{"id":99244,"date":"2020-02-23T17:07:45","date_gmt":"2020-02-24T00:07:45","guid":{"rendered":"http:\/\/www.lankaweb.com\/news\/items\/?p=99244"},"modified":"2020-02-23T17:07:45","modified_gmt":"2020-02-24T00:07:45","slug":"alcohol-abuse-in-sri-lanka-grave-consequences","status":"publish","type":"post","link":"https:\/\/www.lankaweb.com\/news\/items\/2020\/02\/23\/alcohol-abuse-in-sri-lanka-grave-consequences\/","title":{"rendered":"ALCOHOL ABUSE IN SRI LANKA: GRAVE CONSEQUENCES"},"content":{"rendered":"

Dr. Daya Hewapathirane<\/strong><\/em><\/span><\/h2>\n\n\n

About 9 million or an estimated 40% of the population of Sri Lanka consume alcohol and 99% of them are males. Those consuming alcohol daily amount to more than 4 million. The alcohol market includes pure alcohol such as hard liquor mainly arrack and beer and illicit liquor or kasippu. Illicit alcohol accounts for most of the alcohol consumed in the country. Studies done in 2013 reveal that illicit alcohol or kasippu accounts for as much as 65% of the total volume of alcohol consumed in Sri Lanka. <\/p>\n\n\n\n

Considering\nonly those who consume only pure alcohol, the per capita consumption amounts to\n14.9 litres per annum. <\/p>\n\n\n\n

Males          (age 15+)    –   \n18.9 liters<\/p>\n\n\n\n

Females      (age 15+)    –    \n 6.7 litres<\/p>\n\n\n\n

Both sexes\n(age 15+)     –   14.9 litres<\/p>\n\n\n\n

The\nannual per capita consumption of alcohol, both pure and illicit, by  males of Sri Lanka has been estimated to\nbe a staggering 16.2 liters. This incidentally, is the highest per capita\nalcohol use among the SAARC countries (India, Pakistan, Bangladesh, Nepal,\nNepal, Bhutan, Maldives,  Afghanistan). Alcohol\ndependence and abuse is a major health and social problem in the island often\ndestroying our countrymen in the prime of their lives. About 23,000 alcohol\nrelated deaths occur annually in Sri Lanka or about 65 people die daily due to\nalcohol abuse.    Sri Lanka spends about Rs. 247 million per day\non hard liquors. The total expenditure for patients with alcohol related health\nproblems amounts to about Rs. 145 billion, which is affecting the country\u2019s\neconomy substantially. The leading cause of death among Sri Lankan males\nbetween the ages of 25 to 45 is alcohol related diseases. It is reported that\nabout 48% of about 4000 of suicide deaths in Sri Lanka are directly related to\nalcohol abuse. NATA reports that the government spends an enormous amount of Rs.140\nbillion annually on treatment of patients suffering diseases owing to alcohol\nconsumption. Drunk driving is a major cause of road  traffic accidents and related deaths and\ninjuries. <\/p>\n\n\n\n

A\nMALE PROBLEM<\/strong><\/p>\n\n\n\n

Alcohol\nabuse is an increasingly serious problem among a very large segment of the male\npopulation of Sri Lanka. This is not only having the effect of severely\nundermining their health and wellbeing, but also having increasingly harmful\neffects on the welfare and overall advancement of the country. The quality,\ncompetency, vitality and capability of the nation\u2019s human resources are\ndetermining factors in overall development and prosperity of a nation. As the\ndominant component of the nation\u2019s human resources, the male population of Sri\nLanka is threatened with an increasingly serious alcohol abuse problem which\ncalls for immediate attention on the part of the government. <\/p>\n\n\n\n

