HOW TO HELP WITH ISSUES OF SUBSTANCE ABUSE

"The induction of alcoholics into the winter dance ceremonial is understood in terms of cure rather than punishment by the Cowichan...the Puyallup-Nisqually feel the spirit power's satisfaction through dance ceremonies is necessary for individual and collective well-being."

Jelek, 1982, pp. 87-88.

GOALS:

8.1: To explore the causes of alcohol and substance abuse;

8.2: To explore strategies for helping someone with an alcohol or substance abuse problem;

8.3: To practice helping and support strategies.

COMMENT: Ask the participants if they have any questions from the last module. Be sure to allow 5 minutes for questions.

ACTIVITY: 8.1: Presentation

TITLE: Alcohol and Substance Abuse

TIME: 20 Minutes

The effect of alcohol and substance abuse on First Nations' communities has been well documented by government and social service agencies. It is estimated that among First Nations people, 60% of illnesses and deaths and over 90% of criminal activity are the result of alcohol and substance abuse (Wotherspoon & Satzewich, l993). Its effect has been devastating both collectively and individually. However, it is a national problem considering that in Canada approximately one in four deaths is related to substance abuse; 10-15% of the total population are alcoholics; and fetal alcohol syndrome is the most preventable cause of mental retardation. Most of us are aware of how easy it is to become addicted to something like alcohol, particularly if our internal resources are low or support system is weak. All of us know of people who have been affected by this problem and how difficult it is to overcome. Like many addictions, the effect is not only physical, but psychological and spiritual. Alcohol and other substances, if abused, can lead to illness and death. But the most tragic aspect of alcohol abuse is the effect it has on family and community life, and this damage, in turn, produces even more harm. According to the Canadian Psychological Association, alcohol and substance abuse is associated with 70% of criminal assaults; 50% of spousal abuse; 50% of child abuse; 50% of traffic accidents; 40% of suicides; 50% of rapes 70% of robberies and 80% of homicides.

Alcohol is only one of many substances people abuse. Glue, gasoline, marijuana, cocaine, crack, uppers, downers - the list goes on. Whatever the substance, the effect are the same. Those who are addicted loose themselves personally and die spiritually. It is a disease of the mind, body, and spirit. Thus, the cure has to address all of these aspects. Some people say that once someone is addicted to alcohol or any substance, they are "hooked" for the rest of their lives.

All of us are aware of the alcoholics who live on our streets, but in fact, not all those who suffer from this problem are "skid row bums." It affects average people like you and me. In fact, only about 3 to 5 percent of alcoholics live on the streets. People from all walks of life, from all social levels, ages, sex, and ethnic backgrounds are affected by alcohol and substance abuse. In fact, it remains one of the greatest threats to First Nations peoples' well being. It not only puts people at risk through accidents, but also through increased levels of disease.

What it is and how it starts?

What is alcoholism? Some experts stress that anyone who consumes more than two drinks a day is addicted. That may sound extreme, but perhaps as Alcoholics Anonymous states: for the alcoholic one drink is too many and one is not enough. The National Institute on Alcohol Abuse and Alcoholism, states that it is someone who:

In fact most people drink excessively at some point in their lives. Most of us experience remorse and vow not to do it again after a severe "hang-over." Consider this though: the cause of alcohol abuse is not known. However, what is known, is that people who do abuse alcohol and other substances, do it:

There is also a high correlation between low self-esteem and alcohol and substance abuse. People who do not feel in control of their lives, look to other means for emotional support. It is not uncommon to hear secondary school and university students say that alcohol helps them to be more socially competent (e.g. "I worry less about what people will think of me when I drink."). Moreover some female problem drinkers report that they feel more "feminine" and more "desirable" when they are drinking alcohol.

Know one starts out with the express purpose of being an abuser of alcohol and other substances. In fact, there may be some precipitating event that drive people to drink. For example, a close friend began to use alcohol as a means to escape the experiences of the residential schools. Others start drinking after a break-up of a marriage or relationship. It is certainly true that when people drink they forget "today's problems and they definitely "feel good", even if it is only for a short time. Drinking ,in fact, is strongly associated with partying and having a good time. "Let's go out for a drink," is routinely used as a means for socializing. This idea isn't wrong, although it is "scary" to think that in order to have a good time, we have to have a drink in our hands.

Interestingly, there seems to be a difference between men and women. Men tend to drift gradually into drinking, which eventually gets out of hand. They may just get into the habit of stopping at the pub on the way home from work or getting "smashed" after the accomplishment of something (e.g. successful fishing trip). Women, on the other hand, do it after some crisis in their lives. For example, after the break-up of a relationship or some loss. However, for most people who become abusers, the strongest factor is parental alcohol abuse. Alcoholism runs in family, which has lead many researchers to concluded that there exists a genetic link.

