Abstinence from drinking alcohol is harm reduction

Health Care, Heart Care Foundation of India, Medicine, Social Health Community Comments Off

Excessive consumption can case heart problems, liver disease, and even mortality in the longer term

[New Delhi, 17th February 2019: As per WHO estimates, worldwide, 3.3 million (~6%) deaths every year result from harmful use of alcohol. The harmful use of alcohol is a causal factor in more than 200 disease and injury conditions. Overall 5.1% of the global burden of disease and injury is attributable to alcohol, as measured in disability-adjusted life years (WHO).

The diseases that moderate alcohol use prevents (such as coronary heart disease, ischemic stroke, and diabetes) are most prevalent in the elderly, men, and people with coronary heart disease risk factors. For these groups, moderate alcohol use is associated with a substantial mortality benefit relative to abstention or rare drinking. Avoiding or reducing alcohol consumption is also a way of harm reduction as was discussed in the first-ever conference on the subject organized on 30th January 2019.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “That alcohol has negative health is a fact known to all. Yet, excessive alcohol consumption, which includes binge drinking and heavy drinking, is very prevalent and is becoming a public health problem.  There is consensus that non-drinkers should not start and the ones who drink can continue provided they do so in moderation and in the absence of contraindications. People who have been lifelong abstainers cannot be easily compared with moderate or even rare drinkers. Recommending alcohol intake to them even if they would agree to drink is not justified. Men can tolerate more alcohol than women. The ideal therapeutic dose of alcohol is around 6 gms per day. Medically safe limits are 10 g in one hour, 20 g in a day, and 70 g in a week (50% for the women).”

Abstinence is the best solution but not every individual will be able to achieve the same and they may be put on controlled drinking to reduces risk to patients.

Adding further, Dr G K Mani Padma Shri Awardee said, “There is no value for controlled drinking, lower the better. Restrict to minimum amount for least days in a week. Controlled drinking is more likely for people with a mild disorder (or at-risk drinking) and may not be a more severe disorder. In non-pregnant women and patients without other co-morbidities the ideal dose of alcohol for mortality benefit is around 6 g (about one-half of a standard drink) per day.”

Some recommendations

·         Understand why you want to stop and put it in writing. Write what you want to achieve for example will feel healthier; will sleep better, will improve my relationships. For the initial few weeks, keep track of every drink. Note the situations you are most likely to drink in and try avoiding them.

·         Those who are cutting back should set a limit as per their health. Most healthy people should limit to less than 40 ml in one hour, 80 ml in one day and less than 240 ml in a week. Women should take less than half of this amount. Even better would be not keep alcohol within your reach. Observe spiritual retreats as this will help you revisit your commitment to not drink.

·         Eat your drink. Drinking slowly can help. Sip and do not gulp. Sip soda, water, or juice after each drink. This is called Mindfulness drinking. Never drink on an empty stomach.

·         Keep busy. Take a walk, play sports, go out to eat, or catch a movie. When you’re at home, pick up a new hobby or revisit an old one.

·         Ask for support. Let friends and family members know that you need their support.Stay away from people and places that make you want to drink. Learn to say no. Do not drink just because others are, and you shouldn’t feel obliged to accept every drink you’re offered. Lastly, be persistent.