18

Alcohol is the most common “drug” used and abused in this world.

Yes, it’s a drug that has the potential to be beneficial when consumed in moderate quantities and extremely detrimental when abused in large quantities over a long period of time.

And it’s a drug and not “foodstuff” since biology has not endowed the body with the capacity to digest it. In this regard, it’s a foreign body similar to what a dust particle is to the eye. And therefore, after it’s consumption, the liver especially works real hard to eliminate it as it considers it as a “toxin”.

Whereas moderate quantities can be beneficial to the heart and help fight obesity and diabetes- strangely true!- excessive consumption has been associated paradoxically with  the same diseases- obesity, diabetes, heart disease, liver disease, brain damage and cancers. An important area of damage with alcohol is pregnancy and social health. There is an unimaginable and immeasurable cost and suffering from alcohol abusers and addicts who in their lack of exercising control and judgement inflict injuries on their family, lose their jobs and even disintegrate from the stature of humanness. This is a major social problem earlier confined to the illiterate class but now expanded to the upper strata as well. Mahatma Gandhi was a visionary in this regard when he pitched for an alcohol free state in India since he could predict the social ills.

So, while you keep hearing how a glass of wine daily keeps a heart healthy but what it doesn’t tell you is that how many stop at one glass and how many can control the urge to have more with time. Alcohol has a huge potential for addiction that can test the very resolute and the restrained. Many religions such as Islam have not depended on the self-discipline of the individual and accepted the frailty of human nature and has prohibited its consumption totally.

This discussion begs a question ‒ how much is moderate consumption? This is very controversial and differs from nation to nation. However, daily maximal limit generally is 20 grams of alcohol per day or 100 grams a week. This may mean a pint of beer or two units of hard drinks. It’s wise to remember this comes from western countries where the eating pattern and lifestyle are completely different from a country such as India. It would be wise to assume that in our country where heart disease and diabetes occurs at a much lower obesity levels with stress and sedentary lifestyles being a constant accompaniment, much lower limits of alcohol should be permissible. Also, it’s not always possible to predict and prevent a social drinker becoming an addict in a largely unaware country like ours.

A new area of concern with alcoholism is underage drinking. This is a serious public health problem that has led to fatal and non fatal road traffic accidents, suicides, homicides, rapes and drug abuse. Adolescents especially love the lack of inhibition with alcohol intake that leads to dangerous behaviour pattern. Earlier an issue of USA, it is now looming large in developing nations too. Suboptimal legislation coupled with inability to handle a higher degree of freedom that is generally a part and parcel of urban life, is responsible for this steep rise.

Overall, it’s fair to say that alcohol when handled responsibly and in moderation, may be accep- table, but frequently, it is abused and leads to diseases such as obesity, dia betes, liver cirrhosis, heart disease, brain damage and cancers. There is marked detrimental effect on behaviour that leads to various social problems. It’s imperative that we educate our children about the ill effects of alcohol before they associate it with affluence and style.

In my humble opinion, if you don’t drink, don’t start it under peer pressure. It’s best to be a teetotaller. However if you do, then drink responsibly and in moderation.

-The author is a surgical gastroenterologist and a specialist in bariatric, complex ventral hernias and GI cancer surgery. He is also the Director of the Digestive Surgery Clinic of Belle Vue Hospital, Kolkata.