Socializing Without Alcohol

With alcohol problems ranking highest amongst young adults between the ages of 18-29 (31% of college students meet the criteria for alcohol abuse and 6% meet the criteria for dependence), many exchange organizations are discovering that the accommodations that can be provided to individuals in recovery can also assist with preventing alcohol abuse by other participants in international study, volunteer, intern or teach abroad programs.

This tipsheet includes:

About Alcohol Abuse and Alcoholism
Description of alcohol abuse and alcoholism

The ADA and the Recovering Alcoholic
Is alcoholism ADA protected?

Social Security and Alcohol Addiction as a Disability
Can recovering alcoholics receive social security benefits?

The Role of Alcohol in Other Cultures
Traditional events and the use of alcohol and considerations when accommodating U.S. and foreign participants who are in recovery

Tipsheet
Accommodation suggestions for people who are in recovery, resources for finding overseas recovery groups, international drinking laws, suggestions for study abroad programs

Other Resources
Alcoholics Anonymous and other national organizations on alcoholism

About Alcohol Abuse and Alcoholism

Alcohol abuse is characterized by a desire for alcohol and continued drinking even when alcohol related problems occur. The recovering alcoholic is an individual who has abused alcohol but has also reached the point where he/she has become physically dependent on the effects of alcohol. Recovering alcoholics may be using one of two models in their recovery 1) the total removal of alcohol from their lives, based on the disease model or 2) the integration model in which the individual uses alcohol moderately in family and social life situations.

Both recovery models normally rely on physiological, psychological, and nutritional intervention. Physiological intervention may be in the form of medications or in the form of exercise. Nutritional intervention involves developing a good diet that consists of essential nutrients. Psychological intervention may be in the form of individual counseling, group meetings, sponsorship, and/or daily writings.  Psychological intervention addresses many of the factors that contribute to alcohol abuse and alcoholism:

• Social pressure
• Emotional stress
• Pain
• Depression
• Behaviors learned from friends, family, and peers
• Community factors such as the influence of cultural and religious traditions, the addition of new drinking patterns to existing traditional ones, the increased availability of alcohol and the declining price of alcohol

Since most exchange participants fall into the 18-29 year old range and with alcohol often a predominant factor in developing friendships (i.e. going to the pub) or utilized symbolically in cultural traditions, pre-departure education about the country of destiny and its traditions is essential for the recovering alcoholic in order to develop necessary strategies to maintain his/her sobriety, develop friendships, and partake in cultural events.

The ADA and the Recovering Alcoholic

Generally, alcoholism (those still drinking and those in recovery) is recognized as a disease but is less known as a disability. The legal definition of a disability requires that the impairment substantially limit one or more major life activities such as self-care, employment or thinking.

A person who is an alcoholic may be covered by the ADA if he/she is qualified to perform the essential functions of a job or activity. Denying an individual entry into an international exchange program merely based on the fact that the person is a recovering alcoholic is against the law. 

However, if the person is currently using alcohol or uses alcohol during a job or activity and it adversely affects the individual's performance, then disciplinary actions or removal from the program is possible, dependent on the alcohol/drug policies of the employer or exchange organization.

Alcohol-related disabilities
In addition to alcoholism as a disability, it is possible that the individual is also dealing with dually diagnosed physical or psychiatric disabilities such as cancer, liver cirrhosis, immune system problems, brain damage or depression. Although alcoholism has been categorized as a disability in some cases and legal protections are theoretically applicable to people who are alcoholics or recovering alcoholics, advocacy groups contend that due to their absence from the national coalition that passed the Americans with Disabilities Act and the Rehabilitation Act of 1973, the issues of the civil rights and legal protections have developed into a very complex matter. Because of this complexity, NCDE encourages you to refer to the Disability Rights and Defense Fund for more detailed information.  

Social Security and Alcohol Addiction as a Disability

Due to an amendment in 1996 to the Social Security Act, alcohol addiction, by itself, cannot be the basis for a disability determination for social security benefits.  On March 29, 1996, President Clinton signed the "Contract with America Advancement Act." Section 105 of the Act prohibits the receipt of Social Security Disability benefits or Supplemental Security Income benefits if drug addiction and/or alcoholism is material to the finding of disability. This means that if addiction is the person's only or primary disability, they are not eligible for benefits.

