Free Day. A National Alcohol-Free Day will be voluntary, a day when there will be no sale of alcohol. Setting this day aside will send a symbolic message to the country about the dangers of alcoholism. I do not think any bars will go bankrupt if people do not buy alcohol for one day. Accra Brewery or Alomo Bitters will certainly not go out of business. Refraining from drinking for one day will not kill anyone either. To the contrary, it could save a life. My suggestion is for this day to fall on a Sunday. The Ministry of Health should pick a day in the year and publicize it. Symposia and educational activities can be organized to educate people about the dangers of excessive drinking. All advertisements on alcohol would be suspended for that day. Radio and TV carrying social announcements on alcohol abuse would be encouraged and churches should all preach on the topic that day. I hope some media personality picks this idea up and champions it.
There is some effort being made by the FDB to restrict the unregulated promotion of alcohol in the country. I think that effort is laudable, but grossly inadequate. No advert should show people consuming alcohol and this should apply to both print and visual. You cannot show any adverts in the US where people directly consume alcoholic beverages. That same rule must apply in Ghana.
It is very important that we start educating young people very early about the dangers of alcohol. Parents, schools, and churches must assume a greater responsibility on this issue. Women organizations especially, can do much to educate their members to lead an education campaign to instill in our children values that remind them about the harmful consequences of alcohol consumption. Churches and schools can play their role too.
I mentioned earlier that alcoholism is a disease and like most diseases, it sometimes requires radical and sustained medical and social intervention. In developed countries, there are Rehabilitation Centers where alcoholics go to detox (manage the immediate withdrawal symptoms when you are forced to stop drinking suddenly) and to get well. There is the need to build similar facilities in the country. It is best that this sort of facility is a private initiative, rather than a government one.
Those professions that are disproportionately afflicted with alcoholism need to take the lead on education and treatment. It is easier for professional classes that have national associations or unions to embark on a coordinated campaign to educate and help their members who may have problems with alcohol. I believe teachers, the Police, Army, and other services have more structure and cohesion to undertake the education of their members.
Take GNAT (Ghana National Association of Teachers) as an example. Teachers pay dues at the source for years and GNAT has accumulated a small fortune. The leadership of GNAT has a responsibility to educate its members about alcoholism. GNAT must set up a Welfare and Education Program that is district based, led by District Directors of Education who will then coordinate with Heads of Schools to identify members who may be suffering from this disease. Spend some of the money you have taken from teachers over the years and put it to good use. Put your money where your mouth is.
Indeed, I would encourage GNAT to build an excellent for-profit Drug and Alcohol Rehabilitation Center or maybe turn the present GNAT building into one. It would be a far more productive use of that magnificent building, built on the backs of teachers. Teachers who then seek help would do so at highly subsidized rates or get treatment free. Same for SNNIT. SNNIT has similarly accumulated millions of our fathers and mother’s hard-earned contributions and invested in anything that has a name. SNNIT should invest in social programs like this so it can help people while they are still alive and working. In addition, SSNIT has a responsibility to fund a national education campaign on alcoholism.
There are self-help programs in other parts of the world we can learn from, notably the Alcoholics Anonymous fellowship. Founded in 1935 in the US, Alcoholics Anonymous is an international mutual aid fellowship whose stated purpose is to enable its members to “stay sober and help other alcoholics achieve sobriety.” (https://www.aa.org). There are AA Chapters all over the world. I saw a listing in Accra, but the phone number listed was not working and I do not know of any active chapters of AA in Ghana. Anyone can start an AA Chapter. Simply go to the website and read about AA. Members run AA chapters and nonmembers may only attend with permission and invitation.
Anyone dealing with alcohol abuse can be a member. I am sure local churches will gladly allow chapters to use their facilities for meetings. AA chapters often meet and share ideas and motivate each other. Those who attend regularly often report that belonging helps them stay sober. I encourage people who wish to initiate steps to start a chapter in their communities to simply read about AA and start a chapter in their community. There is no shame in seeking self-help. You can visit the AA website to read more about this voluntary self-help organization.
It is not easy for someone who has an addiction to admit to it. Try telling someone that has a drinking problem and see what he or she will say. They probably get irritated or worst get angry with you and I suspect many friendships get broken over that. However, unless you admit you are ill or have a problem, how will you seek treatment? If you believe you have a problem with drinking, talk to someone. Seek help. Personal responsibility plays an important role in any treatment.
Families are the secondary victims of alcoholism. Alcoholism robs us of our loved ones, creates conflict, anger, family tensions and breakups. Living with someone who is an alcoholic is not easy. Your first inclination is to be angry with the person. You blame them for not trying to stop. However, blaming them and getting angry with them will not solve anything. In fact, it could even make things worse. What these people need is the encouragement when they make the effort to stop. Remind them about how much they mean and how you all want them to be well. If you know someone they trust, encourage them to go and talk to them. Maybe a friend, a priest or some individual they respect. Do not judge them harshly, remember they are unwell and need our support and help. In the US, families of alcoholics also have support groups and are encouraged to attend meetings to share their experiences.
As I mentioned already, experience in the US and Canada show how governments, both local and national use the law to regulate alcohol sale and consumption. Thank God for the rural electrification, even remote villages now have refrigerators and cold beer is available around the clock without any regulation. There is zero enforcement of any laws on alcohol purchase and this must change. The way we are going, we are breeding a generation of alcoholics, and in the process destroying our very future because we will continue to lose young productive people to premature illness and death. This great canker is eating at us; destroying lives and we better wake up to it.
No one can tell anyone what and how much he or she should drink. It is up to every individual and I have nothing against what some call social drinking. The problem is for some people, the line between social drinking and habitual drinking is a thin one, and no one quite knows when that line is crossed. Still, we cannot regulate the social life of people. However, we can at least educate them about the dangers of excessive drinking. We certainly can pass and enforce laws that tell young people they must wait until they are 21 to buy alcohol. We can pass and enforce laws limiting the sale of alcohol to particular days and times and place limits on the form of advertising allowed on alcohol and silly disclaimers at the end of a two-minute advertisement will not be enough. This nation must wake up to its responsibilities and put together a national plan on this issue. I hope that as usual we do not bury our heads in the sand and do nothing.
In closing, I say to all families who may have lost someone dear to them because of alcoholism and those whose lives have been destroyed because of drinking, I share your pain. To those struggling with excessive drinking now, may God give you the strength to say no to your next drink. If you do, I hope that will be the start of your journey to recovery. It will not be easy, but it would be worth all the effort.
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Columnist: Henry Adobor, Ph.D.