Systemic Barriers to Quitting Alcohol

Historically, addiction has been viewed, one way or another, as a personal battle. In order to overcome addiction, it was thought, the addicted individual must enter into a period of prolonged or lifelong healing, otherwise known as recovery. Recovery comes in many flavours but common to all is the belief that, at the core of the problem, lies a spiritual and/or mental deficiency.

Unsurprisingly, the dominance of the recovery narrative has led to interventions targeted almost exclusively at the individual, with little attention paid to the environment. In light of this it must come as a surprise to recovery advocates when witnessing thousands of problem drinkers quitting together in Facebook communities, often without recovery interventions. It must seem odd to see hordes of millennials forming sober tribes on Instagram; finding no need for traditional remedies. Indeed, the foundations the recovery narrative are built on are beginning to look extremely fragile.New evidence suggests that our tribal nature goes right to the heart of what makes it so hard to conquer alcohol addiction. When not drinking is not socially acceptable in the drinker tribe and the only other identity available is heavily stigmatised, we have a massive problem.With this in mind we are challenging the recovery narrative and suggest that addiction should not be viewed as a localised struggle but instead as a systemic struggle between a group of people battling discrimination, ostracism and stigma. It’s a battle that costs millions of lives and affects countless others.We know there are those that will argue that addiction is a choice. Given the presence of free will, the argument goes, addiction can’t really be defined along systemic lines. In order to answer this we have to consider firstly, is addiction really a choice and secondly, what are the systemic barriers to making a choice to stop?Let’s be clear, no one chooses to get addicted to alcohol. We find a high correlation between problem drinking and childhood trauma. There may be genetic factors involved too although there is no evidence of an addictive gene.In terms of the barriers to change, well, when we ask a person to go into recovery we are in effect asking them to relinquish membership of the drinker tribe, where not drinking is not socially acceptable, while at the same time to take on a heavily stigmatised identity, that of the alcoholic. Not surprisingly, only some of those at ‘rock bottom’ are willing to go along with this. The rest carry on drinking, often in complete denial of their problem. Sometimes without realising it, they are the victims of a heavily stigmatised environment. Put another way, when the only way to avoid the stigma associated with admitting you have a problem is to deny the existence of the problem then clearly it’s not just a simple matter of choosing to stop.The enormous stigma associated with the alcoholic identity constitutes a systemic barrier to change. If addicted people are fearful of ‘coming out’, if former drinkers live in fear of being ‘outed’ and if publicly ‘out’ non-drinkers feel toxic shame around their identity, it’s because they are fearful of discrimination. The extent to which they might actually be discriminated against is irrelevant. If, once ‘out’, the former drinker is no longer accepted into the mainstream then this constitutes ostracism. A culture where not-drinking is not socially acceptable is ostracising.So how should we proceed? To begin with, we need to open a serious discussion about the language and terms we use to describe people who may be experiencing problems around their drinking or who want to change their drinking habits. Stigmatising labels like ‘alcoholic’ are not just unhelpful but create an imagined ‘other’ that reinforces a them Vs us mentality and fuels the stigmatising climate we find ourselves in.What terms should we use? Well, instead of ‘recovery’ which by definition means ‘subnormal’ we should use the more appropriate term, ‘transition’. As someone who doesn’t drink myself I favour the term ‘mindful drinker’, which has no negative connotations and seems appropriate given I’m a big fan of AF beer. ‘Sober curious’ and ‘AF’ are popular choices tooCrucially, we need to stop thinking in terms of ‘alcoholics’ and ‘everyone else’ and see alcohol misuse as a continuum, from mild to severe. There is no point at which someone magically becomes an alcoholic.Dry January is a wonderful example of an initiative aimed at reducing stigma around not-drinking. And it works. Once presented with a socially acceptable excuse not to drink alcohol millions happily stop drinking. We need to find a way to create an environment where this is the norm.As well as public awareness initiatives we should favour interventions geared towards building stigma-free AF communities; inclusive spaces for anyone wanting to change their drinking habits, such as AF bars, mindful drinking hubs, post-alcohol living cafés and online spaces for sober rebels. Subsidising these ventures until they become sustainable, is a must. Nurturing a climate where not-drinking is acceptable is the only way to solve the problems we as a society face around problematic alcohol consumption.Thanks to the: https://blossomrebels.club/blog/