We hate restrictions and regulations. Consequently, we are driven either consciously or unconsciously to override them. We like to lose control, but are inherently programmed to retain it! Alcohol is perceived as a substance that lets you be – something that gives you the deceptive confidence to shed your inhibitions and even bring out UR true self! You may have come across someone who drinks like a fish and is yet able to stand tall amongst the less tolerant intoxicated. Here is an alcoholic in the making. Excess intake of alcohol opens a Pandora’s Box of health and social problems. As said by Paracelsus, the father of Toxicology, ‘the dose makes the poison!’ Officially, Indians are amongst the world’s lowest consumers of alcohol, but we seem to have a way around it. How? Over half the drinkers fall in the hazardous drinking category! Further, about 15-20 per cent of this lot go on to become addicts or develop dependency syndrome.   So whether you are a responsible social drinker or an addict, you definitely won’t get ‘high’ knowing that alcohol is one of the most toxic substances known to man! Unfortunately, it’s readily and legally available worldwide. As we are currently spoilt for choice, it becomes impossible to know how much is too much! This applies to everything we do, be it the food we eat, the money we seek, and importantly that drink we indulge in. Why We Need To Worry About Drinking Studies suggest that alcohol is connected to more than 60 types of diseases and injuries. For instance, alcohol is a risk factor for oesophageal cancer, liver cancer, and cirrhosis of the liver, stroke, and psychiatric illnesses including suicide, motor vehicle accidents and homicide. There has been an upward surge in patterns and trends of alcohol use in India. People are now drinking at a younger age and in the past two decades; the average age of initiation of alcohol intake has fallen from 19 to 13! The signature pattern of alcohol consumption is frequent and heavy drinking, with more than 90 per cent of alcohol consumption being in the form of hard liquor or distilled spirits. Alarmingly, only 40 per cent of these are branded. The Blame Game! According to the government, powerful international and domestic alcohol lobbies are targeting our young. There are multinationals at work trying to harvest the potential in India’s vast unexploited market for investment in production and distribution of alcohol and alcoholic products. The film industry glorifies drinking: Good guys, drink and good times are associated with intoxication!   Limiting individual alcohol intake and drinking sociably and sensibly is the first step towards responsible drinking. In recognition of the global health issues with alcoholism, the World Health Organization (WHO) kicked in 2012 by sounding out national governments on setting a global target for reducing per capita consumption of alcohol. But the move seems to have hit a roadblock for in April, the WHO dropped it, citing poor support from member states! But why wait until countries and states decide on strategies for reducing alcohol consumption? Limiting individual alcohol intake and drinking sociably and sensibly is the first step towards responsible drinking. For this, drinks need to be quantified, and the guidelines for alcohol intake need to be understood. Count Your Drinks The health authorities in the UK worked on guidelines for alcohol consumption far back in 1981. They very aptly titled it, ‘Drinking Sensibly’ which contained the detailed definition of alcohol misuse and the introduction to the concept of sensible drinking. Three years later, it was followed with guidelines on individual drinking. The latter too was aptly titled, ‘That’s the Limit!’ which outlined ‘safe limits’ for drinking. Their follow-up reports in 1995 formed the basis for quantifying alcohol volume in units and individual drinking guidelines (21 units a week for men and 14 for women). A couple of years later, these guidelines were changed from weekly limits to daily limits. Here are a few points from the new guidelines: Men: 3-4 units a day or less Women: 2-3 units a day or less After an episode of heavy drinking, refrain from drinking for 48 hours to allow the body tissues to recover Units are a fundamental concept used in guidelines on alcohol consumption. Approximately, one unit equals to a 25 ml measure of spirits like whisky, or half a pint of ordinary strength (4 per cent) beer, 100 ml of 10 per cent wine. Therefore, a ‘large’ peg of whisky has two units; a can of regular beer has about 1.5 units; and 175 ml glass of wine contains two units. Awareness about alcohol consumption and associated health hazards, as well as sensible drinking limits, may help to contain and reduce the intake. Also, what we urgently require is education and awareness programmes on the perils of alcoholism and hazardous drinking.

Dr Roshan Jain 4 min read April 10, 2020