The 2016 Global School-based\nStudent Health Survey based on adolescent students of Sri Lanka revealed that\nthe prevalence of alcohol consumption besides smoking and  other illegal substance abuse is an\nincreasingly serious problem among male adolescents in the country. Studies have revealed that adolescents and young\nadults among males are highly vulnerable to the onset and continuation of the\nhabit of alcohol use. Urbanization, westernization, and the availability and\naffordability appear to contribute to the upward trend in the sale of alcohol.<\/p>\n\n\n\n

The National Authority on Tobacco and Alcohol (NATA)\nreports that alcohol consumption in Sri Lanka is associated with a huge\nexpenditure for the drinking public. A small village with around 300 families\nspends an average of Rs. 400,000 (USA $2,446) per month on alcohol and tobacco.\nThis menace is one of the primary reasons for the perpetuation of poverty in\nthe island. The economic\nconsequences of expenditure on alcohol can be significant at household level.\nBesides money spent on alcohol, a heavy drinker also faces other adverse\neconomic effects. These include low wages (because of missed work and reduced\nefficiency on the job), lost employment opportunities, increased medical\nexpenses for illness and accidents, legal cost of drink-related offences, and\ndecreased eligibility for loans. The opportunity cost of expenditure on alcohol\nis most severe for the lower income category as well. The negative economic\nconsequences on households, inevitably exerts a substantial burden on the\nnational economy.<\/p>\n\n\n\n

                                                        \n                                                                                Research\nhas revealed that habitual drinkers among the Tamil  Estate community spend a staggering 40% of\ntheir income on alcohol. Alcoholism is a serious problem among the Tamil\nplantation community. Statistics from Sri Lanka Sumithrayo which is a\ngovernment assisted charity, reveal that in the Tamil plantation community, one\nin every 10 school-going children drop out from school due to alcohol\nconsumption in their respective homes. Also, for every alcohol consuming\nperson, at least 10 other persons in the family including extended family\nmembers get adversely affected. It has been reported that Sri Lanka\u2019s tea\nproduction is on the decline because of increasing alcohol consumption among\nthe Tamil plantation community.<\/p>\n\n\n\n

INCREASED\nCONSUMPTION IN RECENT DECADES<\/strong><\/p>\n\n\n\n

According to WHO studies,\nalcohol consumption in Sri Lanka shows a significant increase in recent\ndecades, especially since the 1980s and most prominently from 2005 to 2016. In most low and middle-income countries, economic\ndevelopment is known to be a key factor associated with increased alcohol\nconsumption. Sri Lanka’s economy picked up soon after the cessation of the\narmed conflict against Tamil terrorists, in 2009, and achieved middle-income\ncountry status in January 2010. The tourism industry, one of the country’s main\nincome sources, started to flourish at the end of the armed conflict. During\nthis period, most likely due to rising incomes, globalization effects, and\nmaking alcohol more available and affordable to people, Sri Lanka  experienced highly increased alcohol\nconsumption. The so-called open economy\u201d\nintroduced to the country in 1978, led to the serious socio-economic\nproblems  including the widespread proliferation\nof alcohol use and the aggravation of alcohol abuse in the country. Open economy\nresulted in increased relations and interactions with foreign countries, increased\nforeign investments within Sri Lanka and increased involvement of foreigners in\nSri Lanka in various capacities, increased international travel and overseas\nemployment of Sri Lankans and most importantly, the significant expansion of\nthe tourism industry \u2013 all leading to  increased importation of foreign liquor and\nthe expansion of local alcohol production and the expansion of the local alcohol\nmarket, the opening of the so-called wine stores\u201d or liquor bars across the\ncountry, most often with the patronage of politicians.<\/p>\n\n\n\n

