Understanding addictions

As we age, we may start to experience major life changes such as adjustments in our living arrangements, managing our health and coping with the loss of close friends. These changes can cause us to feel stressed and overwhelmed.

As a result, addictions can pose significant risks to our well-being. They can often make us spiral into a destructive cycle that affects our health.

Who is this for?

What are addictions?

Addictions are patterns of behaviour where a person becomes strongly attached or dependent on something to the point where it becomes difficult to control or stop that behaviour, even if it has negative consequences on their life.

Types of addictions

These addictions can involve substances like alcohol or activities such as gambling or smoking. The effects reach far, impacting our physical and mental health, relationships, and overall well-being.

Reaching out for support and intervention is a natural and important step in overcoming addiction. Curious about addictions and their common misconceptions? Read more.

Understanding alcohol use disorder

As we age, we may start to experience major life changes such as adjustments in our living arrangements, managing our health and coping with the loss of close friends. While drinking alcohol could be an occasional social activity for many, our bodies may become more sensitive to its effects over time, that’s why it’s important to be mindful of how much we drink, as alcohol can sometimes lead to addiction.

What is alcohol use disorder?

How does alcohol use disorder affect our bodies?

What puts us at risk?

Common
misconceptions

01 It is okay to drink in moderation every day, as long as I stay within limits.

02 It is okay to drink regularly for social reasons.

03 Beer and wine are less intoxicating than liquor, so it is okay to drink more of them.

Signs we may have alcohol use disorder

Alcohol use disorder can range from mild to severe, depending on the number of symptoms the individual experiences.

Diagnosis

Healthcare professionals can diagnose alcohol use disorder by discussing the individual’s medical and psychiatric history, family history, current symptoms, and how alcohol has affected the individual’s daily life. There must be a problematic usage of alcohol that has led to significant impairment over a 12‑month duration, exhibited by at least 2 of the following:

Increasing usage of alcohol, or over a longer period than originally intended
Repeated unsuccessful efforts to cut down or control usage, despite the desire to do so
Large amount of time spent on activities to obtain, use, or recover from the effects of alcohol
Presence of a strong desire or urge to use alcohol
Repeated alcohol usage resulting in a significant failure to fulfil major roles
Persistent alcohol use despite recurring social or interpersonal problems, with continued consumption despite awareness of the physical or psychological issues it causes.
Giving up important activities due to alcohol use
Repeated usage despite significant impairments in physical health
Increased tolerance as defined by either:
- Need for increasing amounts of alcohol to achieve the same or desired effects, or
- Reduced effects with continued use of the same amount of alcohol
Withdrawal as defined by either:
- Characteristic withdrawal symptoms, or
- Alcohol being used to prevent or avoid withdrawal symptoms

A GUIDE TO

Preventing alcohol
addiction

Avoid using alcohol to cope with stress

Alcohol may seem like a quick fix for stress or insomnia, but it often worsens sleep and mood. Instead, try healthier coping strategies like exercise, hobbies, or time with loved ones. Consider placing reminders of these healthy activities—like running shoes or a yoga mat—in visible places at the living room to encourage you to choose them over alcohol.

Moderation is key

If there is a need to drink, remember that moderation is crucial: men should consume no more than 2 standard drinks a day, and women, no more than 1. A standard drink is typically a can (330 ml) of regular beer, half a glass (100 ml) of wine, or 1 nip (30 ml) of spirits.

Avoid binge drinking

Binge drinking, is defined as consuming 5 or more standard drinks for men and 4 or more for women, significantly raises the risk of developing Alcohol Use Disorder.

Eat before and during a drinking session

To prevent intoxication, eat before and during drinking to slow down alcohol absorption. Avoid salty foods, as they increase thirst and alcohol consumption.

When drinking, take small sips

Taking small sips instead of chugging your drink can help you pace yourself, maintain better control over your alcohol intake, and make it easier for your body to process the alcohol.

Ensure you are taking enough fluids

Staying hydrated is essential, especially when consuming alcohol, as it can cause dehydration, particularly in the brain, leading to headaches and more severe hangovers.

