Saturday, September 26, 2020

To hell and back

There had been many awful incidents before, but the most serious one still lay in the future, and when it came, it was the turning point.

The third of January 1975. A case of assault on police officers led to confinement in a psychiatric ward, in a straightjacket. Facing charges of aggravated assault, on the tenth day in the padded cell, a man was let in to see the detainee-cum-patient.

“He began to tell me about his life as an alcoholic. As I listened to him, I began to see myself. Most importantly, he told me he had found a way to stop drinking and stay sober. Now, that’s very important; you can stop drinking, but staying sober is the solution. He asked me, ‘Do you want to do something about your problem?’.

I said, ‘What the hell do you think?’. I realised that if I didn’t do something about it, I was going to be locked like that for the better part of my life. So I said, yes I needed help. I had hit rock bottom, where I fully realised the seriousness of my situation with alcohol, and I really wanted help.”
That was the turning point.

Experts in the field of addiction are unanimous that the road to rehabilitation begins with owning up to the problem – and that is precisely what happened that day in January 1975. After four weeks in a rehabilitation centre and a year in a halfway house, he was ready to face the world and rebuild his life all over again.

This is the story of Jim MacDonald, addiction specialist, and co-founder of the Botswana Alcohol/AIDS Project, an NGO devoted to bringing addiction prevention and recovery concepts and services to Botswana.

“Rehabilitation provided a whole new worldview of myself, alcohol, its destructiveness, and how to recover. Without rehabilitation experience, I don’t think I would be sitting here talking to you,” he says from the comfort of his house, which has seen many visitors since he relocated from his native United States in 2002.

Though he had been to Alcoholics Anonymous (AA) meetings since 1964, it was all for the wrong reasons – either to please someone, or to get some other person off his back. But when he eventually went with a changed attitude, he saw, heard and learnt what he had missed in the previous visits – how to live happily without alcohol.

“What AA taught me and continues to teach me is to remember everyday that one drink will get me drunk because when I put alcohol in my system I’m powerless on how it affects me,” he says. “I have learnt that it is not normal for anyone to put things that they value at risk – starting with reputation, add to that family, add to that employment, add to that freedom.

The way I ensure that I remain aware that I am an alcoholic is by practising what I have been taught by AA, and that is to keep my focus on one day at a time; today is the day I can drink and lose it. I have learnt to live one day at a time. I needed to change people, places, and things. If one drink has the potential to unravel my life, I have no business hanging around bars drinking Coca-Cola.

Bars are for drinking alcohol. I can always meet people at a non-drinking restaurant and have lunch. Everything I have today, and what God gave me, I have been able to receive because I don’t drink.”

After being sober for 31 years, MacDonald still refers to himself as an alcoholic – albeit, a recovering, not recovered, one. He explains it by pointing out that getting out of alcoholism is a progressive recovery. It’s more than just abstinence.

Recovery was preceded by 22 years of hard drinking during which he lost everything he ever held dear to him – an engineering career, reputation, and family.

“Alcohol took away everything from me at the time that it was most important,” he says. “People used to say, ‘When you are drinking we don’t want to be around you’. So I gave up people because drinking was more important. I gave up employment and family because the dominant addicted personality said let them go. That’s the power of addiction.

Alcoholism is a progressive illness. It starts small, and over time it gets worse. But the drinker is usually the last person to see the reality of what alcoholism is doing. He sees it as a friend because it alters his mood, mind, view of reality, and creates an illusion. It’s called denial. [You blame] everything on life, society, work pressure, lack of money – it’s everything, but alcohol.”

Notwithstanding his strong views, MacDonald insists that he is not anti-alcohol, but anti-drunkenness and social ills caused by alcohol abuse. He is equally critical of the advertising and marketing antics meant to attract youth.

His desire to raise public awareness about the dangers of alcohol does not only come from his personal experiences, but is also motivated by the endless list of visions and dreams that were destroyed by alcohol use and abuse. The underlying message is that alcohol is a drug, and alcoholism is addiction to the drug alcohol.

“That’s a medically recognised fact. It’s not Jim MacDonald’s view; it’s the medical profession’s view,” he says.

MacDonald is a regular contributor in the newspaper columns on the subject of addiction – especially to alcohol, and in some of his articles he has taken the alcohol industry to task for its blatant disregard for the harm to society caused by its product. He repeats the same charge today. He finds the alcohol industry to have successfully attuned government and society to the make-believe theory that critics of alcohol are unnecessarily picking on the trade.

