Despite low prevalence of alcohol use in India, alcohol use disorders are prevalent and persistent among men in Goa, India.The finding is reported in a study conducted by the Sangath Institute (India) in partnership with the London School of Hygiene and Tropical Medicine (UK) and is published inDrugs and Alcohol Dependence. It compared the drinking behaviours of almost two thousand men and concluded that in six years, approximately half of alcohol use disorders persisted in the community, and almost twenty percent of initially low-use drinkers developed a new disorder. Fortunately, there is also evidence that those with alcohol disorders can recover within six years.

An Indian national policy on alcohol has so far been impeded by limited evidence of alcohol use prevalence, and its subsequent consequences on later health effects. Therefore, the Sangath team of researchers interviewed 1899 Indian adults about drinking behaviour and other possible consequences of alcohol use at two time points, six years apart. At each time point, participants were classified as a non-drinker, casual drinker, hazardous drinker or harmful drinker according to the AUDIT questionnaire, a validated statistical tool to diagnose alcohol use disorders. Participants were further asked about social problems such as workplace problems or domestic violence, and overall physical and mental health. Blood samples were also taken to assess red blood cell size (a marker of alcoholism) and liver functioning. The changes across six years were then compared across types of drinkers.

The study found that approximately half of harmful and hazardous drinkers suffered from alcohol abuse disorders six years later. Moreover, 3.7% of non-drinkers developed an alcohol abuse disorder, and 15% of casual drinkers developed a disorder six years later. Importantly, not only did alcohol use persist over time, the study demonstrates strong correlations between increased alcohol use and workplace and social problems, high blood pressure, death, tobacco use, suicidal thoughts and attempts, anxiety disorders, oversized red blood cells (denoting alcoholism) and poor liver functioning. Conversely, a third of men with a disorder became casual drinkers within 6 years, suggesting that even in minimal resource settings, recovery from alcohol use disorders is possible.

The researchers suggest that the high persistent of alcohol use disorders warrants investigations into the integration of a national policy into existing healthcare outlets. They currently are investigating the applicability of alcohol disorder screenings or brief interventions by non-specialist. These investigations will be crucial to the development of a national alcohol abuse policy throughout India.

Nathalie MacKinnon

Publication

The six-year outcome of alcohol use disorders in men: A population based study from India.
Nadkarni A, Weiss HA, Naik A, Bhat B, Patel V.
Drug Alcohol Depend. 2016 May 1

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