For many an expat, drinking comes as part of the lifestyle. In Singapore, for example, work culture is inextricably linked with heading out to the bar, while social life in Dubai often revolves around champagne brunches. Thailand has a thriving nightlife culture that expats are frequently drawn to.
It is, after all, much easier to socialise and make new friends after a drink or two to still the nerves. But with high rates of mental illness and substance use among expats, when is it too much?
Risk factors for expat substance abuse
Poor mental health
Chronic depression and anxiety are not uncommon conditions among expats, and research shows expats are at least 40 percent more likely to experience mental illness than the average person.
People suffering from depression and anxiety for the first time may be in denial about what they're experiencing. Those who do recognise that something is wrong are often too afraid to seek help or unsure where to start.
Drinking can ease these feelings – at least for a little while – providing a false sense of security while actually worsening the problem. Alcohol is a depressant, and post-drinking blues tend to linger if someone is already struggling with feeling low.
Loneliness
It is frequently a person's close friends or relatives who notice a change when someone starts suffering from poor mental health. The support loved ones can offer is often instrumental in recovery, whether it's a long, honest chat or something more practical such as helping them book a therapy appointment.
Expats moving by themselves lose this source of support. With nobody to provide an external perspective, expats may not even realise that they're drinking too much, especially if it's for the purpose of making it easier to socialise and meet new people.
Accompanying spouses are particularly at risk of feeling lonely, especially if they've moved to a country where they're not able to work. Many people tie their self-worth to their career and may feel lost or purposeless without it. This, combined with many long hours alone at home, and the possible sense of their partner 'moving on' without them as they get caught up in work, can trigger substance use problems.
Burnout
On the other hand, expats who move for career progression are at risk of overwork and burnout. New to the company, they may feel pressured to prove themselves by working long hours or taking on too many tasks.
If single, it can be tough to arrive home to an empty apartment after a long day. Those with families may find themselves constantly getting home too late to spend time with their children or partners.
The culture of having drinks after a successful business deal, common in parts of Asia, can become a concern, especially if an expat feels pressure to 'keep up' with their colleagues.
Finding help
The good news is that help is available to expats struggling to regulate substance use. Feelings of shame are common and, while it can be difficult to take the first step, expats will soon see that they're far from alone in experiencing this problem.
The best place to start is often your medical insurance provider, assuming they cover substance use disorders (many comprehensive policies do these days, as awareness has increased). The insurance company will be able to provide a list of in-network care providers who can help expats take the first step towards recovery.
Seeing a psychologist is usually a good first step as they can assess the problem and advise on further steps to be taken, whether that includes in-patient treatment in a substance use clinic or working with a mental health team as an outpatient.
Helplines can also be called on in times of crisis and should be able to offer referrals and contact details for professional treatment. Support groups, too, can be a valuable step in recovery. Below are some resources for expats worldwide.
