Somchai used to drink three bottles of rice whisky every day, but when his alcohol addiction began to affect his family relationships and jeopardise work, he decided to call the helpline Stop Drink 1413 and ask for help.
With the help and advice from psychologists on the helpline, he was gradually able to reduce his alcohol consumption and eventually manage to quit altogether. Even after he quit drinking, the hotline followed up every three months initially, then six months and eventually just once a year.
Somchai is one of the many people who were able to quit alcohol with the assistance of the 1413 helpline, which is a network within the Thai Health Promotion Foundation. In 2020, the helpline reported that out of 6,369 callers, 1,702 (over 20%) managed to quit alcohol.
Assoc Prof Dr Rasmon Kalayasiri, director of the Centre for Addiction Studies and the 1413 helpline, explained that the number of callers who were able to quit alcohol due to the service seems low, but this reflects the number of callers who allowed the helpline to follow up for one year. Some callers who did not allow the helpline to follow up might have quit alcohol by themselves, but the helpline does not have their information as part of its statistics.
According to National Statistical Office data for 2021, the Thai population aged 15 and above was estimated to be 57 million. Among them, approximately 5.73 million (10.05%) engaged in heavy drinking within the previous 12 months. Within this group, around 1.37 million were identified as regular heavy drinkers, while approximately 4.36 million were occasional heavy drinkers.
An evaluation of drinking behaviour.
In June, the Ministry of Public Health reported that 857,582 people with alcohol problems had sought treatment in healthcare facilities since the beginning of the year. This represents 65.2% of those who received treatment for alcohol consumption, indicating an increase from 63.71% in 2022.
Dr Rasmon, who is also a lecturer at the Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, revealed that from 2021 to 2022, there were 26,176 calls to the helpline asking for counselling during the Buddhist Lent period. During this period, an increased number of people sought counselling to quit drinking. This year, the Buddhist Lent period falls between Aug 2 to Oct 28. To expand its service, this June, the helpline developed and launched a chatbot called Nong Tangjai on the Line app. Users can add Nong Tangjai via QR Code or LineID: 1413helpline.
"Helpline 1413 was launched in 2005. Because communication methods today have changed and Line is a popular platform, experts at the helpline believe that communication channels should be expanded. While helpline 1413 can provide services on weekdays from 8am to 8pm, Nong Tangjai is available 24 hours every day," explained Dr Rasmon.
"Some people feel awkward conversing with a stranger on the phone and prefer to communicate via a chat platform. Chatbot Nong Tangjai is the initial gateway to draw in people who need help to the counselling process. If they want to speak with a counsellor, they can click on 'contact counsellor' and leave their phone number. Our psychologists will return their calls. All personal data and information is kept confidential."
Nong Tangjai was designed by psychiatrists and psychologists based on data collected from the helpline which recorded conversations between callers and counsellors. The chatbot can provide information including signs and symptoms of alcoholism, alcohol withdrawal symptoms, a daily drinking diary, an evaluation of drinking behaviour and a list of hospitals with drinking counselling services and therapy.
Unlike many helpline services which train people to answer phones, calls to 1413 are answered by counsellors who have a psychiatry or psychology degree.
"Counselling requires skill and practice such as empathy, active listening and questioning callers to motivate them. Counsellors with a degree in psychiatry or psychology have these basic skills," she said.
The 'Stop Drinking During The Buddhist Lent Period' campaign. (Photo: Thai Health Promotion Foundation)
It was a surprise to learn that the number of people seeking counselling to quit drinking increased during the Buddhist Lent period. Dr Rasmon explained that the Thai Health Promotion Foundation runs campaigns which encourage alcohol abstinence during the period.
Some people can quit drinking cold turkey, but many find it difficult to do so.
"Most people who cannot quit are not ready to or do not realise that they have alcohol addiction. Some people are in environments where their friends are drinkers and encourage them to drink. Others experience stress or sadness and use alcohol as a way out," said Dr Rasmon.
Quitting alcohol and maintaining good health are decisions that benefit individuals, but Dr Rasmon warns that in some cases, abrupt alcohol withdrawal can lead to death.
"Alcohol withdrawal symptoms can occur between four to eight hours after stopping consumption. These symptoms may include trembling hands, nausea, vomiting, excessive sweating, rapid heartbeat, anxiety or irritability. If anyone experiences seizures, severe confusion or loss of consciousness, they should be taken immediately to the hospital. If drinkers want to quit alcohol on their own, they should gradually decrease the amount of intake. This approach is safer than abruptly quitting," she said.
"Drinkers who experience alcohol withdrawal symptoms or repeatedly quit and return to drinking should seek professional help. These drinkers may require the use of certain medication to substitute alcohol and such medication will prevent them from experiencing withdrawal symptoms."
Many family members feel frustrated with their loved ones who are struggling with alcohol addiction and want them to quit. Dr Rasmon advises that families should distract their addicts by encouraging them to engage in other activities.
"Some drinkers spend their time drinking in the evening. Their families should distract them by asking them to do something else. If families stall for time, the craving can subside. Family members should also support drinkers in their efforts to quit drinking," he said.
Three weeks after its launch, Nong Tangjai had 277 users. There were 260 new users, while the other 17 were previous users who participated during the development phase of the system. Dr Rasmon hopes that Nong Tangjai will be a buddy or personal secretary for drinkers.
"I hope that Nong Tangjai will be a friend of drinkers. Some drinkers may not be aware their consumption puts them at risk of being alcoholic. Nong Tangjai can help them evaluate their drinking behaviour. I hope Nong Tangjai will be further developed so that drinkers can print out their records and share them with a hospital when they seek therapy," said Dr Rasmon.
"My aspiration is to develop Nong Tangjai into a more comprehensive 'Motivational Enhancement Therapy' which is a therapeutic approach aimed at enhancing motivation for positive behaviour change. The chatbot may be developed to a level where after interacting with Nong Tangjai, drinkers immediately want to quit alcohol."
The Nong Tangjai chatbot is available on Line. Thai Health Promotion Foundation
The Stop Drinking 1413 helpline. Thai Health Promotion Foundation
Assoc Prof Dr Rasmon Kalayasiri, director of the Centre for Addiction Studies and the Stop Drink 1413 helpline.
