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  • Current State Of Alcohol Addiction In India

Current State Of Alcohol Addiction In India

Introduction

Nowadays very frequently we can hear the common term; ‘Alcohol Addiction’. Many of us use the term without having any scientific knowledge of it. In the present Indian scenario, it’s very important to have a clear perspective of alcohol and alcohol addiction as day by day alcohol consumption is increasing in our country. There are many effects that alcohol can have on the body and the life of a person. Alcohol addiction even can do permanent harm to our physical and mental health. So, let’s start to find some alcoholic knowledge.

Table of Contents
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    What is Alcohol and Alcohol Addiction?

    Alchol

    Alcohol is a liquid formed by yeast or other bacteria when ferments (breaks down chemically without oxygen) the sugars present in different food. E.g., wine is made from the sugar of grapes, beer from the sugar of malted barley, cider from the sugar of apples, vodka from the sugar of beets, potatoes or other plants [1].

     

     

    Table 1: Several types of alcoholic beverage and its alcohol content

    Alcoholic Beverage Made from (Sugar) Alcohol Content (%)
    Brandy Fruit Juices 40 - 50
    Whisky Cereal Grains 40 - 55
    Rum Molasses / Sugarcane 40 - 55
    Wines Grapes & Fruits 10 - 22
    Beers Cereals 4 - 8
    Arrack Paddy / Wheat 50 - 60
    Toddy Flowers of Coconut and Palm Tree 5 - 10

    Immediate Effects of Alcohol:

    The effects of alcohol on the nervous system occur within five minutes of alcohol being drunk. Though, the effects may be the same for all who drink alcohol. It varies from person to person depending on body weight, age, health, gender and even the weather. Few instant effects are stated below:


    • A few drinks: One feel relaxed, concentration level decreases, Reflex arc becomes slower.
    • A few more drinks: Slurred speech, coordination reduces among body part, mood changes frequently.
    • More drinks: Vision get blurred, loses control on body part movement, confusion.
    • Still more drinks: Vomiting, feeling asleep and nausea.
    • Even more drinks: Coma or death can happen [2].

    Alcohol Addiction:

    Alcohol addiction or alcoholism is a pattern of alcohol use that involves problems controlling the drinking of alcohol, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when one rapidly decrease or stop drinking of alcohol [3].

    Symptoms of Alcoholism:

    Having alcoholic beverage will not always be treated as alcohol addiction. Sometime alcohol addiction can be difficult to find out as alcohol is widely available and accepted in many cultures. Even in few cold climatic region it is necessary to survive there. Some general symptoms are like:


    • Being unable to stop or limit the amount of alcohol consumption.
    • Spending a lot of time to drink alcohol.
    • Putting alcohol above other personal responsibilities.
    • Feeling urge to drink more alcohol.
    • Avoiding the contact of close people.
    • Wasting a lot of time or money just to drink alcohol.
    • Being aggressive without drinking it.
    • Increased lethargy, depression, or other emotional issues [4].

    Historical Background of Alcohol Use in India:

    The Ancient and Medieval Period:

    In Indian ancient literature dating back to the Vedic period around 2000 BC, it is mentioned that various beverages contain ethanol. Two types of beverage were mentioned; Soma and Sura. Even the side effects and harms of excessive consumption of beverages are mentioned. Soma is the drink of the social elite and it is credited with positive qualities. On the other hand, Sura is a fermented beverage made from rice or sugarcane. It was consumed by warriors to increase their valour and courage. In the post-Vedic era, there was no further mention of Soma. In the traditional Ayurvedic system alcohol is also used as an ingredient.

     

    In the ancient age, there was knowledge and availability of alcoholic beverages but the beverage was never a part of the diet in India. Strict guidelines were there to define who could drink and under what circumstances.

    The Colonial Period

    Before gaining independence in 1947 India remained under British rule for almost 200 years. In this colonial period, alcohol consumption gradually increased and the social attitude towards alcoholic beverages changed in that period only. Gradually distilled beverages of much higher alcohol content replaced traditional alcoholic beverages. After that better fermentation process, packaging and new technology were invented and resulted the alcoholic beverage becoming a mess produced commercial product.

