CONNS CURRENT THERAPY BOPE KELERMAN 2013, section 16 psychiatric disorders- alcoholism no 921-927.
Alcohol as public health problem
Worldwide, 3.3 million deaths every year result from
harmful use of alcohol,this represent 5.9 % of all
The harmful use of alcohol is a causal factor in more
than 200 disease and injury conditions.
Overall 5.1 % of the global burden of disease and
injury is attributable to alcohol, as measured in
disability- adjusted life years (DALYs).
Alcohol consumption causes death and disability
relatively early in life. In the age group 20 – 39
years approximately 25 % of the total deaths are
There is a causal relationship between harmful use
of alcohol and a range of mental and behavioural
disorders, other noncommunicable conditions as
well as injuries.
The latest causal relationships have been
established between harmful drinking and
incidence of infectious diseases such as
tuberculosis as well as the course of
Beyond health consequences, the harmful
use of alcohol brings significant social and
economic losses to individuals and society at
Alcohol impacts people and societies is
- the volume of alcohol consumed
- pattern of drinking
- on rare occasions, the quality of alcohol
- In 2012, about 3.3 million deaths, or 5.9 % of all
global deaths, were attributable to alcohol
Alcohol consumption is a causal factor in
more than 200 disease and injury conditions.
Drinking alcohol is associated with a risk of
developing health problems such as mental
and behavioural disorders, including alcohol
dependence, major noncommunicable
diseases as well as injuries resulting from
violence and road clashes and collisions.
A significant proportion of the disease burden
attributable to alcohol consumption arises
from unintentional and intentional injuries,
including those due to road traffic crashes,
violence, and suicides, and fatal alcohol-
related injuries tend to occur in relatively
younger age groups.
availability of alcohol
comprehensiveness and levels of
implementation and enforcement of alcohol
regulating the marketing of alcoholic
beverages (in particular to younger people)
regulating and restricting availability of
enacting appropriate drink-driving policies
reducing demand through taxation and
raising awareness of public health problems
caused by harmful use of alcohol and
ensuring support for effective alcohol
providing accessible and affordable
treatment for people with alcohol-use
implementing screening and brief
interventions programmes for hazardous and
harmful drinking in health services.
An increasing number of people are becoming
dependent on alcohol. This makes it difficult for
them to function normally within society.
Domestic and sexual abuse is often associated
with alcohol abuse.
This type of behavior can be damaging to
Those individuals who engage in this type of
behavior can begin to fail in their ability to meet
family, social, and work commitments.
Families can suffer financially as a result of
this type of substance abuse.
Business and the economy suffer because of
lost productivity with people coming to work
still suffering from the effects of alcohol.
Drink driving is responsible for many road
Although alcohol is freely available in most
part of India, some states and Union
Territories in the country have various forms
of alcohol bans in force.
Alcohol prohibition is currently in force in
Gujarat, Kerala, Lakshadweep, Manipur, and
Andhra Pradesh, Haryana, Mizoram, and
Tamil Nadu had previously imposed alcohol
bans but were forced to withdraw the
Gujarat – One of the first states of India to
have a no alcohol policy, the state bans the
manufacture, storage, sale, and consumption
. Foreigners are allowed to obtain alcohol
permits valid for a month.
Gujarat’s policy has promoted active alcohol
trade in nearing regions such as Maharashtra,
Rajasthan, Goa, and Diu.
Kerala – Amidst much outrage, the government
of Kerala announced plans to go ahead with
alcohol prohibition in phases in August 2014.
Starting March 2014, alcohol licenses of bars
and shops were not renewed but toddy is still
This ban came as a surprise for two reasons.
Firstly, Kerala is among the highest alcohol
consuming states in the country
secondly, about 22 percent of Kerala
government’s revenue gains (approximately INR
8000 crore) was reported to have come from
alcohol manufacturing and sale licenses.
Lakshadweep – Alcohol consumption is
prohibited on all the islands of Lakshadweep,
except on Bangaram.
Manipur – Manipur government banned the sale
of alcohol in the state in April 1991.
The ban did not do much to curb alcoholism in
the state and local brews are widely available.
In 2002, the five hill districts of the state were
exempt from prohibition, adding about INR 50
crore to the government’s exchequer.
As of July 2015, the government is considering a
total lift of the ban.
Nagaland – Sale and consumption of alcohol
has been prohibited in the state of Nagaland
Illegal sale and trade of local brews,
however, are thriving businesses.
As of 2014, the government had initiated
discussions about lifting the ban.
Alcohol policy is under the legislative power of
Prohibition, enshrined as an aspiration in the
Constitution, was introduced and then
withdrawn in Haryana and Andhra Pradesh in the
midi-1990s, although it continues in Gujarat,
with partial restrictions in other states.
