Dr Irengbam Mohendra Singh
Unlike so much received wisdom, this fragment is absolutely true. It’s notmeant to be a kill-joy. According to the latest (2018) UN Health Agency Report, alcohol kills 3 million people and is responsible for one in 20 deaths each year globally. Road traffic accidents kill 1.3 million people worldwide. 2 billion people drink alcohol out of 7.7 billion world’s population. A massive figure. We will never know the name of the inventor-scientist who first conceived the idea of drinking intoxicating juice of fermented fruit. Vedic people before they became Hindus, drank hallucinogenic Soma juice.Wine has been drunk since ancient times. Jesus Christ drank red wine in his Last Supper before his crucifixion.Christ’s first miracle of turning water into wine at the wedding at Cana must have involved a fermented beverage. It was the introduction of cereal agriculture that made it possible to invent beer (Pukyu in Manipuri). Meiteis used to drink Pukyu before they became Hindus.
Studies in India are very minimal. Officially, Indians are still among the world’s lowest consumers of alcohol. Government statistics a few years ago, show only 21% of adult men and around 2% of women drink. One fifth of this group ie about 14 million people are dependent drinkers requiring help. The concern, say experts, is that there has been a rapid change in patterns and trends of alcohol use in India. Chief among them is the increasing rise in the number of young people drinking alcohol, such as increase from 2% to 14% of 21-year-old in the past 14 years (Lancet, Raekha Prasad, 2009. Alcohol and Drugs Information Centre India, Kerala). I have experience of social drinking with upper and high middle class Indian women in Delhi and Mumbai for the past 40 years, but the recent trend as of 2017, shows a steady rise in the number of Indian women who drink regularly. In Manipur, though I don’t have statistics, I have empirical evidence of the rise of alcohol consumption among Meiteis despite prohibition. Alcoholic drinks, particularly among the youth and young adults in Imphal are visibly on the rise.Serving alcohol at social gatherings and celebrations, such as for Swasti puja (to welcome the arrival of a child on the 6th day) or for a stag party (prenuptial celebration of bachelorhood), Gone with the wind is drinking of home-brewed spirit (atingba in Manipuri and tharda in Hindi) among the middle-class in Imphal as manufactured booze like the scotch are freely available. You can drink alcohol with food in any 4 star hotel provided you hire a private room. This is very good for tourists, because of a meaningless prohibition. The state Congress government at that time, in cahoots with one Meitei underground group, banned the sale of alcohol in April 1991. In 2002, the five hill states of Manipur were exempt from prohibition, adding about INR 50 crores to the state exchequer. The prohibition of alcohol and even a dry day a week, in many Indian states (for reasons of collecting more voters) washistoricallya failure, beginning with prohibition in Bombay in early 1950s.
The present BJP government in Manipur is said to be considering the lifting the ban with a view to attracting tourism to the state. Manipuris coulddo remembering that Ahmadabad, the Capital of Gujarat, is a dry state.
Though you can apply for a permit when you arrive there, which is as cumbersome as pushing molasses up the hill, manyIndians including myself and foreign tourists avoid visiting it.Recently, in a seminarin Ahmedabad,women members of the erstwhile royal families of Gujarat, who now run heritage properties, blamed the state’s prohibition law for drawing tourists away from Gujarat towards neighbouring states and pitched for relaxation of the law. Alcohol is a relaxing and mood-altering beverage, but it affects the structure and function of nerve cells in the area of your brain that controls motivation. It removes self-control and makes you want to drink more and more. Ethanol is the intoxicating part of alcohol and its molecules are so small that they can actually pass into the gaps between brain cells. There, it can interfere with the neurotransmitters that enable all the brain’s activities. Earlier research warned that one or two drinks four or more times a week increased the risk of premature death by 20% compared to drinking three times a week or fewer. ‘Consuming one or two drinks about four days per week seemed to protect against cardiovascular disease – but drinking every day eliminated those benefits,’ said first author Dr Sarah Hartz, an assistant professor of psychiatry at Washington University School of Medicine.She added: ‘But overall, I do think people should no longer consider a glass of wine a day to somehow be healthy.’