EXPANSION DURING THE\nPOST-CONFLICT PERIOD <\/strong><\/p>\n\n\n\n

During the post-conflict period, Sri\nLanka\u2019s alcohol industry expanded and there was increased availability of\nalcohol. Arrack and beer are the popular drinks of Sri Lanka and these are\nlargely produced by two companies – The Distilleries Company of Sri Lanka\n(DCSL) is the leading arrack producer whereas the Lion Brewery (Ceylon) PLC,  is the market leader of the beer\nindustry.  Both companies have seen\nmarket expansion since the end of the armed conflict. DCSL’s net profit\nincreased from 2682 million Sri Lankan Rupees in 2009 to 6873 million Rupees by\n2013, an increment of 156% (Distilleries Company of Sri Lanka PLC, 2014). Lion\nBrewery’s rapid market expansion increased its net profit from 88 million\nRupees in 2009, to 1046 million Rupees by 2013, almost a 12-fold increment\nwithin 4 years (Lion Brewery (Ceylon) PLC).<\/p>\n\n\n\n

                                                                                                              \n                        Rapid\nsocio-economic development, expansion of the alcohol industry, weak law\nenforcement and lack of alcohol control strategies during the post-conflict\nperiod brought about a rapid increase in alcohol consumption among Sri Lankans.\nWeak law enforcement and lack of alcohol control strategies were  among other reasons for this rapid increase\nin consumption during the post-armed conflict period in Sri Lanka. Although the\nSri Lankan government  from 2005 to early\n2015 developed an alcohol control strategy and a new alcohol control Act, they\ncontinued to provide licences for new liquor sales outlets and registered more\nalcohol producers. Conversely, intensive raids on illicit alcohol brewers\ncarried out by the Excise Department and Police Department in 2010 may have\nforced people to consume legally produced alcohol products which would have\nmade a positive contribution towards the increment of recorded alcohol sales. <\/p>\n\n\n\n

ILLICIT\nLIQUOR <\/strong><\/p>\n\n\n\n

Illicitly distilled liquor production and\nsales, especially kasippu, is widespread and is consumed mostly by those with\nlow income. It was reported in the media that in 2015, the Sri Lanka Excise and\nPolice Departments detected as many as 97,000 illicit liquor dens or\nhide-outs.  Controlling this menace has\nbeen severely hampered owing to the political patronage received by illicit\nliquor barons coupled with bribery and corruption on the part of Government\nagencies tasked with prevention and detection of this menace. <\/p>\n\n\n\n

The difficulty in controlling the production,\nsales and consumption of illicit alcohol in Sri Lanka has been attributed to\ncorruption in the enforcement agencies besides undue political interference.\nThose in the legal trade of pure alcohol argue that controls only serve to\nincrease the consumption of illicit alcohol. Police involvement in connection\nwith illicit liquor dens was mostly in connection with the range of crimes\nassociated with these places. Illicit liquor is tied up with gambling dens and\nmany other nefarious activities. Many acts of violence are committed at or in\nthe vicinity of illicit dens. Media reports indicate that Illicit liquor barons\nare known to have close connections with the underworld. It has also been\nreported that crimes, including abduction, assault, robbery and murder have\nbecome a part of the process in auctions to win tenders for arrack taverns. In\nthis situation, only thugs and illicit liquor barons have been in a position to\ntake arrack taverns on rent. Illicit liquor barons have amassed enormous\nwealth and have become powerful and highly influential among politicians. They\nhave been able to obtain large-scale contracts in many government projects\nacross the country. A phenomenon observed in arrack business is the entry of unscrupulous\nbusiness magnates into this business. They promote the sale of adulterated\narrack, and often use the same push to pedal narcotics as well. This mafia is\nsaid to go all-out to sabotage any moves to combat its activities. This\nexplains the huge amount of illicitly bottled arrack that finds its way to\narrack taverns. Arrack business has always been big business and continues to\nget bigger and bigger.   
\n
\n<\/p>\n\n\n\n

ALCOHOL USE BECOMING A NATIONAL\nPASTIME<\/strong><\/p>\n\n\n\n

In recent decades,\nconsuming alcohol has become a widespread national pastime in Sri Lanka. It is distressing\nto note that it has become a practice that is widely and socially accepted. In\nSri Lanka, both in urban and rural settings, most events, including funerals, some\nreligious and cultural events are made into occasions to drink. In addition to\nrecreation and fun with friends, alcohol consumption has become a panacea for\neverything – for joy and sorrow, for insomnia, for\nenergy or laziness, for tiredness, for heat or cold, for courage\nor fear, or sometimes for no reason at all! <\/p>\n\n\n\n

