M.D., M.S. Clinical & Counseling Psychology
What I have written here is not about addiction or alcoholism per se, but alcohol abuse or just “alcohol use.” As you might know, alcohol abuse is different from alcoholism since it does not include strong cravings for alcohol, loss of control, or physical dependence. In addition, alcoholism includes tolerance (the need for increasing amounts of alcohol to get the same effects, i.e. to get “high”) whereas alcohol abuse does not necessarily include tolerance.
However, alcohol abuse includes symptoms such as failure to fulfill major work, school, or home responsibilities; drinking in situations that are physically dangerous, such as while driving a car or operating machinery; recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and continued drinking despite having ongoing relationship problems that are caused or worsened by the effects of alcohol. This pattern usually persists for 12 months.
So one might say: “Then what is the major difference between alcoholism and alcohol abuse?” I put the above paragraph just for your information, and as I mentioned earlier, I prefer to use the term “alcohol use” here to avoid using any more jargons. That helps me open a discussion based on my observation, and the observation of my friends, of the pattern of alcohol use among Afghan immigrants in the United States and England. Let me add that this topic has not been discussed that much. There has not been any significant scientific study on this or at least I haven’t found one yet! The current article/interview is also based on personal observations. It is not a scientific study.
What I observed seems to be excessive use of alcohol in social events such as wedding and engagement parties, particularly among men. I have seen men going from one drink to another, from beer to scotch, and from wine to vodka etc, one after another. In such events, marijuana is also a tasty addition!
So here is a typical scenario: The party is going on. A number of Afghan men leave the building, go to their cars, get some drink out of the trunk, drink a number of shots, and then get back to the party. They may do it several times. Drinks can be served at parties, but it is not customary.
What is the reason behind this behavior? Why drinking outside the party? Why not in front of others? Is it because drinking is forbidden in Islam and some of these men do not feel comfortable drinking in front of others? Is it the culture that emphasizes one must respect women and elders and drinking is a sign of disrespect to those women’s and elders’ beliefs and status? Is it due to shame stemming from breaking a religious code? Is it related to their craving for drinking that was previously suppressed in Afghanistan and now they take the opportunity to address the need? Do they drink to regulate their mood? Is it something specific to Afghans?
I was and still am curious to know more about this pattern of behavior. I came to the United States two years ago and, therefore, I am not personally very knowledgeable with this pattern in the Afghan community here. However, I usually throw questions at my friends who have lived here for a longer period of time, both those who have immigrated and those who were born here.
Dr. Nahid Nasrat Aziz, a clinical psychologist and Argosy University professor in Washington D.C., believes this behavior is because of deprivation: “[Their excessive drinking has] two possible reasons: Deprivation leads to overcompensation and lacking the ability to regulate affect.”
Dr. Danielle Beaumont, an American psychologist in Philadelphia, agrees with Dr. Aziz, saying that it is not necessarily specific to Afghans. As for drinking excessively, she believes that there are similar patterns seen among Americans. “Americans do the same thing [drinking in excess] to a different degree, because we have the age restrictions (21). Those under 21 are compelled to drink, because it is forbidden and indulge in excess because of this. I think that this practice is universal in regards to American teens and young adults. It becomes less evident as they age, possibly because the restriction no longer applies, as well as many other factors. However, those who are genetically predisposed to alcoholism, or those that experience a short-term benefit by drinking (as it decreases their social anxiety and increases socialization or numbs any psychological distress), continue to over-indulge.”
When I asked her about the combination of drinks, Dr. Beaumont said: “I always find it funny when dealing with friends or patients and they tell me that they can’t for example mix tequila with wine or beer because it makes them out of control. They are missing the point. It is not the combination of different forms of alcohol that take them to this point, but the amount. If they have had tequila then beer, wine, vodka and rum in an hour, that’s 5 drinks, not the combination per se.”
One of my friends, Farhad Azad, an Interaction Designer who lives in California and has done some research on Afghan history and culture with a critical look, has also implicated the cultural approach to drinking as one of the major factors behind excessive drinking: “Many reasons [are involved in this behavior], but from what I’ve noted from the past years, it has to do with not being able to drink openly in a very closed, conservative society. And when they find the opportunity to drink they really “drink” to the point of no return. Compare that to say European societies, where drinking is accepted and normal at any instance, there is no need to drink excessively, more so in Southern European countries. Hence another reason why drinking is frowned upon in Afghan society because it is done in excess by those who do drink.”
Maryam Ufyani, an Afghan teacher and graduate student at University of Pennsylvania in Philadelphia, believes that it is not much about deprivation, but the peer pressure. “[It is] peer pressure. I mean the same issues affect Americans as well. It plays a huge role.”
With regard to excessive drinking, Ufyani believes it is about showing one’s strength: “For men, I think it’s to show that they are ‘manly’ enough and that they can handle it. When someone offers them a drink, they can’t refuse it. You see this with the Americans, too. It is a sign of disrespect to not take someone’s offer of a drink. Some men push other men to drink more just to see them make fools out of themselves. I have seen it numerous times and when the guys aren’t able to handle it, they poke fun at them.”
Among other things, she added that it has something to do with the feeling of insecurity among some Afghan men: “They’re insecure and in order to feel better about themselves, they pressure others to drink in excess and look like fools. That’s one side. Another side, I think, is the fact that most Afghan men think they can handle it and they try to show their ‘power and strength’ through it.”
