By: Radhu Basu

LIM Peng Chye recalls that as an Air Force technician in his 20s, he would down two beers with friends after work every day. Soon, two bottles failed to produce the kick he craved, so he progressed to four, eight - and then 12 bottles in one sitting.

'My friends thought I was a hero,' says Mr Lim, now 50. 'They would vomit, but nothing happened to me.' The bachelor lets on that by his mid- 30s, he could polish off a bottle of gin even before breakfast.

He hit his nadir in 1996, when he was on medical leave because of a dislocated shoulder. 'For five days, I drank non-stop, with very little food.' Before passing out, he called his sister, a nurse, who rushed him to the Institute of Mental Health (IMH). Detoxing was hard. But with medication and counselling, he stayed sober for three years. 'I was so scared that I would die, that I did not touch any drink again.'

But one night in 1999 at a 7-Eleven store, he grabbed a Bacardi breezer - a 'mild' drink. He wanted 'just a few sips' as a 'reward' for sobriety. That set off a spiral, landing him back in hospital with alcohol poisoning later that year. He took the hard path to sobriety once more but the addiction, coupled with work stress, set off panic attacks. He has been sober for nearly a decade, but takes medication for anxiety and insomnia. 'Who knows, if I had sought treatment earlier, I may not have had these panic attacks,' he says.

Dr Munidasa Winslow, who has treated alcoholics for nearly 20 years, says patients would seek help sooner if general hospitals had early intervention teams treating alcohol dependency. This is because an alcoholic's first hospital visit is usually because of an accident injury or a problem like jaundice.

'If you have a bleeding ulcer or are vomiting blood like some patients, chances are you will be more willing to start treatment for alcoholism immediately,' says the senior consultant psychiatrist at Raffles Hospital.

As most general hospitals here do not offer alcohol treatment, patients need to overcome their alcohol-related medical problems before seeking addiction treatment at centres like IMH. 'By then, the motivation to change may be gone.'

The profile of alcoholics here is changing, Dr Winslow says. Most patients are men but more young women have been battling alcohol in recent years. Binge drinking is on the rise. A 2007 Ministry of Health paper showed binge drinking by those aged 18 to 29 rose from 3.7 per cent to 7.5 per cent between 1992 and 2004. Among women, the jump was from 2 to nearly 7 per cent.

Treatment is long and arduous: First, a patient needs to undergo detoxification, and take medicines to prevent seizures as well as vitamins to replenish nutrients. Underlying psychological conditions are then treated with a combination of medicines, counselling and therapy.

IMH consultant psychiatrist Guo Song says 40 to 60 per cent of alcoholics have underlying issues such as anxiety, depression or psychosis. 'The biggest challenge for patients is to stick to treatment regularly, for as long as it is required.'

But this is hard. While IMH is unable to reveal relapse data, Dr Guo warns that alcohol dependency is a 'chronic and relapsing brain disease'. Relapse rates, studies overseas found, can be as high as 80 per cent.

Unlike some experts, Dr Guo feels that total cure is possible. 'But cure is likely to come about only with long-term treatment and the experience of multiple relapses. It's crucial for patients to be motivated to seek and continue with treatment,' he says.

In addition to drugs and detox, support groups are a vital lifeline. Alcoholics Anonymous (AA) holds 23 meetings each week for addicts and their families to share their experiences. The addicts are from all walks of life, from corporate bigwigs and tai tais to security guards. At a recent meeting at Raffles Hospital, a group of 10 gathered to hear a fellow sufferer relate the story of a two-decade struggle.

Ms Mary Smith, 44, a Canadian, had an alcoholic father she loathed for deserting the family for long periods. Yet, in her late teens, she too hit the bottle. Sober for over a decade now, the senior executive at a multinational attends AA meetings five days a week to remind herself 'how easy it is to take one false step'.

'Don't blame family circumstances for your addiction,' she says. She and her brother grew up under identical conditions. 'But while I could not live without alcohol, my brother got by with a beer a year.'

Ms V. Sudha, 47, remembers drinking every weekend - and sometimes even on weekdays - as a student at the National University of Singapore more than two decades ago. 'Everyone in our group wanted to challenge each other in drinking contests, get drunk and throw up,' she says.

Later, as a lonely young mother of two in Sydney where her engineer husband was posted, she began drinking alone. Back here, in her late 30s and the owner of a childcare business, she continued drinking. By her early 40s, she was downing at least three bottles of wine every day.

Her husband implored her to quit. But he would 'rescue' her every time she called him drunk from a club in the middle of the night. In hindsight, she says, well-meaning family members can make it tough for alcoholics to quit, by 'protecting them from consequences and cushioning them from pain'.

She remembers trying repeatedly to quit by attending AA sessions, but that did not work. Then, one day in October 2004, her husband said he 'had had enough'. 'He said I could drink till I die, he would not come to get me.' The threat worked. She called AA. Two members went to her home immediately and escorted her to a meeting. She has been sober for nearly five years now.

'No one can force you to change,' she says. 'Recovery has to be an inside job.'

This article was first published in The Sunday Times.