For some people, consuming alcohol with others \u2018for fun\u2019, in\nsocial groups generates social ties and connections. To serve and consume\nalcohol is expected in certain settings, especially at popular events such as\nweddings,  Birthday parties, New Year\ncelebrations etc. In fact, alcohol has become a necessary component in most household\nparties. In some quarters, social status is communicated and judged by the\nabundant amounts of expensive liquor served at social events. <\/p>\n\n\n\n

SPIRITUAL VALUES<\/strong><\/p>\n\n\n\n

Alcoholism has led\nto a marked deterioration of moral and spiritual values and standards in Sri\nLanka. It is a disgrace in a nation which claims to be founded on Buddhist\nprinciples. Refraining from alcohol and other intoxicants is the fifth precept\nof Buddhism and unfortunately, most Buddhist males appear to be ignoring\nthis basic precept. The use of alcohol blunts the shame and moral dread\nand thus leads almost inevitably to a breach of the other precepts.\nOne addicted to liquor will have little hesitation to lie or steal, will lose\nall sense of sexual decency and may easily be provoked even to  murder.\nAlcoholism is indeed a costly burden on our entire society. To indulge in\nintoxicating drinks is to deteriorate through all stages of morality,\nconcentration and wisdom. <\/p>\n\n\n\n

There is no evidence\nof alcohol consumption in Sri Lanka, prior to the arrival of European colonial\npowers. It was the Portuguese, Dutch and British that introduced and promoted\nalcohol consumption in Sri Lanka. In the late eighteenth century, it was the\nBritish who issued liquor licenses to open-up taverns all over the\ncountry. They increased state coffers by tax collections and promoted the\ndrinking habit widely via the “Toddy act “of 1912.<\/p>\n\n\n\n

MOTIVES FOR\nALCOHOL USE AND ABUSE<\/strong><\/p>\n\n\n\n

Comprehensive\nstudies have not been done on reasons and motives for alcohol use and abuse\namong people in Sri Lanka. It is possible that males, and different age groups\ndevelop different motivations towards alcohol use. These motivations may be\ninfluenced by varied factors, including genetic,  environmental and cultural factors. Genes that influence the metabolism of alcohol also\ninfluence the risk of alcoholism, as can a family history of alcoholism. Culture plays a significant role in motivating\nor de-motivating people toward various behaviors. Proper understanding of\nmotives that direct people, especially young people to drink would help public\nhealth and education authorities to formulate effective public health policies\nand develop cost-effective measures to curb the alcohol problem.<\/p>\n\n\n\n

Prominent among the varied domains of drinking\nmotives are personal enjoyment, social pressure, and tension or anxiety\nreduction. The personal enjoyment motive perhaps is associated with heavy\ndrinking whereas social pressure may be associated with lighter drinking\npatterns. Some say that drinks help them to relax, forget their worries and\nhelps them to cheer up and feel good. Some young males in Sri Lanka appear to\ndrink in order to become more prominent among peers and sometimes, especially\nin social gatherings, to attract the attention of others, especially females. To\nsome, alcohol use symbolizes manhood, and thus, drinking behaviors are\noccasionally used to dominate others. Tension-reduction motivations appear to\nbe an important social-cognitive factor in drinking behavior of many young Sri\nLankan males.  Such motives are often\nrelated to solitary and excessive drinking. Among some members of the younger\ngeneration, in addition to the access to and availability of alcohol, the\nmedia, especially television and movies which glamorize alcohol use, appear to\nhave a strong influence in  shaping of\nalcohol motives among the young. In-depth research is required to better\nunderstand the diverse psycho-social-cultural and environmental factors\nassociated with alcohol use behavior among the younger generation of Sri\nLankans. <\/p>\n\n\n\n