Helping Strategies

The basic strategy in helping someone overcome substance abuse is to motivate them toward wanting to quit. If they don't want to quit, little can be done. As a result, the key is helping them see the value of quitting. In part, this means not only stopping the consumption of alcohol or other substances, but moving them away from the environment where abuse has occurred and subsequently helping them develop a positive life style. It may mean the person has to drop those relationships in which the substance abuse occurred. Obviously, this is quite difficult as it means the person may have to change living arrangements and/or develop a new support system. In fact, personal support is one of the most helpful strategies in helping someone break the cycle of addiction.

Obviously, the initial period of quitting is the most difficult. Essentially, the body has become physically dependent on alcohol or a specific addictive drug. The body has grown to depend on it and ,therefore, when it is absent the body craves it. Thus, withdrawal becomes physically and psychologically painful. In fact, at times the body may react in a way that is characterized by unpleasant and life threatening symptoms. Routinely, substance abusers deny they even have a problem. Denial is extremely difficult to counter, but once it is recognized the chances of overcoming the addiction are greatly increased. Admitting there is a problem is crucial. The person may want to quit, but even then, there must be a valid and realistic alternative for the drug abuse. So the person will question their decision to quit and suffer anxiety about developing a new life style. Old friends and acquaintances will try and convince the person to "party" with them. There is also an increased physical need for the substance which, in turn, will increase the stress of quitting. Thus the peer support giver has to constantly reinforce the "wise" decision of the person to adopt a substance-free life style. If you can convince the person that the new life style is worth the "hardship," then half of the battle is won.

One of the most successful groups in helping people cope with alcohol abuse is Alcoholics Anonymous or AA. This group uses mutual support to help its members achieve sobriety. AA, which has no fees, has a telephone service and holds monthly meetings in most communities around the country. This organization will send people, who have recovered from alcohol abuse, to visit anyone who has a problem. Basically, it pairs a problem drinker up, using a buddy system, with a sponsor who has stopped drinking. The task of the sponsor is to be available at anytime to provide guidance and support. AA views alcohol abuse as a disease. Since alcohol cannot be controlled, abstinence is the only solution to heal the body and mind. This is how AA describes itself:

AA is a worldwide fellowship of men and women who help each other stay sober. They offer the same help to anyone who has a drinking problem and wants to do something about it. Since they are all alcoholics themselves, they have a special understanding of each other. They know what the illness feels like - and they have learned how to recover from it in A.A. An A.A. member says, "I am an alcoholic" - even when he [or she] has not had a drink for many years. He [she] does not say that he [or she] is cured. Once a person has lost the ability to control his [her] drinking, this A.A. would explain, he [she] can never again manage to drink safely - or, in other words, he [she] can never become a "former alcoholic" or an "ex-alcoholic." But in A.A./ he [she] can become a sober alcoholic, a recovered alcoholic. (Alcoholics Anonymous Foundations).DATE

The success of AA is the collective or shared experiences of its members. All AA members not only share their addiction, but their strengths and hopes with each other in an effort to solve their common problems. Members constantly reinforce their message of sobriety through learning the "13 steps to alcoholism." These steps are that:

The strengths of AA is quite simple - mutual support. By coming together and admitting that no one can solve alcoholism by themselves, a support network is utilized to help its participants to stop drinking. Any type of drinking is frowned upon. Alcohol, as a disease, can only be cured through complete and total abstinence. The weekly or monthly meetings serve to reinforce this message, while at the same time providing positive support. Thus, through AA, the person is provided with self control models, the importance of which is owning up to the problem and asking for support from "fellow sufferers."

A number of approaches have been utilized by First Nations people to combat alcoholism and other substance abuse. Many of the elements of the AA model have been incorporated into the First Nations approach, but what makes it different is the added use of the many ritual traditions. The experiences of Ovide Mercredi is a prime example. As chief of the Assembly of First Nations, he brought together elders, traditional healers, social workers, counsellors, doctors, nurses and psychologist to deal with the problem. Chief Mercredi stressed that the "AFN cannot continue just on rights advocacy, which is essentially its reason for existence. To have the strength to advocate for our collective rights, we have to be involved in the healing of our people" (Vancouver Sun, March 13, l993, p. B2). He stresses the need for First Nations people to go back to their traditional beliefs, which he feels are compatible to Christian beliefs, by blending the native culture with these practices of the majority culture. Traditional practices, such as the vision quest, sweat lodge, sweet grass ceremony, just to name a few have been used in helping First Nations people cope with abuse. Chief Mercredi, himself, was adopted into the Turtle clan and relies on the spirit of the turtle to guide him. There has been a great deal of success with this approach, because it provides not only social support, but spiritual guidance as well.

