Opinion | Don't fuel the fire: Alcohol dependence is the real issue

Column | Don’t fuel the fire: Alcohol dependence is the real issue

Editor's note: A debate on whether alcohol should be made available to people showing withdrawal symptoms has been raging in Kerala in the wake of the 21-day lockdown. This appears to have deeply divided the state. Onmanorama presents views from both sides to provide a clear picture about the issue. Here, Dr KA Kumar argues strongly against the booze supply. Click here to read Dr M R Rajagopal's piece in support of alcohol supply.

The decision to supply alcohol to addicts was unsettling. As a practitioner of medicine for more than 50 years and a psychiatrist for 40 years, I can’t approve of this method.

Alcohol dependence is a behaviour disorder as it is a complex medical phenomenon. Treating alcoholism with alcohol is against the tenets I have followed in my career as a doctor and a medical teacher.

Of course, withdrawal symptoms can be eased by giving the patient alcohol. That result, however, will be short-lived. The symptoms will reappear and the patients will end up with more alcohol in their body. It is like adding fuel to the fire. It is only a matter of time before the patient is back to his normal intake. That is why medical science does not view alcohol as a medicine.

Instead, those patients have to be given medicines that have alcohol-like effects on brain. Chlorodiasepoxide, Oxazepam, Lorazepam and Heminervin can be used for their treatment. The choice of the drug and dose depends on the functioning of liver and kidney, the level of electrolytes and the health of the heart. These drugs have to be administered for only seven to 10 days.

We have to realize that the real disease is not withdrawal, but alcohol dependence that damages brain, liver and heart. A majority of patients will show withdrawal symptoms for three or four days. About 10 per cent of patients may need medical care. About 2 per cent of extreme cases may require intensive treatment.

About 10 per cent of the people who now show withdrawal symptoms can be free of alcohol dependence for some days at least. We can free 30 per cent to 40 per cent of patients from alcohol dependence if we ensure follow-up treatment to them.

(The writer is a former psychiatry professor at the Government Medical College, Thiruvananthapuram and a former medical education director of Kerala. He is the president of Indian Psychiatry Society.)

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