Consumption of\nalcohol over a period of time leads to physical and psychological dependence\nand the development of tolerance. It is also addictive and psycho active like\nheroin. It is most worrisome to see that the country\u2019s younger generation\nbeing  drawn into this despicable\npractice. As far as the adolescents are concerned, increased autonomy during\nthis period in life, willingness to experiment, and peer influence\/pressure\ncreate an environment encouraging high-risk decisions which influence\nadolescents\u2019 health, such as substance abuse and smoking.  Seeking higher levels of sensation\nduring the developmental stage among males compared to greater inhibitory\ncontrol among females is evident. Thus, males are more likely to experiment\nwith risky behaviors, and this could be one reason for the higher risk among\nmales. Use of alcohol and tobacco by parents and seeing on television and\nmedia, popular movie stars, entertainers and sports celebrities consuming\nalcohol has increased the risk of alcohol consumption and smoking among the\nyounger generation. <\/p>\n\n\n\n

A research investigation in\nselected rural and sub-urban settings in Sri Lanka has revealed that there\nis a special group of males with a problematic drinking practice, who drink\nheavily in solitude on a daily basis. They often have the tendency to display\nembarrassing behavior in public, using unacceptable language, sometimes\nresorting to violent and anti-social behavior creating problems for others. Consumption\nof alcohol, specially binge drinking is associated with the development of\n“Dutch courage”. This leads many alcoholics to engage in violent\nbehaviour and commit crimes that they would never had attempted in a sober\nstate. Media often reports of tragic stories especially from rural and\nsub-urban areas where husbands come home drunk and physically harass and abuse\ntheir wives and children. Also, driving under the influence of alcohol often\nresults in fatal road accidents. Some drunk drivers are overconfident and resort\nto reckless driving and excessive speed. Some suffer from fatigue and\ndrowsiness under the influence of alcohol, and make wrong judgements leading to\nserious accidents. <\/p>\n\n\n\n

HEALTH CONSEQUENCES OF ALCOHOL ABUSE<\/strong><\/p>\n\n\n\n

Medically, alcoholism is considered\nboth a physical and mental illness. Alcohol use can affect all parts of the\nbody, but it particularly affects the brain, heart, liver, pancreas<\/a> and immune system<\/a> and result in\nvaried health ailments. Someone with a parent or sibling with alcoholism is\nthree to four times more likely to become an alcoholic themselves. The\nmagnitude of the increasingly severe problem of alcohol is reflected in the\nrising incidence of hospital admissions due to alcohol related diseases.\nConsumption of alcohol over a period results in fatty changes of the liver\nwhich later transforms to cirrhosis with liver cell degeneration, and\naccumulation of fluid in the abdomen followed by degeneration of the brain. Sri\nLanka has the second highest incidence of cirrhosis in the world.<\/p>\n\n\n\n

The Centre for Disease Control and\nPrevention (CDC) identifies 54 acute and chronic conditions associated with\nalcohol. Alcohol consumption causes degeneration of the\nheart muscle, and heart failure causing alcoholic cardiomyopathy. High blood\npressure and increased cholesterol are also consequences of high consumptions.\nAlso, acute and chronic gastritis and formation of gastric ulcers, and acute\nand chronic pancreatitis with endless abdominal pain and immense suffering are\nconsequences of regular boozing. In addition, there is progressive degeneration\nof the brain leading to deterioration of intellectual functions social\nbehaviour resulting in dementia.<\/p>\n\n\n\n

The negative consequences of alcohol on people\nother than the drinker include injuries and deaths from road traffic accidents,\nharm from interpersonal violence, aggression and crime, harm to families that\ninclude psychological distress, pain and suffering from domestic violence,\nmarital separation and divorce, child and household neglect, poverty, and, harm\nto the developing foetus. Apart from an\nunhealthy population with reduced productivity hindering the development of the\ncountry, a considerable proportion of national health expenditure must be spent\nto treat alcohol related diseases. <\/p>\n\n\n\n