Delhi, for example, has dry days. There was
an earlier failure of prohibition in Tamil
Excise department regulate and control the
sale of liquor in the NCT of Delhi.
Retail supply of alcohol is regulated by Delhi
Liquor License Rules, 1976. It prohibits
consumption and service of liquor at public
Any person, who is found drunk or drinking in
a common drinking house or is found there
present for the purpose of drinking, shall on
conviction, be punished with fine which may
extend to five hundred rupees.
The blood alcohol content (BAC) limits are fixed
Any person whose BAC values are detected more
than this limit is booked under the first offense.
He/she may be fined about 2000 andor he or
she may face a maximum of 6 months
If he person commits a second offense within 3
years of the first then he/she may be fined
about 3000 and/or he or she may face a
maximum of 2 years imprisonment.
1 March 2012 Amendments
Drunk driving would be dealt with higher
penalty and jail terms - fines ranging
from 2,000 to 10,000 and imprisonment from
6 months to 4 years.
Drink driving will be graded according to
alcohol levels in the blood.
For levels between 30-60 mg per 100 ml of
blood, the proposed penalty would be 6
months of imprisonment and/or 2,000 as
For alcohol level between 60-150 mg per 100
ml of blood, the penalty would be one year
imprisonment and/or 4,000.
If the offence is repeated within three years,
the penalty can go up to 3 years
imprisonment and/or 8,000.
For those who are found heavily drunk with
alcohol levels of over 150 mg per 100 ml of
blood, the penalty will be 2 years
imprisonment and or 5,000.
Repeat offence within a three year period
would warrant a jail penalty and fine
of 10,000 besides cancellation of license.
Between 2% and 10% of ethanol is excreted
directly through the lungs, urine, or sweat.
The concentration of the alcohol in the alveolar
air is related to the concentration of the alcohol
in the blood.
As the alcohol in the alveolar air is exhaled, it
can be detected by the breath alcohol testing
8 September 2000
Advertising alcoholic beverages has been
For the purpose of drug demand reduction,
the Ministry of Social Justice &
Empowerment has been implementing the
Scheme of Prevention of Alcoholism and
Substance (Drug) Abuse since 1985- 86.
The Scheme was revised thrice earlier (1994,
1999 and 2008) prior to the recent revision
which came into force from January 1, 2015.
To create awareness and educate people about
the ill-effects of alcoholism and substance abuse
on the individual, the family, the workplace and
society at large.
To provide for the whole range of community
based services for the identification, motivation,
counselling, de-addiction, after care and
rehabilitation for Whole Person Recovery (WPR)
of addicts to make a person drug free, crime
free and gainfully employed.
To alleviate the consequences of drug and
alcohol dependence amongst the individual, the
family and society at large.
To facilitate research, training, documentation
and collection of relevant information to
strengthen the above mentioned objectives.
To support other activities which are in
consonance with the mandate of the Ministry of
Social Justice & Empowerment in this field.
All victims of alcohol and substance (drugs) abuse with
a special focus on:-
Children including street children, both in and out of
Adolescents/Youth Dependent women and young girls,
affected by substance abuse.
High risk groups such as sex workers, Injecting Drug
Users (IDUs), drivers etc.
Prison inmates in detention facilities including
children in juvenile homes addicted to drugs.
All Narcotic Drugs and Psychotropic
substances covered under the NDPS, Act,
Any other addictive substance, other than
Alcohol Use Disorders Identification Test
Add all scores to obtain a total > 8 for men or > 4 for women indicates a higher risk of alcohol
• Alcohol Use Disorders Identification Test (AUDIT)
• Two or more points indicate possible alcohol problem
One yes response indicates need for further assessment; two yes
responses indicates risk of alcohol use disorder.
PleaseanswerYes or No to the followingquestions: Yes No
2. Aftera fewdrinks,haveyousometimesnoteatenorbeenabletoskipa meal
3. Doeshavinga fewdrinkshelpdecrease yourshakinessortremors?
4. Doesalcohol sometimesmakeithardfor youto rememberpartsoftheday or
5. Do youusuallytakea drinkto calmyour nerves?
6. Do youdrinkto take yourmindoffyourproblems?
7. Haveyou everincreasedyourdrinkingafterexperiencingalossinyour life?
8. Has a doctoror nurseeversaidtheywereworriedorconcernedaboutyour
9. Haveyou evermaderulestomanageyour drinking?
10. Whenyoufeel lonely,doeshavingadrinkhelp?
Score1 pointfor each‘yes’answerandthentotal theresponses
2+ points = are indicativeof an alcohol problem
Oct. 12, 2021
Apr. 21, 2021
Dec. 8, 2020
Dec. 4, 2020
Post Graduate Student, Department of Community Medicine