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Addiction help: Booze rehab for expatriates

Dubai: The number of residents battling alcohol abuse is on the rise in the UAE where boozy brunches and binge drinking are the order of the day.

Of late, the problem has assumed such epidemic proportions that authorities are considering offering alcohol rehab services to expatriates. It's the first time this service has been offered to residents, regardless of nationality, rather than to Emiratis only.

The ground-breaking treatment plans follow a National Rehabilitation Centre (NRC) report this year titled Disease Burden on Individuals and Society. It says 5.3 per cent of the total deaths in the UAE are due to alcohol use or illicit drugs, coupled with an expected "considerable proportion of hidden users".

Statistics culled from a 2010 survey by research firm Euromonitor show that alcohol consumption in the UAE has increased by an alarming 30 per cent in the past five years. At the same time, instances of alcohol abuse have also spiked. The frequency of Alcoholic Anonymous Arabia (AA Arabia) meetings which address the issue has registered a staggering 700 per cent increase, from three per week back in the early '90s to 25 per week today.

To combat the problem, Abu Dhabi-based NRC is wading into the expatriate drinking dilemma for the first time ever. In an exclusive interview with XPRESS, Hesham Farouk Al Arabi, NRC head of health, training and education, reveals details of plans to treat alcohol abuse among the expat community. It includes opening a 200-bed facility by 2014 and setting up satellite services throughout the country as part of a "washing machine" model where getting clean on a detox is just the start.

It will be followed with clinics, therapeutic communities, psychological therapies and after-care services linking into health care and mental health, Al Arabi says.

This will be offered to all expats, regardless of nationality, although expatriates involved in violent offences will be excluded.

Al Arabi explains the treatment plans are an attempt to ease the significant burden, both economically and socially, of alcohol and substance abuse on the UAE community. He said treatment outcomes will be improved if the wider community is included.

A cost model has yet to be worked out, but treatment will be delivered within the same context as the UAE health care system. Models include cost recovery and cost subsidisations, but he says it's put into perspective when international data shows that the cost of alcohol abuse on a community is about two per cent of the country's gross domestic profit - in the UAE's case that's about $4 billion (Dh14.64 billion).

ALARMING INCREASE

Al Arabi knows an increasing numbers of expats are battling the bottle just like Emirati patients. Evidence of this, he says, is in the number of inquiries for NRC care, 35 calls per month last year shooting up to 150 calls per month this year.

However, he says, little is known about the size or needs of the booze-fuelled problem in the UAE expat community.

He is unsure what demand there will be for the service, which perhaps is not surprising in a Muslim country where consumption of alcohol by Muslims is forbidden and where there are strict laws regulating alcohol consumption.

In June, the NRC will take a closer look at the UAE situation. At this stage, much of its planning has been based on international alcohol trends and data, but an assignment situation study to find out about the UAE scenario will start soon.

Counsellors and recovering alcoholics describe the scenario as an expat social scene saturated with alcohol, topped up at the weekend with Friday brunches. A social activity unique to the UAE, these brunches offer unlimited food and alcohol for prices ranging between Dh200 and Dh1,000.

"A number of Dubai residents are drowning in booze, unable to keep their heads above the surface," says a counsellor.

Interviews of expatriates on Dubai's drinking scene showed the call for last drinks was much in demand. However, plenty of expats are enjoying a taste of the tipple on offer without going overboard.

British expat Gemma Daly, in Dubai for eight months, had her first five-star brunch experience this year and describes it as four hours of pure indulgence, all for Dh400.

"It tasted amazing and it was wonderful mingling with glamorous people floating around on a Friday afternoon. But as expected, a number of people in our group showed they were unable to handle their alcohol and were intent on drinking what they had paid for. They certainly got their money's worth, but the hangover was included for free," the 24 year old says.

However, others refuse to apportion blame to the city's lifestyle for their illness. Rather, they warn, the city acts as a trigger for people with the genetic make-up to suffer from alcoholism.

XPRESS spoke to AA Arabia members, agreeing to its request for surnames to be withheld. One of the main dangers that frequently arose in the talks was isolation.

It seems alcohol and loneliness make great drinking buddies. American resident Becky says this is amplified in Dubai where most expatriates are stripped of family, friends and any close support, while the devil's drink is ready to fill that place. Becky, 55, sobered up after relocating to Chicago where she looked for comfort and company at the bottom of her wine glass, but says if she hadn't hit rock bottom there, it could have easily been in Dubai where expats face similar issues.

Misconceptions gone

The reality, says former Dubai alcoholic, Sarah, is that most people suffer from alcohol abuse before arriving in the emirate. The misconception among many is that alcohol will be difficult to come by in a Muslim state, so their problem will disappear. But, not so, she says. Dubai's social scene allows you to have a weekend every day of the week.

There was a period in Dubai, about 2002, where she drank in almost every bar, drink-drove most days and sometimes woke up naked on a beach, filled with self-loathing and vowing to get her drinking under control, but with no idea how to do that.

‘‘I didn't see I had a problem because I was seeing the same people out as well, but the difference was they began to move on with their life, getting married or getting a promotion, whereas I was still out on the lash.''

She believes many expatriates work hard and keep afloat by unwinding in the alcohol-laden social scene.

Many of AA's recovering alcoholics are pleased that UAE relief may be in sight for those battling booze, without having to run back to their home country.

Canadian expat alcoholic, John C, described the NRC's treatment plans as being a vital stage of AA's 12 step recovery programme - acceptance. The NRC is admitting there is a problem by opening up treatment to expats, which is the first step to dealing with a drinking problem, he explains.

Other than AA, alcohol abuse treatment in Dubai is almost non-existent, he says.

Dubai counsellor Johanna Griffin is one of the few alcohol counsellors in Dubai.

The independent counsellor, at Manchester Clinic, has had to send back half a dozen patients to their home country for a medical detox because the service simply isn't available in the UAE.

But, by the end of this year, the National Rehabilitation Centre (NRC) hopes to treat the first lot of expatriates here, suffering alcohol and substance abuse.

No doubt many expats will raise a toast to that.

The alcoholism chart

Here is a version of the Jellinek Chart showing the valley curve of alcoholism. The so-called "Jellinek curve" is derived from an alcoholism classification of alcohol researcher E.M. Jellinek, and it was named out of respect for his work. Jellinek later completely dissociated himself from this chart's representations, however it is still known as the "Jellinek curve". 

Alcoholism Chart, below, shows an approximate representation of the decline of the alcoholic and the recuperative process once the ‘disease of alcohol' is arrested and recovery is actively pursued. The so-called Jellinek curve is derived from an alcoholism classification of alcohol researcher E.M. Jellinek and named after him.

the alcoholism chart


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