ECONOMIC IMPACT OF ALCOHOL\nCONSUMPTION<\/strong><\/p>\n\n\n\n

There is a paucity\nof published studies on the economic impact of alcohol and its related\nconditions in Sri Lanka, although there have been recent publications of social\ncosts of alcohol use such as poverty. In 2015, a study was conducted by the\nNational Authority on Tobacco and Alcohol, Sri Lanka Medical Association,\nCountry office of the World Health Organization (WHO), and Health Intervention\nand Technology Assessment Programme, Thailand as part of the WHO SEARO\ninitiative on introducing and capacity building on Health technology\nAssessments among South East Asian countries. The objective of the study was to\nestimate the economic costs of alcohol in Sri Lanka for the year 2015. In this study, among the overall direct\nhealth care costs included government\nexpenditure and out-of-pocket private expenditures for outpatient and inpatient\nvisits as well as clinic visits. The frequency of clinic visits per year and\nthe cost borne by the government providing such services for each person were\ntaken as the direct costs for outpatient care. Although the Centre for\nDisease Control and Prevention (CDC) has identified 54 acute and chronic\ndisease conditions attributable to alcohol consumption, the 2015 study focused\non 8 types of cancers and 19 noncommunicable diseases owing to the sparsity of\ndata on the others. The\ncosts of inpatient care considered the accommodation costs and the costs of\npharmaceuticals, investigations, surgery and the costs of intensive care\nspecific for each disease condition. The out of pocket expenses consists of the\ncosts borne by the family of the patent during the hospital admission and\nclinic visits. The direct healthcare\ncosts of alcohol-related cancers, which consist of the costs of inpatient care,\noutpatient care and private expenses were USD 25.67 million, which was 36% of\nthe overall costs of alcohol-related cancers. The inpatient care costs\ncontributed more than half (USD 14.96 million) of the direct cost. Private\nexpenses were USD 9.98 million, which was nearly 40% of the direct cost.<\/p>\n\n\n\n

Both morbidity and mortality were considered for\ncalculating the indirect costs. The\nabsenteeism cost was the lost income of the patients and the carers due to\ntreatment seeking, hospitalization and recuperation at home following\nhospitalization. The indirect costs\u2014the\ncosts of absenteeism and premature mortality\u2014consisted of 64% (USD 46.47\nmillion) of the cost of alcohol-related cancers in 2015. The cost of premature\nmortality was USD 26.83 million, which was of 58% of the indirect cost. The\ncost of absenteeism was USD 19.64 million.\nOverall, the costs of cancers of the upper aerodigestive tract (lip, oral\ncavity and pharynx and oesophagus) was UDS 61.14 million, which accounted for\n85% of the total cost of alcohol related cancers.<\/p>\n\n\n\n

In the 2015 study, direct and\nindirect economic costs of alcohol related noncommunicable diseases and other\nconditions including different forms\ninjuries, drowning and homicides were taken into consideration. Road injury\ncosts was the most significant contributor to the total economic costs of\nalcohol related conditions other than cancer. It was USD 251 million, which was\n30.8% of the overall cost of these conditions. Alcoholic liver disease,\nalcoholic gastritis and duodenitis, self-harm, alcohol use disorders and\nalcohol associated lower respiratory tract infections were the other\nsignificant contributors to this cost. The\nproportion of direct cost of ischemic heart disease and alcoholic gastritis and\nduodenitis were considerably high compared to their indirect cost component.\nThis demonstrates the high economic burden imposed on the health care system by\nthese conditions. The indirect cost of alcoholic liver disease was considerably\nhigh depicting the nature of high premature mortality with the condition.<\/p>\n\n\n\n