     

    As the British were more familiar and accustom to alcohol, they promoted alcohol use. Giving license to big distilleries the colonial government allowed to local production of alcoholic beverages. Day by day it became one of the most important businesses of the British government and Indian common people get habituated to the western lifestyle.

    Reasons behind Alcohol Addiction:

    Now, we know what alcoholism is. Let’s discuss the reasons what allow a person to shift from having an occasional drink to full alcohol addiction. There are so many major and minor factors. Few of them are:

     

    Stressful Environment: If a person have a stressful work, he may be likely to drink more alcohol to get relief from the stress. Stress may not be always from work or job, it may grow from family problem, health problem or relation problem etc.

    Drinking just to have the taste: Few teenagers and adults just drink alcoholic beverage just to know the taste for the first time. Sometime this kind of curiosity makes the habit and after that addiction.

    Drinking at an early age: Research says that those who drink at an early age are more likely to have alcohol addiction because of not only the past habit but also the tolerance power of body increases.

    Mental health issues: Any kind of mental problem like depression, anxiety, bipolar disorder etc. increase the tendency of alcoholism. Drinking alcohol is the instant and temporary solution of getting rid of mental issue so, most of the people try this instant method.

    Taking Alcohol with Medication: Many people take drugs with alcohol. It’s a very common practice. Some medicine can increase the toxicity of alcohol. Even sometime it can be very dangerous.

    Genetic issue: Family history plays a major role to decide that one person will be alcohol addicted or not. This is a simple biological process as we all know that the characteristics can be transmitted from parental generation to the next generation through DNA.

     

    Lack of family supervision: A lack of support from family or parents can lead a child to be alcohol addicted. Financial condition of the family also can effect on it

    Production and availability of Alcohol:

    India is the third-largest market for alcoholic beverages in the world. Alcohol production, demand and consumption all the three parameters are increasing day by day. Below attached table and diagram show the related information.

     

    Table 2: Selected State-wise Production of Alcohol in India (2009-2010 to 2012-2013) (In Million Litre)

    State / UT 2009-2010 2010-2011 2011-2012 2012-2013
    Andhra Pradesh 63.84 114.96 130.56 115.2
    Bihar 30 47.52 54 48
    Gujrat 122.4 141.12 106.56 139.2
    Haryana 31.44 51.12 66.24 50.4
    Karnataka 257.76 364.8 605.52 348
    Maharashtra 585.84 789.6 756.96 768
    Punjab 22.32 36.72 45.84 36
    Tamil Nadu & Puducherry 165.36 241.92 299.76 240
    Uttar Pradesh 685.44 777.12 924.72 775.2
    Uttarakhand 36.48 37.2 42 36
    Others 15.12 30.96 34.8 31.2
    Total in India 2016 2633.04 3066.96 2587.2

    Source: https://www.niir.org/information/content.phtml?content=266:

     

    In Table 3, the growing up alcohol production of our country is shown. Alcohol production has a great business value as the demand for alcohol is increasing rapidly and every year the Indian government earn a good amount of profit through this business.

     

    Table 3: Annual dirtied spirits production in India by year. (April – March)

    Year Amount of Absolute Alcohol Produced (In Thousands Hectolitres)
    1982-1983 2862.55
    1983-1984 3104.75
    1984-1985 3310.64
    1985-1986 3407.49
    1986-1987 3204.8
    1987-1988 3432.48
    1988-1989 4190.45
    1989-1990 No data available
    1990-1991 No data available
    1991-1992 4895
    1992-1993 3467
    1993-1994 3626
    1994-1995 6056
    1995-1996 7888.04

    Source: https://www.who.int/publications/i/item/alcohol-and-public-health-in-8-developing-countries

     

    There are government registered alcohol shop or restaurant almost in every city and town of India. So, one can easily get it in his grip. Almost in every state after 21 years old people are allowed to buy alcoholic beverages.

    Drinking Pattern in India:

    In 2016 alcohol consumption in India was about 5.4 billion liters and at that time it was estimated that in 2020 alcohol consumption would reach about 6.5 billion liters. 

