While alcohol is a useful social lubricant, it can pop up in unexpected places sometimes. In Singapore, for example, work culture and business deals are inextricably linked with a night out at the bar, while social life in Dubai often revolves around champagne brunches. Thailand, too, 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 does 'one too many' become far too much?
Risk factors for expat substance use
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 might not be able to pinpoint what they're feeling and going through. Those who do recognise that their mental health is under strain may be afraid to seek help or unsure where to start.
Drinking is a common, albeit dangerous, form of self-medication. It can ease these feelings, at least for a time, 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
Most often, close friends or relatives are the first to notice a change when someone begins to show symptoms of poor mental health. The support loved ones can offer is can be instrumental in recovery, whether it's a long, honest chat or something more practical, such as cooking them a meal, helping them book a therapy appointment or cleaning their home.
Expats in a new country by themselves no longer have a direct support network. A lack of external perspective means expats may not even realise they're drinking more than usual, especially if it's to facilitate socialising and meeting 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, can lead to substance use problems.
Burnout
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. Meanwhile, those with families may find themselves constantly arriving home too late to spend time with their children or partners, causing a sense of isolation.
The culture of having drinks after a successful business deal, particularly common in parts of Asia, can become a concern, especially if an expat feels pressure to 'keep up' with their colleagues. These coworkers, more used to the drinking culture, may have a much higher alcohol tolerance than newly arrived expats unused to this tradition.
Finding help for expat substance use
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 challenging 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 can provide a list of in-network care providers who can help you take the first step towards recovery.
Seeing a psychologist is usually a good first step. These professionals can provide judgement-free support and assess the nature and severity of the substance use. They can then help you form a plan for what comes next, whether that looks like time spent in a specialist inpatient facility or partaking in an outpatient programme.
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, where members share their experiences with one another, are also an important part of treatment for many.
No matter where you are in the world, there are resources available to assist you. The following websites are a good start:
