Sober (or Soberer) for October: Moderation, Avoidance, or a Problem?



A message from Dr. Sean Wachtel, FNHA Office of the Chief Medical Officer

The human race has a chequered history with alcohol, which has been around for millennia; its status has been variously that of a revered, sacred substance (think of the wine consumed during communion) or the devil's own brew, to be avoided under literally pain of death (think some extremist ideologies).

For most of us, alcohol falls somewhere in between – a substance some of us enjoy in moderation, some of us avoid altogether, and some of us have a problem with. The medical definitions of "problem drinking" are varied and change frequently. As a practising physician, I think a patient has a drinking problem if they are causing themselves or their loved ones harm, be that physical harm like liver damage, psychological harm like depression, or social harm like interrupting of responsibilities or even family violence. There are many avenues open to treating people with alcohol abuse disorder, also known as the misuse of alcohol, but one of the main predictors of successful treatment is the non-judgmental support of family, friends and community.

In the case of Indigenous peoples, it is perhaps even more important to be non-judgmental and aware of why some people drink more heavily and to understand that there may be traumas in an individual's life that require support and healing. They may consume to self-medicate trauma, including the well-documented trauma experienced because of the Indian Residential School System, and more recently the child welfare system. This trauma is often compounded by the lack of acceptable supports, accessible medical treatment, as well as fewer healthier alternatives and educational opportunities in Indigenous communities. The introduction of alcohol to Indigenous peoples during colonization devastated many Indigenous communities and continues to cause damage, with intergenerational impacts, including alcohol abuse disorder, still being dealt with today.

We all have a part to play in dealing with problem drinking, whether Indigenous or non-Indigenous, beginning with how we view and treat those with alcohol use disorder / a drinking problem. We need to keep in mind that the evidence is clear: if we are to be part of the solution, we need to practise lateral kindness and be non-judgmental, supportive and understanding. To do otherwise – to be self-righteous, shaming, or condemning – is to be part of the problem. We have to help each other, not tear each other down. We are all connected, and what happens to one affects us all.

The other piece to the solution is our own behaviour when it comes to alcohol. Whether we are in positions to influence services or help others in the community, we can choose to abstain from alcohol, to share our thoughts on moderation or sobriety, or to use alcohol responsibly in order to set an example to others, especially our younger community members.

Happy Sober October – or Sober(er) October for those who already drink less – from the Office of the Chief Medical Officer here at FNHA!

Find out more about the Sober for October challenge here.