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Alcohol as public health problem

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Post Graduate Student, Department of Community Medicine

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Alcohol as public health problem

  1. 1. Dr.Praseeda BK
  2. 2.  Worldwide, 3.3 million deaths every year result from harmful use of alcohol,this represent 5.9 % of all deaths.  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).
  3. 3.  Alcohol consumption causes death and disability relatively early in life. In the age group 20 – 39 years approximately 25 % of the total deaths are alcohol-attributable.  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.
  4. 4.  The latest causal relationships have been established between harmful drinking and incidence of infectious diseases such as tuberculosis as well as the course of HIV/AIDS.  Beyond health consequences, the harmful use of alcohol brings significant social and economic losses to individuals and society at large.
  5. 5.  Alcohol impacts people and societies is determined by - the volume of alcohol consumed - pattern of drinking - on rare occasions, the quality of alcohol consumed. - In 2012, about 3.3 million deaths, or 5.9 % of all global deaths, were attributable to alcohol consumption.
  6. 6.  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.
  7. 7.  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.
  8. 8.  economic development  Culture  availability of alcohol  comprehensiveness and levels of implementation and enforcement of alcohol policies.
  9. 9.  regulating the marketing of alcoholic beverages (in particular to younger people)  regulating and restricting availability of alcohol  enacting appropriate drink-driving policies  reducing demand through taxation and pricing mechanisms
  10. 10.  raising awareness of public health problems caused by harmful use of alcohol and ensuring support for effective alcohol policies  providing accessible and affordable treatment for people with alcohol-use disorders  implementing screening and brief interventions programmes for hazardous and harmful drinking in health services.
  11. 11.  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 communities.  Those individuals who engage in this type of behavior can begin to fail in their ability to meet family, social, and work commitments.
  12. 12.  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 deaths.
  13. 13.  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 Nagaland.
  14. 14.  Andhra Pradesh, Haryana, Mizoram, and Tamil Nadu had previously imposed alcohol bans but were forced to withdraw the prohibition.
  15. 15.  Gujarat – One of the first states of India to have a no alcohol policy, the state bans the manufacture, storage, sale, and consumption of alcohol  . 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.
  16. 16.  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 sold widely.  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.
  17. 17.  Lakshadweep – Alcohol consumption is prohibited on all the islands of Lakshadweep, except on Bangaram.
  18. 18.  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.
  19. 19.  Nagaland – Sale and consumption of alcohol has been prohibited in the state of Nagaland since 1989.  Illegal sale and trade of local brews, however, are thriving businesses.  As of 2014, the government had initiated discussions about lifting the ban.
  20. 20.  Alcohol policy is under the legislative power of individual states.  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.
  21. 21.  Delhi, for example, has dry days. There was an earlier failure of prohibition in Tamil Nadu.  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 places.
  22. 22.  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.
  23. 23.  The blood alcohol content (BAC) limits are fixed at 0.03%.  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 imprisonment.  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.
  24. 24.  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.
  25. 25.  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 fine.  For alcohol level between 60-150 mg per 100 ml of blood, the penalty would be one year imprisonment and/or 4,000.
  26. 26.  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.
  27. 27.  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 device.
  28. 28.  8 September 2000  Advertising alcoholic beverages has been banned.
  29. 29.  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.
  30. 30.  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.
  31. 31.  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.
  32. 32. All victims of alcohol and substance (drugs) abuse with a special focus on:-  Children including street children, both in and out of school.  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.
  33. 33.  Alcohol  All Narcotic Drugs and Psychotropic substances covered under the NDPS, Act, 1985.  Any other addictive substance, other than tobacco.
  34. 34.  Alcohol Use Disorders Identification Test (AUDIT)  CAGE questionnaire  TWEAK questionnaire  CRAFFT questionnaire  S-MAST-G questionnaire
  35. 35. Add all scores to obtain a total > 8 for men or > 4 for women indicates a higher risk of alcohol use disorder • Alcohol Use Disorders Identification Test (AUDIT)
  36. 36. • Two or more points indicate possible alcohol problem
  37. 37. One yes response indicates need for further assessment; two yes responses indicates risk of alcohol use disorder.
  38. 38. PleaseanswerYes or No to the followingquestions: Yes No 1. Whentalkingwithothers,doyoueverunderestimatehowmuchyoudrink? 2. Aftera fewdrinks,haveyousometimesnoteatenorbeenabletoskipa meal becauseyoudidn’tfeel hungry? 3. Doeshavinga fewdrinkshelpdecrease yourshakinessortremors? 4. Doesalcohol sometimesmakeithardfor youto rememberpartsoftheday or night? 5. Do youusuallytakea drinkto calmyour nerves? 6. Do youdrinkto take yourmindoffyourproblems? 7. Haveyou everincreasedyourdrinkingafterexperiencingalossinyour life? 8. Has a doctoror nurseeversaidtheywereworriedorconcernedaboutyour drinking? 9. Haveyou evermaderulestomanageyour drinking? 10. Whenyoufeel lonely,doeshavingadrinkhelp? SCORING: Score1 pointfor each‘yes’answerandthentotal theresponses 2+ points = are indicativeof an alcohol problem
  • SuryaprakashMohanty1

    Oct. 12, 2021
  • AliyawarShaikh

    Apr. 21, 2021
  • chaithram19

    Dec. 8, 2020
  • DishaPatel85

    Dec. 4, 2020

Post Graduate Student, Department of Community Medicine

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