Social drinking has now become a norm in urban India

The New Year is heralded in with fanfare, celebrations and frenetic partying by our upwardly mobile, well-heeled and educated urban elite. They can now afford the DJ-compered carousing advertised on billboards. Consumption of alcohol seems to be an essential part of this festivity.

A socially disadvantaged drunk lying asleep on the pavement after an alcohol binge, oblivious to torrential rain or the blazing sun, is only an object of pity. After all, labourers can only afford “hooch”, the cheap stuff that provides them the kick of a mule. It is illicit, illegal and manufactured in slum areas by fermenting fruits, vegetables or grains and then distilled into stronger arrack. All kinds of objects are added to increase the potency, like waste rubber, old jute and the odd dead insect or two. Unfortunately, our young people sometimes cannot afford IMFL (Indian made foreign liquor) where the fermentation is scientific and packing hygienic. They have a "cool" binge with the "raw stuff". This can be fatal as unscrupulous vendors do add toxic methyl alcohol, which can cause blindness and death.

Social drinking has now become a norm in urban India among both men and women. People drink to relax, forget their worries and cope with difficult situations. This may sound innocuous, but 20 per cent of such people develop alcohol dependence and a further 20 per cent become problem drinkers.

Alcohol-related injuries occur when consumption is out of control. This is characterised by a strong, uncontrollable urge to drink earlier in the day and an inability to stop. The numbed brain does not emit the satiety or warning signals saying “enough”. Stronger and larger drinks are required to achieve the same “kick”. Failure to consume alcohol then results in sleeplessness, anxiety, nervousness, hallucinations, tremors and eventually convulsions. Regular heavy drinkers (more than 15 drinks a week for men and nine for women) develop tolerance. Chronic heavy drinkers are at risk of alcohol-related illnesses, and often have the function of their heart, liver, pancreas and brain compromised. But they manage to survive. Moderate drinkers who sometimes binge, suddenly increasing the amount they consume as a result of partying, are most likely to suffer acute injuries. The threshold for “binge” drinking is five or more drinks for men and four or more for women per occasion. It is a self-destructive activity that results in intoxication resulting in a loss of control. The greatest risk to life occurs as a result of accidents occurring due to alcohol-induced faulty judgement and slowed reflexes.

Alcohol is also a great deceiver. Sexual desire is increased, but discernment and judgement are affected. This leads to unwelcome sexual encounters and may even result in rape. The performance, too, may be frustratingly below par, plagued by premature ejaculation or impotence.

Alcohol use, particularly binge drinking, has increased among upwardly mobile, educated elite and employed women of childbearing age. Unplanned pregnancies can occur at this time with the woman subsequently being unaware that she is pregnant. This places the baby at high risk of alcohol exposure, particularly in the early, organ-forming period. It can result in the birth of children with the characteristic birth defects of the foetal alcohol syndrome (FAS). Such babies are small in size, with typical facial appearance and neurological defects.

Alcohol acts as a social lubricant, but more and more people are now turning to the use of “club drugs”, substances like Ecstasy and Ketalar to increase social intimacy and sensory stimulation. They are commonly used at nightclubs, music festivals and parties. They are popular, relatively inexpensive and convenient as they can be consumed as tasteless pills, powders or liquids and taken orally alone, in combination with each other or with alcohol. They can cause fatal reactions as they may be adulterated. Also, the difference between a “fun” dose and a fatal one is very small.

Genetics plays a part in determining susceptibility to alcoholism and drugs as the same area of the brain determines the sensitivity to both. Several members of a family for many generations may become alcoholics. However, although the tendency is inherited, progression to dependence is influenced by availability and environment.

Alcohol has become a problem if —

You are unable to cope with your responsibilities;

People have asked you to stop drinking;

There has been aggressive behaviour at home or outside;

Interpersonal relationships have suffered;

Your organs are biochemically or symptomatically affected.

For a safe New Year —

Don’t drink and drive. At a party, appoint a designated driver who will be a temporary teetotaller.

Don’t take drugs. You could die or be permanently mentally damaged.

If there is the slightest chance that you are or may become pregnant, stay off the drinks. A small sacrifice now is better than a lifetime of regret.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in