Post Graduate Student, Department of Community Medicine

1. Dr.Praseeda BK

2.  Worldwide, 3.3 million deaths every year result from
harmful use of alcohol,this represent 5.9 % of all
deaths.
 The harmful use of alcohol is a causal factor in more
than 200 disease and injury conditions.
 Overall 5.1 % of the global burden of disease and
injury is attributable to alcohol, as measured in
disability- adjusted life years (DALYs).

3.  Alcohol consumption causes death and disability
relatively early in life. In the age group 20 – 39
years approximately 25 % of the total deaths are
alcohol-attributable.
 There is a causal relationship between harmful use
of alcohol and a range of mental and behavioural
disorders, other noncommunicable conditions as
well as injuries.

4.  The latest causal relationships have been
established between harmful drinking and
incidence of infectious diseases such as
tuberculosis as well as the course of
HIV/AIDS.
 Beyond health consequences, the harmful
use of alcohol brings significant social and
economic losses to individuals and society at
large.

6.  Alcohol impacts people and societies is
determined by
- the volume of alcohol consumed
- pattern of drinking
- on rare occasions, the quality of alcohol
consumed.
- In 2012, about 3.3 million deaths, or 5.9 % of all
global deaths, were attributable to alcohol
consumption.

7.  Alcohol consumption is a causal factor in
more than 200 disease and injury conditions.
 Drinking alcohol is associated with a risk of
developing health problems such as mental
and behavioural disorders, including alcohol
dependence, major noncommunicable
diseases as well as injuries resulting from
violence and road clashes and collisions.

8.  A significant proportion of the disease burden
attributable to alcohol consumption arises
from unintentional and intentional injuries,
including those due to road traffic crashes,
violence, and suicides, and fatal alcohol-
related injuries tend to occur in relatively
younger age groups.

10.  economic development
 Culture
 availability of alcohol
 comprehensiveness and levels of
implementation and enforcement of alcohol
policies.

12.  regulating the marketing of alcoholic
beverages (in particular to younger people)
 regulating and restricting availability of
alcohol
 enacting appropriate drink-driving policies
 reducing demand through taxation and
pricing mechanisms

13.  raising awareness of public health problems
caused by harmful use of alcohol and
ensuring support for effective alcohol
policies
 providing accessible and affordable
treatment for people with alcohol-use
disorders
 implementing screening and brief
interventions programmes for hazardous and
harmful drinking in health services.

14.  An increasing number of people are becoming
dependent on alcohol. This makes it difficult for
them to function normally within society.
 Domestic and sexual abuse is often associated
with alcohol abuse.
 This type of behavior can be damaging to
communities.
 Those individuals who engage in this type of
behavior can begin to fail in their ability to meet
family, social, and work commitments.

15.  Families can suffer financially as a result of
this type of substance abuse.
 Business and the economy suffer because of
lost productivity with people coming to work
still suffering from the effects of alcohol.
 Drink driving is responsible for many road
deaths.

17.  Although alcohol is freely available in most
part of India, some states and Union
Territories in the country have various forms
of alcohol bans in force.
 Alcohol prohibition is currently in force in
Gujarat, Kerala, Lakshadweep, Manipur, and
Nagaland.

18.  Andhra Pradesh, Haryana, Mizoram, and
Tamil Nadu had previously imposed alcohol
bans but were forced to withdraw the
prohibition.

19.  Gujarat – One of the first states of India to
have a no alcohol policy, the state bans the
manufacture, storage, sale, and consumption
of alcohol
 . Foreigners are allowed to obtain alcohol
permits valid for a month.
 Gujarat’s policy has promoted active alcohol
trade in nearing regions such as Maharashtra,
Rajasthan, Goa, and Diu.

20.  Kerala – Amidst much outrage, the government
of Kerala announced plans to go ahead with
alcohol prohibition in phases in August 2014.
 Starting March 2014, alcohol licenses of bars
and shops were not renewed but toddy is still
sold widely.
 This ban came as a surprise for two reasons.
 Firstly, Kerala is among the highest alcohol
consuming states in the country
 secondly, about 22 percent of Kerala
government’s revenue gains (approximately INR
8000 crore) was reported to have come from
alcohol manufacturing and sale licenses.

21.  Lakshadweep – Alcohol consumption is
prohibited on all the islands of Lakshadweep,
except on Bangaram.

22.  Manipur – Manipur government banned the sale
of alcohol in the state in April 1991.
 The ban did not do much to curb alcoholism in
the state and local brews are widely available.
 In 2002, the five hill districts of the state were
exempt from prohibition, adding about INR 50
crore to the government’s exchequer.
 As of July 2015, the government is considering a
total lift of the ban.

23.  Nagaland – Sale and consumption of alcohol
has been prohibited in the state of Nagaland
since 1989.
 Illegal sale and trade of local brews,
however, are thriving businesses.
 As of 2014, the government had initiated
discussions about lifting the ban.

24.  Alcohol policy is under the legislative power of
individual states.
 Prohibition, enshrined as an aspiration in the
Constitution, was introduced and then
withdrawn in Haryana and Andhra Pradesh in the
midi-1990s, although it continues in Gujarat,
with partial restrictions in other states.