     

    The average alcohol intake per adult in our country is comparatively less than any other developed country like the United States, but there are many heavy drinkers among young Indians. Men are more likely to drink alcohol than women in our country. It is reported that in 2020, male drinkers consumed around 18.3 liters of alcoholic beverage per capita. Isn’t it a matter of worry?

     

    According to a study, more than 88% of young Indian people aged under 25 purchase alcohol. Even it is illegal in a few states. This was a reason behind the limitations or bans on alcohol in some states of our country [9].

     

    Among the Indian metropolitan cities, Mumbai is on the top in terms of alcohol consumption. 39% of total wine consumption is done over here. After Mumbai, Delhi consumes 23% and Bengaluru 20%. Below mentioned figure 1 shows the details of it [10].

     


    Figure 1: Major Wine Consuming Cities in India, Source: https://eprints.manipal.edu/138255/

     

    Researches were done in the last part of the 1970s and mid-1980s discovered that12.7% of secondary school understudies, 32.6% of college understudies, and 31.6% of youthful non-understudies devoured liquor. During a similar period, clinical understudies detailed a lot higher commonness of liquor utilization of 40%–60%. Studies during the 1990s proposed forbearance paces of 83%–97% in 15–19-year-olds [11].

    Preference for an Alcoholic Beverage:

    According to the research it is published that Indian drinkers prefer whisky than any other alcoholic beverage or it can be said that whisky is the most sold alcohol in India. Related data is shown below in figure 2. In India, the preference of wine is less as its production is less than any other alcoholic beverage.

    Figure 2: Alcohol Preference in India, Source: https://eprints.manipal.edu/138255/

    Alcoholic Epidemiology:

    You will be astounded to become more acquainted with that around 140.6 thousand individuals passed on because of liver cirrhosis brought about by liquor utilization across India in 2016. Street traffic wounds and malignant growth were likewise common among shoppers of the refreshment during the deliberate time-frame [12].

     

    Not only liver cirrhosis or road accident, there are also a number of examples of diseases caused by drinking  excessive alcohol as it can harm both our mental or physical health. Below in table, some of the examples are noted for better understanding.

     
    Table 4: Major disease and injury conditions (%) attributable to alcohol worldwide
    Condition Men Women Both
    Malignant neoplasms
    Mouth and oropharynx 22 9 19
    Oesophageal 37 15 29
    Liver 30 13 25
    Breast NA 7 7
    Neuropsychiatric disorders
    Unipolar depressive 3 1 2
    Epilepsy 23 12 18
    Alcohol use: Dependence and harmful use 100 100 100
    Diabetes mellitus -1 -1 -1
    Cardiovascular disorders
    Ischaemic heart disease 4 -1 2
    Haemorrhagic stoke 18 1 10
    Ischaemic stroke 3 -6 -1
    Cirrhosis of the liver 39 18 32
    Unintentional injury
    Motor vehicle accidents 25 8 20
    Drowning 12 6 10
    Fall 9 3 7
    Poisoning 23 9 18
    Intentional injury
    Self-inflicted 15 5 11
    Homicide 26 16 24

    Source: Article: Alcohol: Its health and social impact in India. http://archive.nmji.in/archives/Volume_19_2_March_April2006/Medicine_and_Society/Medicine_and_Society.pdf


    Few dangerous health diseases can be caused by excessive alcohol drinking:

    Breast cancer:  Alcohol consumption increase the risk of breast cancer. Researches have shown a linear increases in the risk of breast cancer with increasing average volumes of consumption of alcohol.

    Coronary heart disease: Compared with now no longer consuming, low-to-slight intake of alcohol is related to decrease CHD (Congenital heart disease) occurrence and mortality. For more common volumes of alcohol intake, the danger reverses.

    Intentional injury (violence): Alcohol has been constantly related to violent crime, even though the affiliation may not constantly be causal.

    Liver disease: Worldwide alcohol is one of the most important reasons for an end-stage liver disorder. Up to 90% of alcoholics have fatty liver, a disease this is seldom deadly and normally resolves inside 2 weeks if alcohol intake is discontinued. However, 5% – 15% of sufferers with alcoholic fatty liver expand cirrhosis

    Alcoholic cirrhosis: Patients who have alcoholic cirrhosis have the same clinical features of other causes as cirrhosis. 