TOTAL ECONOMIC COST\nOF ALCOHOL CONSUMPTION<\/strong><\/p>\n\n\n\n

The total economic\ncost of alcohol in Sri Lanka was USD 885.85 million in 2015. USD 388.35 million\n(44%) consisted of direct costs, while USD 497.49 (56%) consisted of indirect\ncosts. The loss of productivity due to premature mortality, USD 388.86 million,\nwas the highest cost category, accounting for 44% of the overall cost. The next\nhighest cost was the inpatient care cost of USD 293.75 million, which was one\nthird of the total cost. When specific disease conditions are considered,\nthe economic costs of the cancers of the lip, oral cavity, pharynx and\noesophagus amounted to USD 61.14 million. It reflects the fact that Sri Lanka\nhas one of the highest incidences of cancers of the lip, oral cavity and\npharynx. They  are commonest cancers\namong Sri Lankan males. Alcohol related cancers of the liver and colon cost USD\n1.63 and 2.65 million. Therefore, addressing alcohol use should be a major\naspect of prevention of cancers in Sri Lanka. Road injuries accounted for USD\n251.28 million, which was 28.5% of the total cost. Preventing such injuries\nneed cooperation of many sectors other than health. This underlies the\nimportance of multi-sectoral involvement in addressing alcohol related harm.<\/p>\n\n\n\n

Spending on purchasing alcohol, absenteeism and private\nexpenses due to alcohol related conditions can exacerbate and perpetuate\npoverty. The impact of alcohol on poverty occurs through many mechanisms and is\nseen even in high income counties. In a study conducted in Sri Lanka examining\nthe link between alcohol and poverty, some men revealed that their alcohol\nexpenditure was greater than their income. Another study showed that the two\nlowest income categories spent more than 40% of their income on concurrent use\nof tobacco and alcohol. Therefore, alcohol use and its consequences should be a\nmajor dimension in developing and implementing policies for alleviation of\npoverty in Sri Lanka. <\/p>\n\n\n\n

Sri Lanka provides free healthcare to all its\ncitizens. People have the choice of seeking treatment in the government or the\nprivate sector for health services. The state sector is by far the largest\nprovider of health services. The direct costs of in-patient care for alcohol\nrelated conditions, excluding private out of pocket expenditure amounts to\nabout 40% of the recurrent health expenditure of the state health sector in\n2015.  This is a substantial cost, which\nunderlies the importance and the priority required for effective initiatives to\nprevent or minimize alcohol abuse in the country. In 2015, the government excise tax revenue from\nalcohol was less than the estimated total economic cost of alcohol to the\ngovernment. In 2015, alcohol related conditions imposed a significant\neconomic burden to Sri Lanka, with indirect costs (56% of total) exceeding the\ndirect costs (44%). <\/p>\n\n\n\n

Several types of costs were not included in the\nestimations. These include the opportunity costs of spending on purchasing\nalcohol products, costs of disease prevention and screening programmes, out of\npocket expenditure by patients seeking services of the private sector,\ntransport costs borne by the patient, enforcement and judicial costs and cost\nof property damage and insurance. Spending on drugs and devices which sometimes\nneed to be purchased by the patients while obtaining treatment from the state\nsector was also not included in the estimate of out of pocket expenditure.<\/p>\n\n\n\n

The economic cost of presenteeism (reduction in\nproductivity despite working) due to alcohol related illness which has been\ntaken into consideration in some studies was also not calculated. Furthermore,\nintangible costs of the effects of alcohol were not included in the analysis.\nStudies show that intangible cost may account for 20% to 27% of the total cost\nof alcohol. Recently, a study in Scotland found that the intangible cost\naccounted for 78% or the largest component of the total cost of alcohol use.\nThe intangible costs in this study included costs of pain, grief and suffering\nto the casualty, relatives and friends, and, for fatal casualties, the\nintrinsic loss of enjoyment of life, excepting consumption of goods and\nservices\u201d. The costs of alcohol related violence, suicides too were not\nincluded.<\/p>\n\n\n\n

