Close to one fourth of the male population of rural Madhya Pradesh has consumed alcohol over a one-year period, a study published last month in the British Medical Journal (BMJ) has claimed, with the last consumption far higher amongst Hindus (14.7%) than Muslims (1.2%). Researchers conclude that there is a need for identifying and treating people with alcohol use disorders.
Dr Rahul Shidhaye, principal investigator of the research project and senior co-author of the research paper, said it was the first population-based survey of alcohol use conducted in Madhya Pradesh in 10 years, and one of the few studies of alcohol use in India to include women.
Titled ‘Epidemiological features of alcohol use in rural India: a population based cross-sectional study’, the study was conducted by Sujit D Rathod, Abhijit Nadkarni, Arvin Bhana and Dr Shidhaye in 2014. It was conducted on 3,220 adults in Sehore district, using the Alcohol Use Disorders Identification Test (AUDIT) to know the number of people who consumed alcohol and the proportion of people who faced various problems due to it, Dr Shidhaye said, adding that among drinkers, 33.2% had AUDIT scores consistent with hazardous drinking, 3.3% with harmful drinking and 5.5% with dependent drinking.
Dr Shidhaye, a psychiatrist who works with the Public Health Foundation of India (PHFI), said the study shows that 49.2% of men with alcohol use disorder (AUD) felt embarrassed by their problems with alcohol, but only 2.8% had sought treatment for the same over the past 12 months.
The researchers concluded that there exists a need for effectively identifying and treating people with AUDs. Health promotion services, informed by commonly-expressed stigmatised beliefs held among those affected by AUDs, may be an effective step in closing the treatment gap, the study stressed.
According to Dr Shidhaye, the study is part of Programme for Improving Mental Health Care (PRIME), a consortium of research institutions and ministries of health in five countries — Ethiopia, India, Nepal, South Africa and Uganda — with partners in the UK and the World Health Organization (WHO). It is funded by the Department for International Development (DFID).
As part of PRIME and in partnership with the MP health department, Sehore district was selected to implement a district-level mental healthcare plan to integrate mental health diagnostic and treatment services into the primary healthcare sector. NGO Sangat and the New Delhi-based Public Health Foundation of India (PHFI) is jointly coordinating this project in MP.
The study was conducted on 3,220 adults in Sehore district, using the Alcohol Use Disorders Identification Test
23.8% of men had consumed alcohol in 12 months of the study.
14.7% people among the polled Hindus had recently consumed alcohol while 1.2% among the polled Muslims had recently consumed alcohol.
33.2% of those who recently consumed alcohol indulged in hazardous alcohol consumption, 3.3% with harmful behaviour and 5.5% with dependent behaviour.
2.8% of adults with Alcohol Use Disorder (AUD) sought treatment for problems with drinking
23.9% people with AUD spoke about drinking to their spouse/partner or a friend.
49.2% adults felt embarrassed because of their drinking, 47.2% were disappointed with themselves, while 16.6% said they were ignored because of their alcohol problems.
In the long run, heavy drinking can result in problems like liver disease, heart disease, certain forms of cancer and pancreatitis.
It can lead to circulatory system complications that include poisoning of the heart muscle cells (cardiomyopathy), high blood pressure, weak muscle control and so on.
Heavy drinking can cause platelets to clump together into blood clots, increasing chances of heart attack or stroke.
It can cause a condition in which the heart muscle weakens and heart can have rhythm abnormalities
It can impair decision-making abilities and motor skills, leading to road accidents. It can also lessen the oxygen-carrying red blood cells
What health authorities say
Dr RC Gupta, chief medical and health officer (CMHO), Sehore, said the problem of alcoholism in Sehore district has many reasons. First, there is a large section of labour class and people from economically lower strata who are used to drinking. He said country liquor is also produced in large quantities here and there are many outlets selling it. There are also some communities where consuming liquor is not considered a bad thing. Also, the district hospital doesn’t have a de-addiction unit, he added.