It is no longer a taboo. It has become a socially accepted norm to drink alcohol in India. It is, quite simply, here to stay. Therefore it augurs well for the welfare of our society and our health that we familiarize ourselves with the ill-effects and limits of alcohol intake.
With alcohol and drug rehabilitation centres mushrooming all across our urban landscape – a general indicator of the rising levels of alcohol dependence – it is all the more important for us to contain the drinking problem; prevention and moderation being the key words here.
Alcohol abuse indicates excess intake of alcohol, more than for socializing purposes, and is only a step away from alcohol dependence, wherein the person is unable to quit drinking. There are definite criteria which help a professional diagnose these conditions. But to get an idea if you or your relative has ended up with the drinking problem, the CAGE questionnaire devised by Dr John Ewing of University of North Carolina is traditionally used worldwide. It involves asking yourself or the person the following:
- C: have you felt the need to cut down on your drinking?
- A: have you felt annoyed when people criticized your drinking?
- G: have you ever felt guilty about your drinking habit?
- E: have you ever drunk as first thing in the morning to steady your nerves (eye-opener)?
Two or more ‘yes’ answers to these four questions indicate an alcohol-related problem. While this questionnaire does not provide a definite diagnosis of dependence, it is nevertheless useful in making a quick assessment.
Problems and treatment
It is better to involve the professionals at an early stage of the drink problem, although from clinical experience, we know that individuals with alcohol related problems can be notoriously resistant to advice or any suggestions of treatment. It is not an uncommon scenario where the individual would have to be sedated or even dragged along kicking and screaming to a rehab unit.
Alcohol dependence is associated with a variety of problems:
- Medical: fatty liver and liver failure, pancreatitis, neurological disorders
- Psychiatric: acute withdrawal syndrome, seizures, change in personality
- Social: breakdown of relationships, neglect of social/family life, social isolation
- Financial: debts to fund drinking habit, loss of job
- Legal: drink-driving accidents, disinhibition leading to sexual assaults and crime
It is, therefore, necessary that you are aware of the limits of alcohol intake, so that you never become dependent on the habit in the first place. So how much drinking is enough? What is the daily limit?
Unfortunately there is no easy answer to the question of limit of alcohol intake, as the guidelines vary from country to country, depending upon the drinking culture prevalent in that particular country. For example, the standard recommended drink varies from an alcohol content of 8g in the UK to 14g in the US. Websites relating to alcohol use in India advise drinking no more than ‘one drink’ for women and ‘two drinks’ for men. What constitutes a drink – as different types of alcoholic beverages contain varying alcohol levels – is not clear from this advice.
However, the National Health Service (NHS) of UK recommends that men should not drink more than 3-4 units in a day (or 21 units in a week), and women should not drink more than 2-3 units in a day (or 14 units in a week). What constitutes a unit?
One has to begin by looking at the Alcohol by Volume (ABV) label on any bottle of alcohol. A reading of ‘8% ABV’ indicates that 8% of the volume of that drink is pure alcohol. Once you know this, the units of alcohol are calculated by this formula:
Strength (ABV) x Volume (ml)
Units = _________________________
Thus, 750 ml of an ‘8% ABV’ drink would contain 6 units of alcohol. The following table gives the unit content in some of the popular alcoholic drinks:
|Small glass of red/white wine||125 ml||12%||1.5|
|Bottle of lager/beer||330 ml||5%||1.7|
|Can of lager/beer||440 ml||4.5%||2|
|Pint of strong lager/beer||568 ml||5.2%||3|
|Small shot of spirits*||25 ml||40%||1|
(* Spirits are high alcohol content drinks such as whisky, rum, gin, vodka, tequila and sambuca)
The key take-home message is, drink in moderation, know your limits, and never let drinking become a habit that you cannot shake off.