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.