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Alcohol Dependency Syndrome

Alcoholism is not a crime or moral weakness (though it requires strength and determination in giving up) but an ILLNESS and a disorder. Any individual who drinks heavily and regularly affecting his health, social and occupational functioning is an alcoholic. The word ‘ALCOHOL‘ is generally associated with parties, fun and pleasure which are short lasting and most alcoholics started on the above basis. That which started as a social drinker gradually promote to drinking on regular manner with gradual increase in quantity and frequency of consumption to get the desired ‘kick’ or effects which in technical term is called as ‘TOLERANCE’. With the increase in amount and frequency of drinking the individual’s responsibilities are also inversely affected as drinking attains greater necessity and importance in his/ her life. Development of dependence on alcohol or alcoholism is signaled by loss of control over drinking, regular pattern of daily drinking and when one starts drinking in the morning known as eye opener. Other alarm includes black-out where there is inability to recall events that occurred when under the influence of alcohol, withdrawal fits or rum-fit on reducing the usual amount or giving up alcohol. Problems arose when drinking interferes with family life, job performance, career, budget or personal health and has become a social nuisance.

What contribute to alcoholism has been studied and there is no one single cause but multifactoral. Heredity or genetic predisposition is one of the cause but other settings leads to alcoholism. Alcoholic parents act as role model to the developing child that encourage or induce their children to drink. If any individual has alcoholism in his/her life family (parents, grandparents and other blood relations) he /she are more at risk to developing dependence and at best should avoid alcohol. Other causes are personality disorder, psychological factors such as depression and last but not the least social factors that can precipitate alcohol dependence. Stressful situations, emotional disturbance and mood alteration and lack of coping skills may contribute to the disorder.

Cultural influence is important as some cultures accept use of alcohol more liberally leading to more alcohol related problems. Free and abundant availability is also considered as a significant predisposing factor to alcohol abuse and dependence but imposition of ban and restriction on alcohol availability does not appear to have much positive effects. More importantly alcohol itself as a drug/substance is psychotropic and has an innate property to cause dependence or addiction.

Alcohol does not contain any vitamins, minerals or proteins essential in our daily diet. It has no nutritive food value except that it provides ready energy or calories. About 80 calories is produced by consumption of 30 ml whisky/gin/rum or 60-90ml of wine or 250-300ml of beer. Alcohol is directly absorbed through the wall of the stomach and intestine and goes straight to the blood stream which is broken down in the liver by its enzymes. Though a small amount is eliminated through breath, urine and sweat the rest is taken up by the body. The elimination of alcohol from the body takes time and its breakdown is at a fixed rate in the liver at the rate of one standard drink per hour. Hence the result is disastrous, when after consuming large amount of alcohol venturing to drive or handling machineries. Most of the road traffic accidents, falls etc occur when the person is under the influence of alcohol as the motor activities and coordinations are impaired. In many countries of the world including India, driving under the influence of alcohol is an offense liable to legal punishment. Penalties may vary from disqualification from driving for a period, cancellation of license and even imprisonment depending on the blood-alcohol level and the nature of the crime committed.

The acute effects of alcohol depends largely on the amount consumed, period over which it is taken, person’s constitutional status such as body weight and health, individual’s past experience with alcohol and the circumstances or setting and the company in which it is taken. After a person consumed 1 to 2 drinks there is flushing of the skin with sense of hotness, increased heart beats, desire to talk a lot with loss of inhibition. The person may feel relaxed with a sense of well-being. With 3 drinks judgment is gradually affected and a general loss of coordination. Blurring of vision, giddiness, slurred speech and slowing down of reactions with 5 drinks. Double vision (seeing things in two); staggering gait, loss of balance happens by 8 drinks. When an individual reach 15 to 20 drinks medical attention may be required, a situation when the skin becomes clammy, pupils are dilated, vomiting, loss of bladder control and ultimately loss of consciousness. Taken in combination with other drugs can prove dangerous especially taking with sleeping pills such as calmpose, valium etc (diazepams), charas, ganja and antihistamines, besides others. The combined effect can lead to slowing down of respiration and heart rate which can cause cardio-respiratory failure.

Manipur scene

Though no study on prevalence and other factors are available, alcohol related problem in Manipur is by no means low. Hospital experience and attendance of clients in NGO run treatment centers along with what is seen in our community speaks volume of the serious problem of alcohol. One of the contributing factors of alcohol dependence has been cited as free availability of alcohol. However, declaring Manipur as a dry state does not reduce or reverse the problem. The health problem is apparently increased both in terms of physical (head injury, accidents, hepatitis, cirrhosis, gastritis, hypertensions, diabetes, heart problems etc to name but a few) and mental (depression, panic disorder, alcohol induced psychosis, alcohol withdrawal with complications ‘“hallucinations, delusions, fits etc). If prohibition has any effect on alcohol related problems it certainly is on the wrong side. Illicit and spurious local brew is available at large, its demand is on the rise as there is no alternative except for the privileged few who can manage to procure better quality product. It is likely local brew is causing health hazard with increased morbidity and mortality. It is said that due to increased demand of local brew and to meet the need certain methods are being adopted for faster production like use of certain chemicals/substances for quick processing. Perhaps this situation may hasten onset of liver diseases, which we in the medical profession come across clinically. Besides many cases of alcohol related problem and death in our community may have never attended hospital.

The general public should be aware of the fact that alcoholism has both short term and long term ill effects which harm not only the individual, but his/her family and society as a whole. Once the individual reach the status of alcoholism or alcohol syndrome medical consultation can help giving up drinking and prevent going downhill and help restore health. Physical, mental, social, occupational and economic conditions can be improved with abstinence of alcohol and timely medical intervention.

*The article is written by Dr K Shantibala Devi

(Courtesy: The Imphal Free Press)

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