    Morbidity: Though all liver cirrhosis in India might not be alcohol-associated, an evaluation of Indian research of biopsy-tested instances of liver cirrhosis from 1933 to 1975 located a cumulative imply of 16% of sufferers with alcohol dependence. However, in current years, the prevalence of alcohol-associated cirrhosis is increasing. In a current have a look at in Kerala, in 60% of sufferers with cirrhosis in a huge tertiary hospital, alcohol intake turned into the cause. Nearly 80% of the alcoholics had been additionally smokers. Almost all alcoholics develop fatty liver, which’s reversible following abstinence from alcohol [13]. 

    Psychology and Alcohol Addiction:

    Alcohol addicted people have a different kind of psychology or because of different kind of psychology, they become alcohol addicted. Both the statement can be true. Let us discuss that.


    • Every person tries to do whatever he feels right, so the alcohol-addicted people also think that they are also doing the right thing.
    • Even after knowing that they are wrong, they can’t leave the addiction and always tries to make the same excuse that this is the last time and after that, they won’t touch alcohol.
    • Disease theory says that alcohol issues result in individuals with innate issues which makes it unthinkable for the addicts to control their alcohol addiction.
    • According to Biological speculations that hereditary and genetic additives in alcohol dependency problems whilst diffused specifics aren’t but understood.
    • According to Psychosocial speculation that private mental problems, social, and environmental elements lead youth to alcohol dependence. Evidence demonstrates that a problematic combo of genetic, social, and mental elements underlies dependency problems [14].

    Family Issues Due to Alcoholism:

    Damaged Family Relationships: One manner wherein alcoholism influences households are in broken relationships. Families of human beings stricken by alcohol abuse frequently conflict to create sturdy emotional bonds, even inside their own circle of relatives unit. This generally starts with the parents.
    Developmental Problems in Neglected Children: Children of mother and father who war with alcoholism are at better threat for cognitive, behavioural, and emotional problems. Since an expected 6.6 million kids stay in families in which alcoholism is present, that is a large concern.
    Domestic Abuse: One of the maximum sobering outcomes of alcoholism is an improved hazard for home abuse in the family. Abuse tied to alcoholism may be both emotional and physical in nature.
    Drained Family Finances: The dependency of drinking alcohol on a regular basis is expensive. While the whole quantity spent on alcohol will range relying on the frequency and kind chose, the prices upload up.
    Physical And Mental Health Problems: Finally, warfare with alcoholism influences the physical and mental fitness of maximum participants of the family. The man or woman preventing dependency will cope with physical fitness troubles due to the effect of immoderate alcohol consumption [15].

    Alcohol and Sexual Risk:

    In our society men generally have more social liberties than women in terms of alcohol use as well as sexual activities. Teenage pregnancies also are on the rise. Sexual experimentation outside marriage is increasing. Risky sexual behaviours keep regardless of a confirmed STI/HIV status, as mentioned in India, Zambia, Belarus, etc.


    Liquor use has additionally been connected to early sexual encounters. Liquor use and sexual danger practices are especially predominant in settings, for example, dance clubs, bars, dull houses, interstate eating joints and inns, and massage parlours. Liquor use and sexual danger practices increment during specific merriments and festivities across nations [16].

    Govt. Rules and Alcohol Addiction:

    Every year 3 million people die because of the harmful effects of alcohol. So The World Health Organization (WHO) has stated ten key areas of policy options and interventions at the national level to reduce the morbidity and mortality due to harmful use of alcohol and their ensuing social consequences.


    • Leadership, mindfulness and responsibility.
    • Health administrations’ reaction.
    • Community activity.
    • Drink-driving strategies and countermeasures.
    • Availability of liquor.
    • Marketing of mixed refreshments.
    • Pricing strategies.
    • Reducing the negative results of drinking and liquor inebriation.
    • Reducing the general wellbeing effect of unlawful liquor and casually delivered liquor.
    • Monitoring and reconnaissance [17].