Ufyani agrees that drinking in excess is also an attempt to numb feelings.
Another Afghan friend of mine in the United States, who chose not to be named in this article, shares a similar opinion with Dr. Nahid Aziz and Farhad Azad: “In Western culture, alcohol has been integrated into religious ceremony, family events, work events, etc. for centuries, so drinking has more of a role in lots of social interactions. People see light social drinking in these contexts while growing up. They see people get trashed too, but that’s not all they see. For the most part, Afghans have seen their elder Afghans drinking mainly in the context of men getting hammered on hard alcohol at family parties. This may be slowly changing in the West but there is not really any culture of moderate drinking in Afghan social interaction.”
Naheed Elyasi, an Afghan American author, includes trauma and societal/religious pressure as factors behind this behavior: “Anything frowned upon and repressed usually bubbles to the surface in an unhealthy way. The societal and religious pressure in our culture is immense. Everyone finds their own way to deal with it, be it drugs, alcohol, or another way of shutting down. Afghans, including Afghan men, have experienced so many trauma.”
She has also observed that the “Afghan pride” and a tendency not to express emotions play a role: “For a people who pride themselves on having so much pride, to lose their identity or not be sure about how to fit in western society can be overwhelming. As a culture, we are not taught how to express our emotions. You can see it early on with how kids are raised and shut down if they express themselves: ‘Bay tarbia (impolite), ‘bad maloom mesha’ (it does not look good), etc..etc. So as sentient beings, we feel, yet we are taught to not feel.”
Dr. Lina Aimini, a practicing ophthalmologist in Maryland, highlights the importance of education: “In my opinion, it is lack of education, both for Afghans and Americans. If they understood the effect of small versus large of amount of alcohol intake, alcohol content of each drink, the rate of alcohol metabolism, blood alcohol level, end organ effect of short and long term alcohol consumption, and lastly implication of long term alcohol consumption and risk of dependency (physically and psychologically), I am sure most will not behave in the same way. This education needs to happen at a young age just like driver’s education and anti-smoking education. And even with that you will be able to save most but not all.”
Dr. Beaumont, however, has a different opinion on the role of education, sharing a personal experience: “I believe that education can help, but only to a certain degree. When I was younger, I went to a very nerdy school. No one drank in my home and I strongly believed that people who drank or used drugs were ‘losers’. Then I got to college at age 16. I was suddenly in an environment that condoned substance use and started to question what it was that I was missing. The marathon of drugs and alcohol began and all of my knowledge about the harmful effects of drugs and alcohol went out the window (the same with cigarettes). I consider myself to be a logical, educated person. But it didn’t matter because the short-term benefits of indulging prevailed in that environment and others later. It was only when I got to a point in my life when reality was pleasant enough that I wanted to remain in that state, that I realized that I didn’t need to escape reality to be happy.”
I shared the same questions with two friends in England. BBC Correspondent Tahir Qadiry shares the same view about some Afghan immigrants who are trying to overcompensate as “they normally go on extreme when they have had restrictions back in their home country. So, having seen a dozen tastes, they can’t control themselves.” He also believes that some of them drink heavily just to prove they are stronger than others or numb their feelings “to express their sorrows and pain they suffered a decade ago.”
Another friend of mine in England believes that the new immigrants “tend to take it too far and have less control over drinking.” She continued that perhaps one of the reasons was that for those born in England “it has been normalized somewhat, whereas the new ones like their relishing in their new found freedom a little too much.”
She believes these men avoid drinking at the parties and instead go outside because of the “shame” drinking brings to their families. She also sees a difference between the pattern of drinking in England and some other countries, for instance Germany. She, for instance, argues that “maybe the families here are more isolated and spread out, so we have not developed a ‘westernized’ community as such. And that naturally pushes you to stay together and protect your cultural identity & values.”
A question may arise as to why I am not discussing alcohol use among women. The answer is: First, it is not the focus of this article, and second, women either avoid drinking or generally drink less than men in such settings.
One of my friends told me that “we still live in an environment where women who drink are looked down upon, so if an Afghan woman drinks openly, she might already have a certain reputation within the community. If she drinks in excess, it might also be to numb the stresses of life.” But she agrees with me on the fact that such a behavior poses at least two problems: First, she may have to deal with more stress because of her drinking. In other words, her drinking will backfire. Second, she may keep it as a secret, thus having to deal with the pressure caused by secrecy and the health issues caused by drinking.
Hashmat Ghanizada, an Afghan medical student in Denmark, blames families and the education system for the problem: “I blame two important institutions: education and family. These are intertwined in educating a child to adulthood. However, in my view, both are equally blamed for not providing enough, adequate information for our teenagers. Youth of our country are lacking important information on different social and moral issues. By the way, a young Afghan teenager does not know his limits because he is never educated on those issues. He/she will learn based on his/her experiences and sometimes end up going too far and out of reach of everything. By education, I mean, learning to control, to be moderate and knowing the consequences and it should be thought at all levels continuously like a loop, because we tend to forget these kinds of info very quickly.”
Drinking among Afghan immigrants is obviously a culturally sensitive issue and it seems that “shame,” “disgrace,” “trauma,” and “overcompensation” are some of the major factors involved in this behavior. As much as important this issue is, it appears that it has not been discussed in detail yet. Given such a pattern may lead to addiction, it is very important to raise awareness in the community so that family members can openly discuss topics related to drinking and how it impacts their lives.