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Addiction risk factors and treatment among expats: How to get help with alcohol and substance abuse

By: Maureen Esmus

“Work hard, play hard” is a common refrain among expats in Hong Kong, and it’s true that many who live here throw themselves with equal relish into their jobs and their social lives. For some, however, the partying can begin to take over, with a range of damaging consequences.
John (not his real name), who works in Hong Kong’s finance sector, has been living as an expat in various parts of Asia for the past 20 years, and describes himself as a long-time heavy drinker. “I always knew I had a problem,” he says. “I experienced patterns of negative impacts due to drinking; I had to resign from three different jobs after embarrassing alcohol-related incidents.”

However, despite mounting problems, his numerous attempts to stop or cut back were always in vain. “Over the past five or six years living in Hong Kong, I was mildly keeping things together,” he says, “but after another close call threatened to jeopardise my career, I decided that enough was enough, and that I had to do something about this.”

After a month-long retreat and a series of chance meetings with people who urged him to seek additional support upon returning to Hong Kong, he finally Googled “alcohol therapy Hong Kong” and found The Cabin – a new outpatient addiction treatment centre that seemed to fit his need for treatment while allowing him to continue working and living a sober life in HK.

Of course, not all expats who use drugs and alcohol will develop an addiction. Addiction is a disease with a strong genetic factor that accounts for up to 50 percent of a person’s risk. According to Joanne Schmitt, head addiction counsellor at The Cabin Hong Kong, the following are addiction risk factors prevalent in expat lifestyle, which, when combined with genetic predisposition, can lead people like John into the downward spiral of addiction.

Loneliness and isolation

Loneliness is a huge factor in addiction. Expats are often isolated from a true support network of close friends or family. Over and above that, feeling different and out of place can be depressing and lead to further isolation. Stay-at-home spouses are especially vulnerable to this type of loneliness – living in a new culture where they don’t speak the local language, many unintentionally begin to self-medicate with substances and it soon turns into a problem.

Speaking of his own experience, John says, “At home when your behaviour becomes worrisome, friends and family are more likely to intervene; but as an expat the isolation can lead to problems left unchecked and developing further.”

Job stress and moving to a new city

Most of the jobs for expats in Hong Kong are in the financial industry, or at managerial level in other industries. “These jobs offer great pay, but they come with long hours and intense pressure,” says Joanne Schmitt, “leading some to use alcohol and other substances to cope or relax. There is also pressure on family members to make a good impression in order to fit in with their new social circles. For wives, stress can build up, as they find themselves having to host business or social parties with different cultural norms, find the right schools, and keep up appearances.”

“Many expat children have it no easier, especially adolescents – they miss their old friendships, and try to gain acceptance with their new peers. It’s well established that the inability to deal with stress effectively is a leading cause of substance abuse.”

Accessibility of drugs and alcohol

Depending on the location, expats may find that alcohol and even illicit drugs are more affordable than back home. For example, cocaine in Hong Kong is readily available and is cheaper to purchase than in most Western countries. Cocaine addiction is the second most common addiction treated at The Cabin, only behind alcohol.

Social environment

Alcohol is a major part of social and business environments all over the world. Unlike in the West, in Asia hard liquor and long, heavy drinking sessions are a characteristic part of business networking and client meetings. Furthermore, expats may think that a bar or pub is a good place to go out and meet people and unknowingly find themselves indulging in drinks much more often than they would at home. According to John, “The expat culture in Asia is conducive to heavy drinking. The sheer number of people in similar situations away from home and under the seductive lure of cheap bars and seemingly fun stress relief makes the drinking culture of expats massive.”

Life as an expat can be incredibly rewarding. However, this same lifestyle exempts no one from the risk factors for addiction. For expats struggling with addiction, there is help available. In speaking of his own recovery, John offers others a sense of hope: “I’m six months sober now, and I can say that life is much better and I can still have fun in Hong Kong.”
7 ways to tell if someone is suffering from an addiction

  1. Relationship problems
  2. Irritability and mood changes
  3. Lying and keeping secrets
  4. Decreased productivity at school or work
  5. Changes in sleeping habits, energy and motivation
  6. Sudden money problems
  7. Drastic physical changes