Should alcohol be brought under essential services during lockdown?


New Delhi, Apr 10 (IANS): The COVID-19 restrictions have quite understandably made life difficult for many. But it may not be possible for everyone to imagine what those with untreated alcohol use disorder go through when they do not get to drink at all.

Some have allegedly attempted to commit suicide, while it is also not uncommon for addicts to try to get alcohol from other unsafe sources such as alcohol-based hand sanitizers. Reports of alcohol smuggling and rise in bootlegging have emerged from several parts of the country in recent times.

Given that more than 5.7 crore people in India are estimated to be affected by harmful or dependent alcohol use, and most of them do not have any access to treatment, should alcohol be made easily accessible just as groceries and vegetables during the time COVID-19 restrictions remain?

Experts have different views on the issue. While some argue that making alcohol easily accessible can help reduce hospitalisations of those suffering serious conditions due to withdrawal symptoms, thereby reducing the burden on already stained healthcare systems due to COVID-19, others feel that identifying and treating these people by experts is the right way to move forward.

This is because in addition to threatening the social distancing measures, making alcohol available during a lockdown situation may increase domestic violence and abuse of children.

"(When denied access), people with substance addiction can have acute withdrawal symptoms and can face serious issues. They can go wild, they can go into delirium. So they need to be treated. People who have substance addiction (including alcohol addiction) is a medical condition that warrants attention," Oommen John, Public health Researcher at The George Institute for Global Health India told IANS.

Alcohol and drug de-addiction specialist Sameer Malhotra said that alcohol withdrawal is characterised by excitement and can vary from mild symptoms like some anxiety, restlessness, palpitations, sweating, disturbed sleep and some irritability to severe symptoms like epileptic fits/ seizures (withdrawal fits), hallucinations, scary dreams including dreams of snakes, delirium tremens(disorientation, marked confusion, significant tremors, agitation and a threat to life).

"The risk of severe complicated alcohol withdrawal is approximately 10 per cent amongst those dependent on alcohol. However timely psychiatric intervention and medication can prevent people with alcohol dependence from facing significant withdrawal," Malhotra, who is Director, Mental Health & Behavioural Sciences at Max Hospitals, told IANS.

"Instead of considering alcohol as essential, people with alcohol dependence should be strongly advised to seek timely psychiatric intervention, as alcohol dependence is a biological disorder with risks of psychological, neurological, hepatic, family, social, occupational and legal complications including the risks of accidents," he said.

So if you know someone with alcohol use disorder, it is better to ask them to seek help from experts. Typically it is a psychiatrist who helps people with alcohol use disorder.

"Alcohol dependence disorder needs to be seen as a medical disorder, as withdrawals may have medical complications. In this situation taking medical advice/treatment is the right way forward," said Samir Parikh Director and Head of Department of Mental Health and Behavioral Sciences Fortis Healthcare.

In India, about 14.6 per cent of people (among 10-75 year old) are current users of alcohol, i.e. about 16 crore people, according to a recent report from the National Drug Dependence Treatment Centre (NDDTC) of the All India Institute of Medical Sciences (AIIMS), New Delhi.

Prevalence is 17 times higher among men than women, said the report titled "Magnitude of Substance Use in India".

About 5.2 per cent per cent of Indians (more than 5.7 crore people) are estimated to be affected by harmful or dependent alcohol use.

In other words, every third alcohol user in India needs help for alcohol related problems.

  

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