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Legal drug wreaking havoc

Mary Clasquin-Johnson, Ina Joubert, Cycil Hartell

Alcohol has formed an integral part of human life for many thousands of years.

Alcohol has formed an integral part of human life for many thousands of years. Evidence of Stone Age fermentation confirms the production of alcohol as early as 10 000BC.

Fermented fruit and grains were an important part of ancient cultures and alcohol was interwoven into religion and ritual, early medicine, monetary systems and, of course, pleasure and recreation.

This contrasts with today when we see alcohol being consumed on a much larger scale as part of recreational activities.

Although alcohol consumption has occurred for thousands of years, the link between alcohol consumption and negative health effects has been established only recently.

The World Health Organisation (WHO) notes that alcohol consumption has both health and social consequences, either through intoxication (drunkenness), dependence (habitual, compulsive and long-term drinking) or other biochemical effects.

In addition to chronic diseases that may affect drinkers after many years of heavy use, alcohol contributes to traumatic outcomes that kill or disable at a relatively young age, resulting in the loss of many years of life to death or disability.

There is increasing evidence that besides volume of alcohol, the pattern of the drinking can dramatically affect an individual’s health.

The WHO states that overall there is a causal relationship between alcohol consumption and more than 60 types of disease and injury.

Alcohol is estimated to cause about 20% to 30% worldwide of oesophageal cancer, liver cancer, cirrhosis of the liver, homicide, epilepsy and motor vehicle accidents.

Globally, alcohol consumption has increased in recent decades, with all or most of that increase in developing countries.

This often occurs in countries with few methods of prevention, control or treatment.

Researchers at the WHO believe the rise in alcohol consumption in developing countries is ample cause for concern when viewed alongside the matching rise in alcohol-related problems in those regions of the world commonly regarded to be most at risk.

Globally, WHO credits alcohol for the cause of 2,5-million deaths annually (3,8 % of the total) and 69,4-million (4,5 % of total) of disability-adjusted life years (DALYs). Unintentional injuries alone account for about one-third of the 2,5-million deaths, and neuropsychiatric conditions account for close to 40% of the 69,4-million DALYs.

The South African National Council on Alcoholism and Drug Dependence (Sanca) is an NGO that aims to prevent and treat alcohol and drug dependence.

The organisation lists the health risks associated with alcohol misuse in three categories: the detrimental effects on health experienced by adults; teratogenic effects (linked to high intakes of alcohol during pregnancy); and negative social and economic effects.

Sanca defines high-risk drinking as more than four standard drinks a day for men and more than two standard drinks a day for women.

Most of society has a fixed idea of the alcoholic as the down-and-out, sometimes indigent individual, but the reality is that substance abuse is changing its nature.

Many communities even accept abusive behaviour as the norm rather than the exception. Another concern is the alarming increase in binge drinking in large section of the population.

In fact, this country’s level of alcohol abuse is staggering. According to the Medical Research Council (MRC), South Africa has the second-highest rate of substance abuse and dependence in the world and consumed each drinker consumes between 17 and 20 litres of alcohol a year.

It is clear that alcohol has become one of the biggest problems facing modern society. And, although its abuse is certainly not unique to South Africa, the rising social and economic costs of dealing with its effects are certainly becoming more pressing.

Savera Kalideen, Advocacy Manager at Soul City says: “The estimated R7-billion a year that government spends on direct costs as a result of alcohol abuse or misuse, is money that belongs to us all as taxpayers.

Irrespective of whether we consume alcohol or not, we are all, as taxpayers, paying the bill to mitigate the harm that is caused by alcohol.

The question that we should be asking is, if private alcohol companies earn their profit from manufacturing, distributing and selling alcohol, should they not be paying for the harm that their product is causing?

“That would allow our government to use the R7-billion for other urgent social needs such as housing, health and education.”

Professor Charles Parry, director of the alcohol and drug abuse research unit of the MRC and professor in the department of psychology at Stellenbosch University, in a paper published in 2005, “South Africa, Alcohol Today” says policies should include making the necessary resources available, ensuring effective leadership and speeding up the pace of implementation in general.

“Priority should be given to implementing a coherent liquor outlet policy; increasing random breath testing of drivers, counter-advertising and brief interventions and other forms of treatment for high-risk and hazardous drinkers; and addressing issues of training and accreditation of treatment and prevention programmes,” says Parry.

He says based on present realities, it is likely that levels of alcohol consumption will increase in South Africa in the next decade; a very scary prospect for a country constantly offsetting the cost of alcohol abuse against its investments in economic and social growth initiatives

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