This new study comes on the heels of research from Washington University in Seattlethat found
just one daily glass of beer or wine could raise your risk of premature death by one-fifth, no matter how old you are. Any protection against heart disease, stroke and diabetes turned out to be not ‘statistically significant’.’
Some of you might find it sticks to the craw. Some researchers admit that those who live in one of the world’s five ‘Blue Zones’ – geographic areas with low rates of chronic disease and home to some of the world’s oldest people, may disagree. Residents of Icaria, Greece; Sardinia, Italy, the Nicoya Peninsula and Costa Rica, all follow a Mediterranean diet with a glass or two of red wine a day. People who live in Okinawa, Japan, drink a wine made from rice. The Seventh-Day Adventists in Loma Linda, California, are the only Blue Zone to not consume alcohol.
In the UK, most people drink more than the National Institute of Health guideline of no more than 7 units for women and 14 units for men a week, which is roughly equal to seven drinks, spread over at least three days. British teenage girls are among the heaviest drinkers in Europe. They are more likely to have got drunk at least twice a week.British women are now among top drinkers in the world and consume the same amount of alcohol as men (The Lancet, August 2018).
In Britain a recent survey of an average university student’s budget for alcohol is around £250 (INR 2,500) per week. Most university students are self-financed by borrowing ‘student loans’ from banks (my two children didn’t). They only start repaying their loan have graduated and start earning more than £21,000 a year. After that, they will pay back 9% of anything they earn over £21,000. Student loans will be written off after 25 years if they are still unable to pay back.
According to Dr Hartz, thoughrelatively few people die globally in their 20s from alcohol-related diseases, a 20-percent increase in mortality is still significant, more so for the elderly people.With regard to cancer risk, any drinking at all is detrimental. For some cancer types, alcohol is particularly harmful if you also smoke.Another study at the University of Washington has found there is no safe level of alcohol, because the good sides (protecting against heart disease) are heavily outweighed by the downsides (a great swath of cancers).
It’s known for quite some time thatalcohol in excess is related to seven types of cancer. A study bythe World Cancer Research Fund that reviewed all available research from around the world, find convincing evidence of linking alcohol with increased risk of cancers of the breast (postmenopausal), colorectal, oesophagus (squamous cell), liver, mouth, pharynx, and larynx. The analysis also cites probable increased risk of stomach and premenopausal breast cancers.
Last year (Lancet, 2017), Prof Connor, Clinical & Health Psychologist, Queensland, Australia, cited evidence of alcohol-attributable cancer deaths, accounting for 4.2% of all cancer deaths in people under the age of 80, though he could not say at what level of drinking people are likely to develop cancer.
In establishing alcohol-related cancers, researchers found some mechanism by which alcohol consumption exerts its carcinogenic effect though it hasn’t been defined fully. ‘This is the plausible genotoxic effect of acetaldehyde, the main metabolite of ethanol; increased oestrogen concentration for breast carcinogenesis, as solvent for tobacco-produced carcinogens, and changes in folate metabolism.’
There is now a strong association between alcohol consumption and the risk of many types of cancer. In 2018, Dr Max Griswold of the University of Washington said: ‘previous studies have found a protective effect of alcohol on some conditions, but we found that the combined health risks associated with alcohol increase with any amount of alcohol.’
Dr Hartz predicts that as medicine becomes more personalized, doctors may suggest people with a family history of heart problems have the occasional drink. But in people with a family history of cancer, physicians may recommend abstinence. ‘If you tailor medical recommendations to an individual person, there may be situations under which you would think that occasional drinking potentially could be helpful.’
It would be desired to dismantle the age-old alcohol industry worth $1.3 billion (2015).But it’s as impossible as to raise the dead, at least until there is undeniable proof that it causes many cancers, as in the case of lung cancer with smoking. The best option is to cut down the quantity.
The writer is based in the UK.
Dr Irengbam Mohendra Singh