Conclusion

Alcohol and substance abuse is a difficult problem in the First Nations community. In order to mitigate these difficulties, there has to be some fundamental changes in the community to make life more purposeful and meaningful. It is a difficult task, but not impossible. The most consistently successful strategy for overcoming problems like alcohol and substance abuse has been the adoption of traditional "ways." Tradition is a powerful way to bring meaning to someone's life. Chief Dan George, who talked about the draw of city life on young people, felt that "...the train that carried [us] into the city never brought the spirit along that guides lost hunters through the woods" (p. 35). Destructive habits are difficult to break, particularly when immediate gratification is derived from them. Yet the media and peer pressures which often leads to alcohol and substance abuse has to be broken. In that respect, preventative education and social support are the strongest ingredients of successful strategies. For example, conveying attitudes such as ,it is possible to have a good time without drinking or you don't have to do it because that's what everyone else is doing. Drinking is definitely not "manly" nor "feminine."

COMMENT: After the presentation, ask the participants if they have any questions. Be sure not to spend too much time on answering questions, because the modeling and practice is were the participants learn the most.

ACTIVITY 8.2: Brainstorming and Sharing Experiences

TIME: 30 Minutes

DIRECTIONS: The purpose of this activity is to personalize the experience of alcohol and substance abuse and to brainstorm for strategies the participants are familiar with. It is a good idea to start this activity by disclosing any personal experience you have had yourself involving alcohol or an experiences in which you were indirectly involved with that had harmful effects. As people share, summarize their experiences. Next, using a chalk board or chart, write down any of the strategies the class is familiar with or which they have heard about. After the list is generated, summarize some of the actions that these strategies employ (e.g. physical and spiritual cleansing involving the sweat lodge, modeling, group support, etc.)

ACTIVITY 8.3: Helping Circle

TIME: 60 Minutes

DIRECTIONS: Everyone should be sitting in a circle during this activity. Start by explaining that someone will role play a problem and the rest of the group will respond using any of the helping skills that have been presented. Ask one of the participants to role play a problem or present any issue related to alcohol or substance abuse. Some possible role plays may be someone who is in denial or someone who doesn't know what to do. What you want to do is provide everyone with an opportunity to utilize their skills in a collective format. Someone may start the helping process through self-disclosing or by asking some clarifying question. Your role is to keep the process on task and to ensure that people are provided with feedback at the end of the session. The idea is not to solve the problem, in a short time, but to provide the participants with the opportunity to work together.

ACTIVITY 8.4: Individual Practice

TIME: 30 Minutes

DIRECTIONS: Ask the participants to get into a triad, with each participant taking one of the following roles: peer support giver, person, and observer. The peer support giver is to use the skill of self-disclosure, the person is to present some issue or problem, and the observer is to give feedback using the feedback guidelines (Module 2). The observer should also be the time keeper, allowing the role play and feedback to last five minutes each. After 10 minutes, ask the participants to change roles, until everyone in the triad has had a turn in each role. You may have to give the participants some suggestions on issues or problems to present.

ACTIVITY 8.5: Using the Gage self-examination

TIME: 20 Minutes

DIRECTIONS: Start by presenting the Gage self examination model. The model is based on a number of questions that are put to people who may or may not have problems with alcohol. The purpose of the model is to raise people's awareness about alcohol abuse. Ask the participants to pair up and then ask each other the following questions:

1. Have you felt the need to cut down on your drinking?

2. Have you been annoyed by criticism of your drinking?

3. Have you felt guilty about your drinking?

4 Have you ever had eye-opener drinks that is a drink first thing in the morning?

If the person answered yes to two of the four questions, then there might be a problem with alcohol. Following the completion of this exercise, participants can share their thoughts about their drinking habits or a friend's drinking habits.

ACTIVITY 8.6: Prevention, Getting Help and Referral

TIME: 30 Minutes

DIRECTIONS: This activity should be presented in an informal, but instructive approach. The purpose is to provide the participants with some idea on how to get information and how to share it with others. Start by sharing the following information in your own words:

Educating people about the harmful effects of alcohol and substance abuses is one of the best preventative measures available. Effective alcohol and substance abuse programs have the following characteristics:

1. provides information about alcohol and substance abuse in a non-threatening manner;

2. influences attitudes and behaviours into more accept able and rewarding manner;

3. reinforces actions that are acceptable to the family, community and band;

4. provides alternative coping behaviours that are non-destructive (e.g. vision quest).

Since these characteristics are based on influencing others' attitudes and feelings, the approach to prevention must deal with communication. Information can be provided by either verbally sharing or by giving printed information. A number of private and Government agencies provide information about alcohol and drug dependency. In addition, most First Nations bands have some affiliation with an agency that deals with this issue. Passing on brochures about where to get treatment can provide someone with an alternative. [Assemble a number of brochures and share them with the participants. For example, the Ministry of Health of every province and state has brochures which explain where to get help at out-patient services, detoxification facilities, residential treatment and support homes in every region of the country (e.g. "Help is Available," "New Stresses, New Strengths" or "Alcoholics Anonymous, Al-Anon & Alateen," "Alcohol & Drug Commission Fact Sheet" are just a few)].

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|Page Updated: May 2, 2000 |