    Conclusion

    After discussing all the topics now we have a clear perception of alcohol and its harmful effects. We also know the better option for our physical or mental health. Now our decisions need to be strong enough to gain a healthy and wealthy life. There will be several options to disturb our mental or physical health condition, but the main thing is that we have the power to choose them for our better life. So, it’s all about our knowledge, our thinking, our awareness and a strong ‘NO’ for alcohol. Reach out to us for alcohol addiction treatment details

    References


    [1] Centers for Disease Control and Prevention, “Alcohol and Public Health,” CDC, 2020. [Online]. Available: https://www.cdc.gov/alcohol/faqs.htm. [Accessed 17 December 2020].
    [2] MyDr.com.au, “Alcohol: what is it?,” MyDr.com.au, 2019. [Online]. Available: https://www.mydr.com.au/addictions/alcohol-what-is-it. [Accessed 17 December 2020].
    [3] Myo Clinic, “Alcohol use disorder,” Myo Clinic, 2019. [Online]. Available: https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243. [Accessed 17 December 2020].
    [4] Alcohol Rehab Guide, “What is Alcoholism?,” Alcohol Rehab Guide, 2020. [Online]. Available: https://www.alcoholrehabguide.org/alcohol/. [Accessed 17 December 2020].
    [5] Mayo Clinic, “Alcohol use disorder,” Mayo Clinic, 2019. [Online]. Available: https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243. [Accessed 17 December 2020].
    [6] S. Saxena, “Country profile on alcohol in India,” Alcohol and public health in 8 developping countries, vol. 8, pp. 37-60, 1999.
    [7] M. David Sherman, “The 10 Most Common Causes of Alcoholism,” Sanalake, 2020. [Online]. Available: https://sanalake.com/blog/the-10-most-common-causes-of-alcoholism/. [Accessed 19 December 2020].
    [8] N. S. a. M. R. B. Miller, “A Common Cause of Alcoholism,” Journal of Substance Abuse Treatment, vol. 6, pp. 41-43, 1989.
    [9] S. Keelery, “Consumption of alcoholic beverages India 2016-2020,” statista, 2020. [Online]. Available: https://www.statista.com/statistics/727026/consumption-of-alcoholic-beverages-india/#:~:text=Consumption%20of%20alcoholic%20beverages%20India%202016%2D2020&text=Alcohol%20consumption%20in%20India%20amounted,6.5%20billion%20liters%20by%202020.. [Accessed 21 December 2020].
    [10] N. P. a. P. N. B. Nayak, “A study on alcohol consumption patterns and preference of liquor over wine amongst the youth in Manipal,” Journal of Hospitality and Tourism (Atithi), vol. 1, pp. 77-88, 2013.
    [11] S. K. a. B. V. a. V. D. Das, “Alcohol: its health and social impact in India,” National Medical Journal of India, vol. 19, p. 94, 2006.
    [12] Statista Research Department, “Number of alcohol attributable deaths across India in 2016, by cause,” statista, 2020. [Online]. Available: https://www.statista.com/statistics/946803/india-number-of-alcohol-related-deaths-by-cause/. [Accessed 21 December 2020].
    [13] S. K. a. B. V. a. V. D. Das, “Alcohol: its health and social impact in India,” National Medical Journal of India, vol. 19, p. 94, 2006.
    [14] S. Tripathi, “Alcohol Addiction among Young Adults and Psychological Practices in Treatment and Preventions,” Journal of Psychology & Psychotherapy, vol. 6, 2019.
    [15] Turning Point, “5 Effects Of Alcoholism On Family,” turningpointtreatment, 2019. [Online]. Available: https://www.turningpointtreatment.org/blog/5-effects-alcoholism-on-family/. [Accessed 22 December 2020].
    [16] M. d. l. S. D. o. M. H. a. S. A. a. W. H. Organization, Alcohol Use and Sexual Risk Behaviour: A Cross-Cultural Study in Eight Countries, World Health Organization, 2005.
    [17] World Health Organization, “10 areas governments could work with to reduce the harmful use of alcohol,” WHO, 2019. [Online]. Available: https://www.who.int/news-room/feature-stories/detail/10-areas-for-national-action-on-alcohol. [Accessed 23 December 2020].
    [18] Centers for Disease Control and Prevention., “Alcohol and Public Health,” 17 12 2020. [Online]. Available: https://www.cdc.gov/alcohol/faqs.htm.

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