4-10 October 2013 #676

Raksi Lagyo

Dhanvantari by Buddha Basnyat, MD

With Ghatastapana a day away, it’s a good time to talk about alcohol. Many people, including doctors, do not know what comprises a single drink in terms of quantity. In order to know what alcohol abuse is, it is important to understand how a drink is defined. We can broadly categorise drinks into three groups: beer, spirits (whisky, rum, vodka, gin), and wine. The regular alcohol content is about five per cent in beer, 40 per cent in spirits, and 12 per cent in wine. About 350ml of beer (one regular can), about 150ml of wine (about two thirds of a regular wine glass, not full), and 45ml of spirit (not a ‘Patiala’ peg) each comprise a drink. 

Based on these figures, a healthy man without any contraindications to alcohol may have two drinks per day and a healthy, non-pregnant woman can consume one drink per day, as women metabolise alcohol differently. Because it isn’t known whether any amount of alcohol is safe during pregnancy, the US Surgeon General urges abstinence for women who are or may become pregnant. The quantity should not exceed more than 14 drinks per week for men and seven drinks per week for women. When people cross this limit they risk abusing alcohol.   What about all the news about alcohol being good for you? Drinking like most things in life is a double edged sword. There is some good evidence to show that moderate consumption of alcohol may be cardioprotective. Alcohol in moderation also enhances the fun and frivolity of any party. People are more keen to attend parties which say ‘cocktail dinner’ instead of just dinner. 

All people who drink are certainly not alcoholics and individual responses to liquor vary. But homicides, liver diseases, cancer, strokes, certain heart diseases are all problems associated with alcohol. Heavy drinkers face greater risk of hypertension, gastrointestinal bleeding, sleep disorders, major depression, hemorrhagic stroke, cirrhosis of the liver, and several cancers. Being able to ‘hold your drink’ does not afford protection against the ill effects of excessive drinking. In addition, trying to drink in moderation is difficult given the addictive power of the drug.  

Screening for heavy drinking is important because about three in ten adults drink at levels that elevate their risk for physical, mental health, and social problems. Clinical trials have demonstrated that brief interventions by clinicians can promote significant and lasting reductions in drinking levels in at-risk drinkers.  Heavy drinking, especially in our part of the world, however, often goes undetected. Doctors very rarely ask their patients how much they drink. Or, there is a misconception of what makes an alcoholic. For example: when a patient reports that he drinks only one drink a day, he may be mistakenly labelled an alcoholic by the physician. 

Teetotallers should certainly not start drinking based on what they have read in the papers about alcohol being good for health, specifically cardiovascular health. By the same token, healthy adults who drink according to the above guidelines and have no contraindications, need not necessarily stop drinking because their mother-in-law does not like them consuming raksi.

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