SAVING THE YOUNGER GENERATION
\n
\n<\/strong><\/p>\n\n\n\n

Targeting\nadolescents and young adults is regarded as an important step to reduce the\nharm of alcohol abuse. Increasing the age at which alcohol can be purchased,\nthe banning or restricting advertising of alcohol can be among alternative ways\nof reducing the harm of alcohol dependence and abuse. Credible, evidence\nbased<\/a> educational\ncampaigns in the mass media about the consequences of alcohol abuse cane be\nuseful.  Guidelines should be made\navailable for parents to prevent alcohol abuse amongst adolescents. <\/p>\n\n\n\n

Our young people should be\ninformed that too much alcohol affects the central nervous system and how the\nbrain functions. They should know that it affects perception, thinking, and\ncoordination. It impairs judgment, reduces inhibitions, and increases aggression.\nThose who abuse alcohol are more likely than others to engage in high risk,\nthoughtless, or violent behaviors. Anyone who have developed alcohol related\nproblem should be strongly encouraged to seek treatment. <\/p>\n\n\n\n

An\nNGO titled Alcohol and Drug Information Centre (ADIC) in Sri Lanka, was\nestablished in 1990 and obtained Approved Charity Status in 1992.  ADIC drawing funds\nfrom many international and local sources, works for the reduction in demand\nfor alcohol, tobacco and other drugs in Sri Lanka. It believes that through\nscientific and evidence-based research and investigations, and a participatory\napproach involving the community and all stakeholders, it is possible to make\npeople realize that whatever drug, at whatever level is an impediment to human\nhappiness. ADIC advocates for effective policy formulation for alcohol, tobacco\nand other drugs control. Its annual alcohol industry profile reports provide\ntrend analysis of the Sri Lankan situation of alcohol consumption, sales,\nrevenue and the industry in general. <\/p>\n\n\n\n

A\ncomprehensive approach is required in the development of well conceived,\nrealistic short and long-term plans and programs to manage the problem, with\nthe active involvement of the community at large, and all stakeholders connected\nwith the problem. Such plans and programs should be based on in-depth research\npertaining to alcohol use and abuse, \nrelated motives and varied consequences. Enforcement of\nexisting policies and formulation of new alcohol control strategies in Sri\nLanka are vital. Saving the younger generation from alcohol abuse should be a\nhigh priority consideration in planning against alcohol abuse. Overall\nconsequences of alcohol abuse, in particular its serious harm to the physical\nand mental development of the younger generation, should be a necessary\ncomponent in school curriculum on social studies.<\/p>\n\n\n\n

Future research\nshould focus on identifying the individual-level characteristics of drinkers,\ntheir  average volume of total\nconsumption, patterns of drinking such as binge drinking and alcohol use\ndisorders among drinkers in the rural, semi urban and urban settings, and in places\nwhere alcohol related problems have shown an increasing trend in recent years.\nProblems encountered in implementing control strategies and alternative ways to\nresolve them are important considerations. Such information will facilitate the\ndevelopment of realistic plans initially aimed at minimizing the problem and\neventually to contain this increasing serious national problem.   <\/p>\n\n\n\n

Dr.\nDaya Hewapathirane<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Dr. Daya Hewapathirane About 9 million or an estimated 40% of the population of Sri Lanka consume alcohol and 99% of them are males. Those consuming alcohol daily amount to more than 4 million. The alcohol market includes pure alcohol such as hard liquor mainly arrack and beer and illicit liquor or kasippu. Illicit alcohol […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":true,"template":"","format":"standard","meta":{"footnotes":""},"categories":[101],"tags":[],"class_list":["post-99244","post","type-post","status-publish","format-standard","hentry","category-dr-daya-hewapathirane"],"_links":{"self":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts\/99244","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/comments?post=99244"}],"version-history":[{"count":0,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts\/99244\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/media?parent=99244"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/categories?post=99244"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/tags?post=99244"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}