By Sukant Khurana:
Simple economic, age, gender and professional dimensions that define alcohol consumption patterns in small homogenous western nations are insufficient in a multilayered society like India. Despite adoption of western lifestyles, middle class in urban India has yet to entirely do away with the old mores and values. For few in the big city, the old values are still the core of their identity, while for others they are suitable pretences, resulting in schizophrenic environment where youngsters grow up absorbing the worst of both the eastern and the western influences. Rural India is witnessing a different yet equally seismic shift, where the old joint-family value system and associated economic enterprises are collapsing and people are moving away from traditional professions. There is significant migration in search of livelihood due to ever shrinking size of the agricultural land holdings. Apart from the stress of displacement, a break from ones communities also removes the social safety net that keeps check on alcohol abuse.
In some previously semi-arid and moderately populated regions, improvements in irrigation and industrialization of agriculture has created excess wealth and removed the need for few previously agricultural people to work with their own hands. Instant money for these people and also for the land holders in areas near big cities where prices of real estate have sky rocketed has resulted in youngsters who do not know how to handle their newfound wealth and are prone to addiction. Alcohol abuse combined with ready availability of opium derived drugs seeping in from our western borders has resulted in a whole generation of addicts in Punjab, Jammu, Haryana and parts of Rajasthan. In the flux of values and economic relations of our multilayered society four denominators are can still describe the major pillars of alcohol related problems in India: 1) lack of information 2) adulteration of alcohol 3) inefficient alcohol regulation policies and 4) the paucity of appropriate medical intervention.
While the debate over the merits of alcohol consumption is hotly contested worldwide, the views about alcohol consumption in India usually do not come in shades of gray but often in black and white. There is a taboo concerning alcohol consumption in any amount, especially by women and conservative sections of society, but also in general due to religious teachings of the Vaishnav sect of Sanatan Hinduism, Islam, Jainism, Sikhism, and Arya Samaj and the remnants of anti-alcohol Gandhian drive. Actual practice of alcohol consumption is altogether a different matter, which covers the whole gamut from healthy consumption to fatal abuse. History has taught us that making something a taboo does not solve the problem; it only makes the forbidden fruit more tempting.
Taboos encourage closeted and unsafe behavior like binge drinking in the case of alcohol or unsafe sex in the case of premarital relationships. Humans have been enjoying alcoholic beverages since prehistoric times. Alcohol has been celebrated in the Vedic hymns, Shaivism, Buddhism, Tantra, streams of Catholicism, and many indigenous animist and tribal traditions that celebrate alcohol in moderation. In fact many anthropologists and biologists claim that it is likely that alcohol from fermented grains was used as food source much before the bread was invented. In fact, if consumed in moderate amounts over many years, alcohol can have numerous positive health consequences. Moderate amounts of alcohol have been correlated with reducing dementia and Alzheimer’s disease, improving cardiac functioning, and reducing stroke incidences, type 2 diabetes, osteoporosis, gallbladder diseases, arthritis, renal cell carcinoma, thyroid cancer, and non-Hodgkin lymphoma among many other diseases.
When alcohol is consumed in an uncontrolled and excessive manner however, the story is much different. Binge drinking, especially as a repeat pattern, is associated with many health problems including alcohol poisoning, liver sclerosis, cardiovascular diseases, sexual dysfunction, and fetal alcohol syndrome in unborn children of pregnant women. The World Health Organization estimates that 2.5 million deaths per year worldwide are caused by alcohol related incidents, mostly due to heavy inebriation. A strong correlation exists between heavy alcohol consumption and crime.
Also, heavy drinking can result in blackouts that leave people vulnerable to crimes such as rape. Apart from health issues, the economic drain and the disruption of societal peace due to increased crime can be quite a big strain on society. Heavy alcoholics (not mild healthy drinkers) are more often involved in domestic abuse than rest of the population. So instead of making something taboo we need to understand a drink or two a day is good for health, unless the woman consuming is pregnant or if someone is patient of a kidney or a liver disease. On the other hand heavy amounts, i.e. more than three to five drinks a day, depending on the size of person, not just causes health issues but it wrecks families. The solution is in moderation for those who like to drink and not in professing abstinence.
Apart from lack of information on alcohol for people to make their own informed choice, adulteration of alcohol and lack evidence based regulation policy are reason for grave alcohol related health problems. Alcohol poisoning is due to non-ethanol alcohols: frequently methanol, also known as wood alcohol, which is highly toxic. Methanol can cause blindness and even death in sufficient quantity. It is sometimes added into illicit alcoholic beverages to increase their potency. In fact, most hooch related tragedies, like the recent one in Gujrat, have happened in dry states or on dry days in wet states. This is not surprising. When one cannot get regulated good quality alcohol and it is taboo to consume alcohol, people resort to shoddy alcohol consumption in hiding. Such prohibition on alcohol also results in binging due to fear of being caught. Failure of prohibition in Gujrat and Mizoram and earlier in Andhra should be an eye opener. This counterproductive nature of prohibition is a global trend and the disasters from the American prohibition era and Pakistani prohibition from the Zia time onwards should act as stern reminder for anyone professing prohibition.
One of the most laughable and pretentious acts of alcohol regulation in India is the current ban on alcohol advertisements while allowing alcohol manufacturers to advertize low-selling, almost hypothetical products like music CDs and bottled water that have the same name as their alcoholic beverage. Well-intentioned grass roots movements due to lack of information frequently push for prohibition and so do the self-benefiting NGOs that are merely acting as fronts for converting black money to white through Hawala schemes. One needs a non-prohibitionist, informed grass root movement to set the minds of ruling political elite to focus on the problem of addiction and alcohol abuse in India.
We are also missing well-trained physicians with information on efficacy and availability of de-addiction drugs and an awareness of benefits of psychological, exercise and vocational therapies. Appropriate information to both the health professionals and the family of addicts can result in much needed counseling and support required for anyone wanting to quit alcohol addiction.
I hope as India strives to maintain its much hyped growth rate it also stops its infantile approach in dealing with alcoholism and many other health issues that are part of reason why people’s quality of life is not going up at the same rate as economy. What is needed of people is to be informed of the beneficial and harmful effects of alcohol, shed away taboos that do not serve any good and understand that addiction is a disease that can be cured in most instances and the sooner one intervenes the better one can expect the outcomes to be. What is needed of the government is to have a smart regulation of alcohol that will add to revenue, ensure quality of alcohol, and spread information on the ills of alcoholism without making it the forbidden fruit.