Alcohol consumption causes 5.1% of the global burden of disease and nearly 3.3 million deaths every year. Alcohol is a major risk factor for disease, and is causally linked to over 200 diseases, in particular non-communicable diseases and injuries. 60% of liver cirrhosis in men and 33% in female is caused by alcohol with approximately 140632 deaths every year.

Alcoholism is more a societal problem

Alcoholism is more dangerous than what we gather through statistical data because it is not an individual problem it impacts the immediate family and the people in the surrounding.

Alcohol impacts one’s power to think, take decisions, memory, and alcoholics tend to lose control of themselves overtime. It is one of the highly used psychoactive substance and least controlled one.

The families of alcoholics suffer worser fate in form of economic losses, violence, injuries related to alcohol abuse. Alcohol goes hand in hand with other risk-taking behaviors, other substance-abuse, gambling, debt, theft, crimes. Since most of the alcoholics spend half of their income on alcohol, they tend to cut nutritional needs of family, childcare money. So, rate of nutritional deficiencies, childhood depression, domestic violence, accidents are higher. Even the strangers are not spared from the effect of alcoholism in society in form of road traffic accidents, abuses, harassment from drunk strangers. One more important thing that is left unrecorded in case of alcohol is low productivity at work, more absenteeism, more hospitalization of oneself or family members, more work place accidents, more corruption (to fulfill alcohol needs).

Alcoholism is unique in its characteristics that even after taking toll on so many human lives it’s still considered a friend not a foe.

      Prevalence of alcohol use disorders and alcohol dependence (%), 2016*

	Alcohol use disorders**	Alcohol dependence
Males | Females	9.1      |     0.5	7.0       | 0.4
Both sexes	4.9	3.8
WHO South-East Asia Region	3.9	2.9

* 12-month prevalence estimates (15+); **including alcohol dependence and harmful use of alcohol.

There is even increase in social acceptance of alcohol use. Say it a side effect of globalization, India has seen a jump of more than 30% in seven years from 2010 to 2016 from 4.3L per capita to 5.7 L per capita of alcohol consumption. Compared to 10-15 years back, there is an increasing availability and greater accessibility to alcohol. If it continues to increase at this alarming rate, India may as well will become Alcohol capital of world in coming years.

Challenges in alcohol control and need of national policy

*There is no direct national program targeting alcohol.

*Alcohol control comes under State governments powers so rules vary in different part of country. So even if few states have banned alcohol its illicit trafficking from adjacent states continues to be big issue. Policies demands more coordinated approach towards alcohol control in forms of regulatory laws alcohol age bar, taxes, limiting sales outlets, monopolizing production (because privatization leads to more sales and production) and sales and strict enforcing of these laws.

 *Even though ban is imposed on advertisement but still indirect advertisements on alcohol continue with brand producing advertisements for its other products like soda, drinks, music. No ban on internet advertisements. With more users shifting towards mobile for entertainment this ban has become futile. There should be more practical laws to prohibit alcohol advertisement.

*Weak infrastructure and less training competencies at different levels of health, police, traffic, law to strictly enforce the current laws on alcohol. We need to improve so as to ensure early detection and proper treatment for alcohol use disorders.

*Institutional settings for interventions at workplace, educational institutes, communities to curb alcohol impacts.

*Involving people of Religious importance and social activists and NGOs for creating a community revolutionary movement to encourage reduction in alcohol use.

*More investment in research, technological advancements to help control alcohol.

*Alcohol control policies can also be added in district level programs to improve grass root outreach.

Need of global alcohol control convention

There is still no international treaty on control of alcohol like there are for many for other drugs through 3 drug treaties of 1961,1971and 1988. Even tobacco is also controlled through Framework Convention on Tobacco Control.

These treaties help the governments to enforce strict regulation on alcohol production and consumption, which is not possible in current scenario because there is no scope of international pressure placed on national and local control policies through trade agreement and disputes.

About the Author: Dr. Glory Ghai is Research Associate, CHD Group working on policy and governance issues. Views expressed are the author’s own.