Hyderabad: Along with tobacco, improper diet and lack of exercise, abuse of alcohol remains a major risk factor that contributes directly to the rise in a variety of Non-Communicable Diseases (NCDs) in India. Alcohol is directly associated with all the major NCDs, including cancers, cardiovascular diseases, chronic liver and kidney diseases, mental illness and even injuries.
Under Sustainable Development Goals (SDGs) of the United Nations, in the next few decades i.e. by 2030, India aims at reducing one-third of premature mortality among individuals due to NCDs. While authorities have set targets to reduce SDGs, there is a definite lack of focus on reducing substance abuse and in providing treatment options for persons struggling with disorders related to it.
It would be a challenge to reduce the burden of NCDs unless health authorities also lay equal focus on reducing substance abuse and strengthening de-addiction centres, public health experts point out.
A landmark survey titled ‘Prevalence and Extent of Substance Abuse in India-2019,’ conducted by Ministry of Social Justice and Empowerment in collaboration with All India Institute of Medical Sciences (AIIMS), taken up in Telangana and other Indian States and released this February, highlighted this ‘treatment gap’ i.e. the gross mismatch of patients due to substance abuse and treatment facilities available.
According to the report, only one person among 37 people affected by alcohol-related disorders in the country and only one person among 20 affected by drug abuse receive or have access to proper treatment. This is quite similar to the National Mental Health Survey (NMHS), which said close to 85 per cent of individuals struggling with alcohol-related disorders do not have access to facilities that treat for substance abuse.
Prevalence of alcohol use in Telangana and India
The survey, ‘Prevalence and Extent of Substance Abuse in India-2019,’ which covered 2,00,111 households across 29 States and 7 Union Territories, along with interviews of 4,73,569 individuals, said alcohol use in Telangana was prevalent among 30 per cent of adults between the age groups of 18 years and 75 years. It is 28 per cent in Tamil Nadu and 26 per cent in AP and Kerala while the lowest is in Karnataka at 12 per cent. The national Indian average is 27 per cent. An overwhelming majority of alcohol users are males i.e. about 95 per cent and fall in the age bracket of 18 years and 49 years.
“The demographic group with the largest prevalence of alcohol use is men of more than 18 years of age. While 27.3 per cent of men use alcohol, the corresponding figure for women is 1.6 per cent. Further, about one in five alcohol using men suffer from alcohol dependence, while only one in sixteen alcohol using woman is dependent on it,” the substance abuse report said.
Needless to say, the prevalence of alcohol disorders is quite high, the survey said. Close to 5 per cent of alcohol users between the age group of 18 years and 75 years in Telangana suffer from alcohol disorders and in AP, it is much higher and hovers between 5 per cent and 10 per cent.
The AIIMS survey indicated that a sizeable population in the country which is affected by substance use disorders is in need of urgent help. There is a mismatch between the demand and supply of treatment services for substance use disorders.
Besides enhancing treatment services as outpatient clinics, which have all necessary components such as trained human resources, infrastructure, medicines and supplies, a system of monitoring and mentoring is urgently required. The report said there was a need to scale up Drug De-Addiction Programme by establishing drug treatment clinics in the States. There is also a need for innovative schemes for preventing Alcoholism and Substance (Drugs) Abuse, the report said.
Little help for substance abuse patients
Only 2.6 per cent of individuals dependent on alcohol have received some kind of treatment for their medical condition. Ironically, among those who received treatment or help, about 33 per cent of them received help from ‘spiritual or religious’ sources followed by 25 per cent of individuals who got help from a government doctor or a healthcare facility.