25.  Delhi, for example, has dry days. There was
an earlier failure of prohibition in Tamil
Nadu.
 Excise department regulate and control the
sale of liquor in the NCT of Delhi.
 Retail supply of alcohol is regulated by Delhi
Liquor License Rules, 1976. It prohibits
consumption and service of liquor at public
places.

26.  Any person, who is found drunk or drinking in
a common drinking house or is found there
present for the purpose of drinking, shall on
conviction, be punished with fine which may
extend to five hundred rupees.

27.  The blood alcohol content (BAC) limits are fixed
at 0.03%.
 Any person whose BAC values are detected more
than this limit is booked under the first offense.
 He/she may be fined about 2000 andor he or
she may face a maximum of 6 months
imprisonment.
 If he person commits a second offense within 3
years of the first then he/she may be fined
about 3000 and/or he or she may face a
maximum of 2 years imprisonment.

28.  1 March 2012 Amendments
 Drunk driving would be dealt with higher
penalty and jail terms - fines ranging
from 2,000 to 10,000 and imprisonment from
6 months to 4 years.
 Drink driving will be graded according to
alcohol levels in the blood.

29.  For levels between 30-60 mg per 100 ml of
blood, the proposed penalty would be 6
months of imprisonment and/or 2,000 as
fine.
 For alcohol level between 60-150 mg per 100
ml of blood, the penalty would be one year
imprisonment and/or 4,000.

30.  If the offence is repeated within three years,
the penalty can go up to 3 years
imprisonment and/or 8,000.
 For those who are found heavily drunk with
alcohol levels of over 150 mg per 100 ml of
blood, the penalty will be 2 years
imprisonment and or 5,000.
 Repeat offence within a three year period
would warrant a jail penalty and fine
of 10,000 besides cancellation of license.

31.  Between 2% and 10% of ethanol is excreted
directly through the lungs, urine, or sweat.
 The concentration of the alcohol in the alveolar
air is related to the concentration of the alcohol
in the blood.
 As the alcohol in the alveolar air is exhaled, it
can be detected by the breath alcohol testing
device.

32.  8 September 2000
 Advertising alcoholic beverages has been
banned.

33.  For the purpose of drug demand reduction,
the Ministry of Social Justice &
Empowerment has been implementing the
Scheme of Prevention of Alcoholism and
Substance (Drug) Abuse since 1985- 86.
 The Scheme was revised thrice earlier (1994,
1999 and 2008) prior to the recent revision
which came into force from January 1, 2015.

34.  To create awareness and educate people about
the ill-effects of alcoholism and substance abuse
on the individual, the family, the workplace and
society at large.
 To provide for the whole range of community
based services for the identification, motivation,
counselling, de-addiction, after care and
rehabilitation for Whole Person Recovery (WPR)
of addicts to make a person drug free, crime
free and gainfully employed.

35.  To alleviate the consequences of drug and
alcohol dependence amongst the individual, the
family and society at large.
 To facilitate research, training, documentation
and collection of relevant information to
strengthen the above mentioned objectives.
 To support other activities which are in
consonance with the mandate of the Ministry of
Social Justice & Empowerment in this field.

36. All victims of alcohol and substance (drugs) abuse with
a special focus on:-
 Children including street children, both in and out of
school.
 Adolescents/Youth Dependent women and young girls,
affected by substance abuse.
 High risk groups such as sex workers, Injecting Drug
Users (IDUs), drivers etc.
 Prison inmates in detention facilities including
children in juvenile homes addicted to drugs.

37.  Alcohol
 All Narcotic Drugs and Psychotropic
substances covered under the NDPS, Act,
1985.
 Any other addictive substance, other than
tobacco.

38.  Alcohol Use Disorders Identification Test
(AUDIT)
 CAGE questionnaire
 TWEAK questionnaire
 CRAFFT questionnaire
 S-MAST-G questionnaire

39. Add all scores to obtain a total > 8 for men or > 4 for women indicates a higher risk of alcohol
use disorder
• Alcohol Use Disorders Identification Test (AUDIT)

41. • Two or more points indicate possible alcohol problem

42. One yes response indicates need for further assessment; two yes
responses indicates risk of alcohol use disorder.

43. PleaseanswerYes or No to the followingquestions: Yes No
1. Whentalkingwithothers,doyoueverunderestimatehowmuchyoudrink?
2. Aftera fewdrinks,haveyousometimesnoteatenorbeenabletoskipa meal
becauseyoudidn’tfeel hungry?
3. Doeshavinga fewdrinkshelpdecrease yourshakinessortremors?
4. Doesalcohol sometimesmakeithardfor youto rememberpartsoftheday or
night?
5. Do youusuallytakea drinkto calmyour nerves?
6. Do youdrinkto take yourmindoffyourproblems?
7. Haveyou everincreasedyourdrinkingafterexperiencingalossinyour life?
8. Has a doctoror nurseeversaidtheywereworriedorconcernedaboutyour
drinking?
9. Haveyou evermaderulestomanageyour drinking?
10. Whenyoufeel lonely,doeshavingadrinkhelp?
SCORING:
Score1 pointfor each‘yes’answerandthentotal theresponses
2+ points = are indicativeof an alcohol problem