Mag. Of alcoholism, media roles in intake of alcohol, impact of alcohol in infants.
Alcohol a social problem by dr. rajan bikram rayamajhi for medical students
ALCOHOL : A SOCIAL PROBLEMDr.Rajan Bikram RayamajhiSchool of Public Health & Community MedicineB. P. Koirala Institute of Health SciencesDharan, Nepal1
BackgroundA state of complete physical, mental & socialwellbeing & not merely an absence of disease orinfirmity that enables an individual to lead socially &economically productive life.Family is the primary unit of all the societies. It is agroup of biologically related individuals living togetherand eating from the same kitchen.The family share the common physical and socialenvironment.2
o Family, being a part of cultural unit. It reflects theculture of the wider society of which it forms a partand determines the behavior and attitudes of themembers.o Alcohol abuse is a pattern of drinking that results inharm to one’s health, interpersonal relationships, orability to work.o Current guidelines set by America Health Societystates that alcohol consumption per week, for adultsnoted to be nine drinks for a male and seven for afemale. 3
Alcohol abuse is a psychiatric diagnosis describingthe recurring use of alcoholic beverages despitenegative consequences.Alcohol abuse is sometimes referred to by the lessspecific term alcoholism.Alcoholics – 2 Types: Those who have social andpleasure-seeking tendencies & Those who areanxiety-ridden people who are able to go withoutdrinking for long periods of time but are unable tocontrol themselves once they start 4
o Easy accessibility of alcohol is one of the mainreason behind alcohol abuse.o Another influencing factor among adolescents andcollege students are the perceptions of social normsfor drinking.o People often drink more to keep up with their peersbecause they believe that their peers drink more thanthey actually do or that they expect to drink moregiven the context. (sporting event, fraternity party).o Alcohol abuse is also associated with acculturationbecause social and cultural factors such as an ethnicgroup’s norms and attitudes can influence alcoholabuse. 5
Binge drinking: Four or more drinks fora female and five or more drinks for amale at one sitting.Chronic drinking: Daily or almostdaily alcohol consumption(60 drinks per month)6
Drinking is a personal choice butaffects the person and environmentsurrounding you.8
o 58.5% of them were male whereas rest of them werefemale.o 56.6% of them belonged to groups which traditionallyuse alcohol.o 64.8% of them were from rural areas whereas otherswere from urban areas.o About 0.8% of them had drink for 20+ days in a month.o The median age of drinking was 13 years.o Traditional and cultural occasions were the mostimportant occasion for initiating drinking. (60%)9
o Individual who responds to alcohol in acertain way. [Positive reward]o Personality characteristics that encourageuse. [Impulsiveness]o Member of social group:o Pressure to drink. [College Fraternity]o Confusion over drinking ground rules.o Drink with meals or drink to get drunk.
Social FactorsAlcoholism is high:Americans, Swiss, Irish, Poles.Low in others:Chinese, Greeks, Orthodox, Jews
Culture with Lower Alcoholismo Children learn alcohol is abeverage.o Served in dilute forms.o Abstinence is acceptable.o Parents model moderatedrinkingo Getting drunk not seen ascomical.o Everyone knows ground rules .
Culture with Higher Alcoholismo N o g r o u n d r u l e s .o M i x e d m e s s a g e s f r o m d i f f e r e n ti n d i v i d u a l s a n d g r o u p s .o G e t t i n g d r u n k i s a c c e p t a b l e .o H e a v y d r i n k i n g i s e n c o u r a g e d .o D r i n k i n g a s i g n o f m a s c u l i n i t y o ra d u l t h o o d .
Media Images of Alcoholo I r e l a n d h a s h i g h e s th e a v y d r i n k i n g r a t e si n E u r o p e .o Yo u t h b o m b a r d e dw i t h a l c o h o l a d s .o H a v e b e g u n t or e s t r i c t a d v e r t i s i n g .o C h a n g e t h e c u l t u r e .
Driving LimitsIn United States,Most states set the legal level of intoxication at 0.08 to 0.10BAL ( Blood Alcohol Level)16
Drinking is a Personal ChoiceBut StillOthers are affected !!!! Friends and family Strangers Unborn babies: Fetal alcohol syndromeWhen mother drinks, baby drinks.Alcohol disrupts brain development 17
Fetal Alcohol Spectrum Disorders The most serious risk during pregnancy is fetal alcohol spectrumdisorders (FASD). It describes permanent birth defects caused by maternal consumptionof alcohol during pregnancy. Establishing the prevalence of FASD is very difficult, but it isestimated that at least 1 percent of children in the U.S suffers fromFAS or other alcohol-related birth defects. Approximately 1 percent of children are affected by fetal alcoholspectrum disorder
Smokingo Women aged 15 and over who smoked any formof tobacco, including cig., cigars and pipesexcluding smokeless tobacco: 28.57% .o Similarly, in males it was found to be 35.95%.o Study done in Dharan by S. R Niraula found thatmajority of the smokers were in the age group 15-24 years.20
TRADITIONALo Smoked in a pipe forceremonial purposeso Used as an offering to ahealer, elder or otherperson as a sign ofrespect or thankso Medicinal tobacco wasoften used as apainkillerCOMMERCIALo Deliberate targeting ofspecific consumergroupso Premeditated andconscious addition ofchemicals that lead toaddictiono Scarcely containsactual tobacco21
o 85% of teenagers who smoke two or more cigarettescompletely, and overcome the initial discomforts ofsmoking, will become regular smokers.o In a study of high school seniors, only 5% of thosewho smoked believed they would still be smokingtwo years after graduation. In fact, 75% were stillsmoking eight years later.o One-third to one-half of young people who trycigarettes go on to be daily smokers.22
o Nicotine is a vessel constrictor, reducingthe body’s blood flow. Smoking increasescholesterol levels and hardens arteries.o Diabetes increases cholesterol levels andthe levels of some other fats in yourblood.o The combined cardiovascular risks ofsmoking and diabetes is as high as 14times those of either smoking or diabetesalone.23
Familial & Social Connection with Smokingo People who encounter smoking on a regular basis will bedesensitized to cigarettes and won’t see the health risksreadily.o Parents are the greatest influence on their children’sbehavior.o Children whose parents smoke are twice as likely to becomesmokers themselves.o Perceived parental opinion is also a major contributingfactor in youth smoking. If children believe their parentsdisapprove of smoking they will be less likely to becomesmokers.o Siblings also serve as contributors to youth smoking. 24
Societal or Economic Costo Alcohol abuse is associated with many accidents, fights, drivingoffenses and unprotected sex.o Alcohol is responsible in the world for 1.8 million deaths andresults in disability in approximately 58.3 million people.o Approximately 40 percent of the 58.3 million people disabledthrough alcohol abuse are disabled due to alcohol relatedneuropsychiatric disorders.o In South Africa, where HIV infection is epidemic, alcoholabusers exposed themselves to double the risk of this infection.o Additionally, alcohol abuse increases the risk of individualseither being the victim of sexual violence or perpetrating sexualviolence.25
o Alcohol misuse costs the National HealthService (UK) three billion pounds sterling peryear and the cost to employers is 6.4 billionpounds sterling per year.o It doesn’t include the crime and social problemsassociated with alcohol misuse.26
Preventiono Increased taxation of alcohol and smoking.o Stricter regulation of alcohol and smoking advertising.o Brief Interventions for alcohol abuse reduce theincidence of accidents, sexual violence, unplannedpregnancy.o Information and education on social norms and theharms associated with alcohol abuse delivered either viathe internet or face to face has been found to result in adecrease in harmful drinking behaviors in youngpeople.27