Women highest consumers of alcohol in Sikkim, Mental health concerns trumping cultural significance
As per the recently released National Family Health Survey (NFHS), 2019-20 by Ministry of Health and Family Welfare (MOHFW) 16% of women in Sikkim are alcohol consumers accounting much higher than other Northeastern counterparts such as Assam at 7.3%, Telangana at 6.7% and Goa at 5.5%.
Earlier, alcohol-related surveys mostly revolved among men. It’s only recently that women have been made part of alcohol surveys in the country. The NFHS-4 report 2015-16 showed women consuming alcohol at 23% in Sikkim, while alcohol consumption in Sikkim and the Northeast can be due to cultural significance owing to the tribal tilt, alcohol does have dire consequences as seen by the number of rehabilitation centres across the state.
Since 1956, the American Medical Association (AMA) has identified alcoholism as a disease characterized by compulsive decision-making, impulsive behaviour and relapse.
The AMA's disease theory of alcoholism is based on the following criteria:
- Biological in nature (illness exists in and of itself)
- Does not go away or heal on its own.
- Exhibits observable signs or symptoms.
- Is progressive (can get worse—even fatal—if left untreated).
- It has a predictable timeline of development and recovery
K.C. Nima, the founder of Freedom Facility, an NGO that deals with deaddiction measures says that alcohol drinking is a socially connected practice, however, alcoholism is not socially connected. He explains that women alcoholics mostly above the age of 25 are indirectly ostracized by the society he has also given various past cases wherein alcoholic women have tried to self-harm themselves and also have suicidal tendencies taking steps such as Suicide,
He mentions about various steps taken by their NGO through social media outreach, raising awareness, family meeting and counselling, in a nutshell, he concludes that alcohol, be it addiction can be treated and as a society, there is a need to come out in support for those having this social disease.
Additionally, co-occurring mental health disorders like depression, personality disorders, anxiety, and others are linked to an increased rate of alcoholism in patients, and women are more likely to be diagnosed with these disorders than men. Higher rates of serious mental health symptoms may contribute to the likelihood that a woman may attempt to self-medicate those issues with alcohol and ultimately develop an alcohol use disorder, including alcoholism, as a result.
Women face serious health problems when they drink heavily and struggle with alcoholism. For example, they may be at high risk of experiencing health issues, including:
Heart problems: Heart disease, especially, is a high risk for women who drink heavily and struggle with alcoholism
Breast cancer: As little as a single drink per day can increase a woman’s chance of developing breast cancer by 10 per cent. That risk increases by 10 per cent for every extra drink each day
Liver damage: Liver inflammation is a common problem among women who drink heavily
Reproductive issues: Even a small amount of alcohol can be negatively impactful for the unborn foetus during pregnancy. Heavy drinking and alcoholism can contribute to the development of a range of developmental, learning, behavioural and physical impairments and dysfunction.
Dr Satish Rasaily, Senior Psychiatrist and Nodal Officer, Centre for Addiction Medicine says, “Alcohol addiction is a complex disease with physical, psychological, biological, and social components. The usage of alcohol over long periods of time harm the person’s mental biology, it distorts the brain’s wiring. Some people can drink alcohol and even overindulge, and it doesn’t become an issue. For others, drinking can turn into a severe problem that needs medical and psychological attention.”
According to research by biological psychologists, individuals who are more susceptible to addiction as well those who are genetically susceptible to certain mental health disorders likely have lower levels of dopamine in their brains. These biological differences in brain chemistry are not choices.
Dr Rasaily adds, “There are different factors that play into one being addicted to substance abuse and that is personality, we know that there are a lot of kids in schools but those who have a rage issue, are violent, and have a tendency to be really harmfully naughty go on to become the ones who indulge in addiction in comparison to kids who are the compassionate, kind, and have healthy behaviours. The other factor is the environment, there are many triggers that cause people to become mentally affected, like social cues, economic factors, familial issues etc.”
He adds, “Any substance be it drugs or alcohol when it gets into your body, it acts in your brain and changes the way you think, feel, and behave. This is the actual definition of what these substances are: it is a chemical when ingested or injected acts on your brain and changes your thoughts, feelings, emotions, and behaviour.”
Alcohol sale is likely to stay in Sikkim, however, the larger question remains on tackling alcoholism which goes further beyond mere occasional drinking
While the liquor business serves as a source of revenue for the government as well as job opportunity who are employed across various breweries in the state, amid the revenue stagnation due to COVID-19 lockdown where the income base of Sikkim and various states have narrowed, alcohol despite its initial demand slowdown has been an important contributor to the exchequer.
Despite this, welfare elements ought to take care of the excesses produced as a result and focus on curbing the alcoholism-related menace, balancing the revenue commitments of the states against the problems created by this.
By Karma Lendup Sherpa
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