Avoid or refrain from buying or stocking up on alcohol at home

Limiting access to alcohol in our immediate environment creates a physical barrier that helps reduce temptation and prevent excessive drinking.

Get involved at Active Ageing Centres (AAC)

Active Aging Centres are dedicated community hubs where seniors can take part in a variety of social and recreational activities such as karaoke, arts and crafts, cooking, and exercise programmes.

Treatment

National Addictions Management Service (NAMS)

Visit www.nams.sg
Call the All Addictions Helpline at 6‑7326837 (6‑RECOVER)
Operating hours: Everyday 8:30am‑9:00pm (inclusive of public holiday)

We Care

A Community-Based Addiction Recovery Centre that treats all forms of addictions including drugs, alcohol, and compulsive behaviours like problem gambling. They provide counselling, education and therapy groups and also has community-based drop-in centre.

Alcoholics Anonymous

This is a fellowship of men and women who share their experiences, strength and hope with each other, that they may solve their common problem and help others in recovery.

SobeRISE

This specialised programme offers support and assistance to individuals and families affected by issues associated with alcohol abuse.

Understanding gambling addiction

While gambling addiction often affects younger people, some individuals develop this issue later in life, particularly around retirement. Feelings of boredom, depression, loss of friends, and other challenges can lead seniors to turn to gambling as a way to cope or escape.

What is gambling addiction?

What puts us
at risk?

Common
misconceptions

01 If we do not develop a gambling addiction by middle age, we’re unlikely to develop it later in life.

02 Seeking help for gambling problems is a sign of weakness.

03 It's too late for seniors to seek treatment because of their age, and there’s no point in getting help now.

Signs we may have gambling addiction

Behavioural Signs

Stop doing things that were previously enjoyed
Ignore self-care or family tasks
Missing family events or regularly late for scheduled appointments
Less willing to spend money on things other than gambling
Frequently thinking and talking about gambling
Cheat or steal to gamble or pay debts
Legal issues related to gambling
Conflicts over money

Emotional Signs

Withdraws from family and friends
Distant, anxious, or has difficulty paying attention
Mood swings and sudden outbursts of anger
Boredom or restlessness

Financial Signs

Frequently borrowing money or asking for salary advances
Cashing in savings accounts or insurance plans
Alternating between being broke and flashing money

Health Signs

Headaches
Stomach issues
Difficulty sleeping
Changes in appetite

Diagnosis

Persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period.

Diagnosis

Persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:

Problem gambling: 1-3 criteria met

Mild disordered gambling: 4–5 criteria met

Moderate disordered gambling: 6-7 criteria met

Severe disordered gambling: 8–9 criteria met

Needs to gamble with increasing amounts of money in order to achieve the desired excitement
Restless or irritable when attempting to cut down or stop gambling
Repeated unsuccessful efforts to control, cut back, or stop gambling
Often preoccupied with gambling (e.g. having constant thoughts of reliving past gambling experiences, hindering or planning the next venture, thinking of ways to get money to gamble with)
Often gambles when feeling distressed (e.g. helpless, guilty, anxious, depressed)
After losing money gambling, often returns another day to get even (“chasing” one’s losses)
Lies to conceal the extent of involvement with gambling
Has jeopardised or lost a significant relationship, job, or career opportunity because of gambling
Relies on others to provide money to relieve desperate financial situations caused by gambling

Additionally, gambling behaviour can lead to significant mood changes such as feeling unusually happy or on the other hand, highly irritable. These mood shifts can last more than a day and may extend for weeks or longer.

Wonder if you might be experiencing gambling addiction? Try answering these questions.

Have you ever lied to prevent people from discovering your problem with gambling?
Do you gamble with money you can’t afford to lose (e.g. rent money, grocery money, etc.)?
Have you ever borrowed a large sum of money from a friend or loved one and lied about what it was for?
Have you ever traded your possessions or stolen things from others in exchange for gambling money?
Do you find yourself gambling more to win back losses?
Have you taken your gambling online in an attempt to hide your gambling activity?