He regards it as sheer arrogance for the industry to seek to hold society to ransom by threatening job cuts in the event that access to alcohol is restricted, as the new regulations being put in place by the Ministry of Trade and Industry seek to do.

“The alcohol industry’s work is to sell booze. They need new drinkers to replace old drinkers, and advertising has proven to be effective to attract youth and other new drinkers. They are coming up with alcopops and other drinks that are alcoholic but are made to attract youth and women who don’t like the taste of alcohol. So, they disguise the taste.

How does that make them a responsible industry? The average person doesn’t drink because they are delighted with the taste of booze. Non-alcoholic beer is not a big seller because it’s not a drug.

People drink alcohol because it changes how they feel. They don’t drink to quench their thirst. Otherwise they would drink water – and it’s free.”
MacDonald’s view is that the first step towards recognition of the problem that Botswana is grappling with is to understand alcohol for what it is – a drug. Period. He makes the observation that if one were to make a random survey and ask people to name a drug they have heard of, the majority would list cocaine, heroin, glue, and ecstasy. Only an odd one out would identify alcohol as a drug – and therein lies the problem because until there is acceptance that alcohol is as deadly as the so-called designer drugs, there would not be enough concerted effort to fight it.

He says the cost to society that comes from alcohol use far outweighs the perceived benefits. Among these costs, he mentions increased medical expenses, prison costs, judicial costs, insurance costs, and the incalculable costs of family break-ups.

Information he gleans from the Ministry of Health’s rapid assessment studies and other researches leaves MacDonald in no doubt that Botswana is in the throngs of an alcohol crisis. He believes the same level of attention paid to HIV ought to be paid to alcohol as well.

“Unfortunately, there are no detoxification and rehabilitation facilities. I am the only addiction specialist in Francistown, and I may be the only one in the country. So there is nothing for the people who need help, and that’s the danger. Only BPOMAS (Botswana Public Officers Medical Aid Scheme) pays for alcohol addiction treatment. People have need for inpatient treatment, but have no means to get it. People look at someone who has an alcohol problem and say, ‘Why can’t he just quit drinking?’. He can’t, otherwise he would experience withdrawal symptoms.

We need to develop an understanding that alcohol is a public health issue, and it is one of the reasons HIV prevalence rate hasn’t dropped. Multiple millions have been spent in fighting HIV, but we have ignored alcohol, and there seems to be no understanding that society’s use of alcohol is intrinsically linked to HIV,” he says.

MacDonald’s view of dealing with alcohol is not only limited to education, and provision of detox and rehab facilities. He is an advocate of restricting alcohol availability – something he says has been successfully used among countries in the developed world. While he understands the fears expressed by bar owners and other alcohol dealers that the action might put some people out of work, he finds that they are crying far too loud.

“They make it sound like the suggested regulations will be drastic. The regulations are not closing down bars; they only aim to reduce the hours of trade. Bar owners are not concerned about their employees, whom they underpay to begin with, but a reduction in their income,” he says.

He calls alcoholism a biological, psychological, sociological, and spiritual illness because it impacts on all the four areas – and any successful recovery process has to address all the areas. Recovery, he points out, is a journey. Since embarking on his since January 1975, he has managed to rebuild bridges. He made up with his children, and happy relationships with his grandchildren.

“Part of the process of recovery is making amends; to make a list of persons you have hurt, and over time – with a lot of prayer and a lot of serious attempt – make direct amends where possible, except where to do so might emotionally injure the person whose forgiveness you seek. Making amends is owning your wrong behaviour, accepting responsibility and the harm caused – not explaining. I asked my children to forgive me, and they did – for which I am grateful.

Today my life is so rich and so full; I’m just continuing to work on my recovery and to try to improve my character.

“I continue to go to AA meetings, and to give strength and hope to other people to also experience recovery. It helps me stay focused and find a tiny piece of humility to remember where I came from, who I was, and who I don’t want to be again. I have learnt that there is no problem so bad that I can make worse by taking a drink,” he says.
And what happened to the visitor of January 1975?
“He became a close friend and mentor. He died a few years back. I miss him.”
The cracking voice betrays deep emotions. (FPN)

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