If a claimant has another source of disability and secondarily happens to be a drug or alcohol addict, the claimant is still eligible if the other source of disability meets Administration criteria. Further, if the claimant now has a disabling condition meeting Administration criteria caused by life-long addiction, the claimant may still be eligible. For example, if the claimant now has pancreatitis due to years of heavy drinking, the claimant can still collect.

See the following link for more details:

• Social Security Disability Law Center

The Role of Alcohol in Other Cultures

 

Alcohol, in most cultures, is a central element of transitional rituals such as birth, coming-of-age, marriage, and death. Alcoholic beverages and drugs are also used for medicinal purposes in various cultures. For example, traditions show that in Poland christenings are celebrated at the local tavern. In the Mestizo community, drinking chicha (maize-beer) celebrates such life events as ear-piercing or hair-cutting ceremonies. Beverages such as wine are used in Christian and Jewish rituals and some drinks are even seen as symbols of national identity. Therefore, the rejection of national or traditional alcoholic beverages can be an emotive issue when recovering alcoholics reject offers of traditional drinks.

Accommodation tip:
For individuals in overseas exchange programs, knowing the social expectations in regard to alcohol use, the types of alcohol, and a means of rejecting or moderating alcohol use and still being able to fit in socially is one of the keys to accommodation.

Take into Consideration...

• There may be little understanding of U.S. recovery services or the models on which the services are based
• The use of alcohol may be a gender or cultural issue
• What constitutes as a ‘drug’ or ‘alcohol’ addiction differs between cultures
• Individuals may need assistance with a translator in health care/counseling situations so it helps to partner with health workers with the same language background
• Beliefs regarding health, illness, and significance of alcohol in treating illness differ from country to country
• Note: Make sure that the participant is aware that in-country community groups and counselors may not speak English, may not have the same model as U.S. groups or counselors and the country may have a different attitude to alcohol use. 

Tipsheet: Accommodations and Planning Ahead

 

When an individual self-identifies as a person in recovery, education abroad advisors should not dissuade the individual from participating in an overseas opportunity. Instead the exchange organization, its disability service office, and various partners should work in partnership with the individual to identify and provide appropriate reasonable accommodations that take into consideration some of the tips below. This knowledge can also be integrated throughout exchange program orientations and information sheets.

Provide information on the alcohol and disability laws, cultural policies towards drinking, and a comparison on high risk drinking for various countries:

• WHO Global Status Report gives per capita consumption, traditional drinks, percentage of abstainers and high risk drinkers
• Disability Rights and Education Fund provides information about disability laws for various countries 
• Institute of Alcohol Studies presents an international comparison of high risk drinking in various countries
• International Center for Alcohol Policies lists the minimum drinking and purchasing ages for alcohol in various countries
• World Health Organization on Global Status Report represents the diversity of cultural attitudes on alcohol policy

Prepare an information sheet or orientation specific to the country and cultural context that includes:

• The social and political situation of the country
• The country's cultural values towards health care, counseling and alcoholism
• Clubs and social activities where alcohol is not a factor
• A list of drug/alcohol prevention organizations in the country that the individual can contact or participate in community work with the program. Visit the Institute of Alcohol Studies website for a list of drug/alcohol prevention organizations by country.
• The exchange organization may want to suggest that all participants take an electronic health assessment that includes an assessment and feedback on alcohol problems  (i.e. University of Minnesota's Self Assessment)

Partner with health clinics and counseling centers

to become involved in orientation centers concerning counseling, medication, health and stress reduction strategies. These professionals can also address the common misconception by some participants that being overseas will diminish physical, emotional, and psychiatric problems.  Also, utilize the Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention for assistance and training.

Notify overseas social coordiantors

to plan social events that do not revolve around alcohol.

Review the Drug Free Schools and Campuses Act (DFSCA)

with the student as it is applicable to overseas programs and provide the student a copy of this information.

Assist individuals in locating on-line resources:

• Recovery Resources has links to books, tapes, chat rooms, newsgroups
• SAMHSA's National Clearinghouse for Drug and Alcohol Information lists resources for alcohol prevention and treatment
• Alcoholics Anonymous provides recovery information including on-line version of Big Book, international meetings, and audio tapes of speakers
• On-line Intergroup provides on-line AA meetings in various languages

Assist the individual to locate community groups

in the country of destination so that he/she can become involved in community work (Hint: Many volunteer groups are dedicated to alcohol education and prevention - ask Mobility International USA for assistance in locating such groups).

 

Assist the individual in locating counselors

in country of destination for one-on-one counseling or group session counseling by contacting some of the international psychological associations.