If you answered yes to any of these questions, you should consider seeking help for your gambling problem.

FACING A GAMBLING
PROBLEM?

Here is what
to do next

Depending on the severity, individuals can consider trying these self‑help strategies:

Reduce access or frequency of gambling

Curb or gradually reduce visits to gambling venues or online sites, and schedule other activities to avoid gambling. This self exclusion order or visit limit form to the casino through the National Council on Problem Gambling (NCPG) website may be helpful.

Curbing the amount to gamble

You can consider leaving credit and ATM cards at home and bring only minimal cash. Once the money is lost, it is a sign to leave the venue.

Avoid alcohol or substances before gambling to avoid impulsive decisions.

Focus on developing healthy coping mechanisms

Engage in activities you enjoy, explore ways to develop healthy coping mechanisms, or seek professional therapy to learn effective strategies tailored to your needs.

Set a cut-off date for these self-help strategies

You should set a cut-off date to try these self-help strategies. If these measures fail to reduce or curb your gambling problems by their stipulated cut-off date, seek professional help.

Treatment

National Addictions Management Service (NAMS)

Visit www.nams.sg
Call the All Addictions Helpline at 6‑7326837 (6‑RECOVER)
Operating hours: Everyday 8:30am‑9:00pm (inclusive of public holiday)

We Care

National Council on Problem Gambling (NCPG)

Available daily from 8am to 11pm:

Helpline: 1800-666 8668*
*Airtime charges apply for mobile calls to 1800 service lines.
Webchat: https://go.gov.sg/ncpg-webchat

Understanding smoking addiction

There may be moments where one reaches for a cigarette, despite knowing the potential harm. Smoking and using e-cigarettes carry risks to our health and to those around us. The nicotine in these products is highly addictive, making the journey feel particularly challenging.

What is smoking addiction?

How does nicotine
affect you?

What puts us at risk?

Common
misconceptions

01 l am a casual smoker, smoking one or two cigarettes a day is not very harmful.

02 Rolling my own cigarettes (Bidis) is less dangerous.

03 There is no point in quitting smoking at this age—it’s too late.

Signs we may have smoking addiction

If you or someone you care about is experiencing these symptoms, it might be time to consider reaching out for help.

Diagnosis

A healthcare professional can diagnose nicotine dependence through a detailed clinical interview about the individual’s medical history, current symptoms, and how tobacco use is affecting their lives. The individual may also have to fill out a questionnaire to assess how dependent they are on nicotine².

A GUIDE TO

Additional support for quitting smoking

I Quit Programme

This tailored programme supports individuals through their quitting process by taking their lifestyle, habits, and level of smoking dependence into consideration. Tools available include daily SMS tips, weekly calls from trained QuitLine advisors or weekly face-to-face counselling sessions with health specialists.

Start to S.T.O.P.

Start to S.T.O.P. (Speak To Our Pharmacists) is a quit smoking programme championed by the Pharmaceutical Society of Singapore (PSS) Community Chapter. It is a nationwide collaborative effort by community pharmacy chains Guardian, Unity and Watsons to help you quit smoking and improve your health.

Learn more about this programme and select a location that is convenient for you.

I Quit Programme

Treatment

National Addictions Management Service (NAMS)

Visit www.nams.sg
Call the All Addictions Helpline at 6‑7326837 (6‑RECOVER)
Operating hours: Everyday 8:30am‑9:00pm (inclusive of public holiday)

We Care

First-Stop Touchpoints

Not sure whom to reach out to? You can approach any of these First-Stop Touchpoints. They can help identify your mental health needs, provide brief support, and guide you to the most suitable services:

In-person services

CREST

CHAT (for individuals aged 16-30)

Digital

Mindline.sg

In-person services

Digital

Alternatively, you can click here to explore mental health resources and services located near you.

References

CONTRIBUTED BY

Health Promotion Board

MindSG

Understanding addictions

Who is this for?

What are addictions?

Types of addictions

Alcohol

Gambling

Smoking