If you have visited a hospital between Dasain and Tihar, you may have noticed the occasional 'raksi lageko' patient. What many Nepalis don't seem to realise, however, is the magnitude of alcohol abuse that happens during the festive season.

Patients with cirrhosis of the liver caused by excessive alcohol intake are all too common in emergency wards during this time. The well-known complication of cirrhosis, namely upper gastrointestinal bleeding, is also tragically a regular occurrence.

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 one 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. 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 'drinks and dinner' instead of just dinner.

All the people that drink are certainly not alcoholics. But homicides, liver diseases, cancer, strokes, certain heart diseases are all problems associated with alcohol. And even trying to drink in moderation is difficult given the addictive power of the drug. Being able to 'hold your drink' is no protection against the ill effects of alcohol either.

Those of us who like alcoholic beverages will do well to drink in moderation in Tihar. Also with the zero tolerance on drinking and driving in Nepal, it may be wise to use public transportation (if available), take a taxi home or have a designated driver who did not drink that evening.