 

Advise the student on how to transport the needed medications

to the country of destination

 

For individuals with sponsors,

make sure that the participant has access to e-mail accounts, phone numbers, text messengers and postal addresses

 

Outline plans of action for times of stress,

homesickness, culture shock, and social and community events that involve alcohol. For example:

Teach the Individual Stress Relief Strategies
Exercise
Eat a healthy diet
Organize by making lists and prioritizing tasks and planning your day
Give yourself plenty of time to get to activities or to complete work or studies
Talk to friends or family about problems or fears
Talk to a professional about anxieties, fears, problems
Listen to music or relaxation tapes
Tense and relax muscles
Take frequent breaks
Learn to say 'no'
Be flexible
Rely on humor to relieve tension
Reduce or eliminate caffeine
Get massages
Get enough sleep
Practice breathing techniques
Soak in a hot bath
Meditate or pray
Do volunteer work
Listen to music
Keep a journal

Teach Suggestions for Turning Down Alcohol
Say 'no thanks' with no explanation
Individual says unable to drink alcohol because of the medications he/she is using
Individual states that he/she is allergic to alcohol
Individual brings or fills a cup with a substance that can be mistaken for the alcoholic beverage (i.e. ginger ale for vodka)

For Study Abroad Programs
Allow extra time for longer assignments
Allow the student to tape lectures
Have teachers do check-ins with the student
Use alternative methods of testing such as oral exams or allow the student to use noise reducing ear muffs or allow the student to test in a separate room
Allow frequent breaks
Make syllabi and class notes available to the student in advance
Assign a classmate as an assistant

 

Other Resources

 

Al-Anon Family Group Headquarters, Inc.

1600 Corporate Landing Parkway

Virginia Beach, VA 23454–5617

Phone: (757) 563–1600

Fax: (757) 563–1655

Email: WSO@al-anon.org

 

Makes referrals to local Al-Anon groups, which are support groups for spouses and other significant adults in an alcoholic person’s life. Also makes referrals to Alateen groups, which offer support to children of alcoholics. Free informational materials and locations of Al-Anon or Alateen meetings worldwide can be obtained by calling the toll-free number (888) 425–2666 from the United States or Canada.

 

Alcoholics Anonymous (AA) World Services, Inc.

475 Riverside Drive, 11th Floor

New York, NY 10115

Phone: (212) 870–3400

Fax: (212) 870–3003

Email: via AA’s Web site

 

Makes referrals to local AA groups and provides informational materials on the AA program. Many cities and towns also have a local AA office listed in the telephone book. All communication should be directed to AA’s mailing address: AA World Services, Inc., Grand Central Station, P.O. Box 459, New York, NY 10163.

 

National Council on Alcoholism and Drug Dependence, Inc. (NCADD)

20 Exchange Place, Suite 2902

New York, NY 10005

Phone: (212) 269–7797

Fax: (212) 269–7510

Email: national@ncadd.org

 

HOPE LINE: (800) NCA–CALL (24-hour Affiliate referral)

 

Offers educational materials and information on alcoholism. Provides phone numbers of local NCADD Affiliates (who can provide information on local treatment resources) via the above toll-free, 24-hour HOPE LINE.

 

National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Scientific Communications Branch
6000 Executive Boulevard,Willco Building, Suite 409
Bethesda, MD 20892–7003
Phone: (301) 443–3860
Fax: (301) 480–1726
Email: niaaaweb-r@exchange.nih.gov

 

The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention

Education Development Center, Inc.

55 Chapel Street

Newton, Massachusetts 02458-1060

Phone: (800) 676-1730 - TDD Relay Friendly, Dial 711

Fax: (617) 928-1537

E-mail: HigherEdCtr@edc.org

Provides training, technical assistance, and publications for the higher education community.

SAFETI On-Line Newsletter
Volume 3, Number 1, 2005 Edition
Article: "Last Call for U.S. Students Studying Abroad?Continuing Concerns About Alcohol Use and Abuse During Study Abroad" By Joel Epstein

• For Recovering Alcoholics with Other Disabilities - review other Disability Specific Tipsheets provided by the National Clearinghouse on Disability and Exchange. 

_{Although efforts have been made to ensure accuracy, MIUSA/NCDE cannot be held liable for inaccuracy, misinterpretation or complaints arising from these listings. Mention of an organization, company, service or resource should not be construed as an endorsement by MIUSA/NCDE. Please advise NCDE of any inaccuracies you may find.}