This document discusses alcoholism in India and the need for a holistic approach to treatment. It provides statistics on alcohol use in India and negative health and social outcomes of untreated alcoholism. It advocates treating the physical, psychological, and social aspects of a person through detoxification, counseling, social support, and addressing any co-occurring conditions. Relapse is viewed as part of recovery. A holistic approach involves medical treatment, psychosocial interventions, motivation, family support, and changing social and government policies.

1. ALCOHOLISM
CURRENT PROBLEM STATUS
AND
NEED FOR HOLISTIC
APPROACH
Dr. Prasanna P. Khatawkar
Consultant Psychiatrist
Aadhar Hospital
Specialty centre for Psychiatry and De-addiction
Solapur
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2. ALCOHOLISM
CCUURRRREENNTT PPRROOBBLLEEMM
SSTTAATTUUSS
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3. wwwwww..mmhhggii..iinn

4. INDIAN PERSPECTIVE
 ‘INTOXIFICATION’ PATTERN MORE PREVALENT
IN INDIA
 > 62.5 MILLION ALCOHOL USERS IN INDIA
 6 – 8% RISE IN ALCOHOL SALES PER YEAR
 80% DRINKING IN FORM OF HARD
LIQUOR
 40% BRANDED ALCOHOL
 REST COUNTRY LIQUOR
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5.  The mean age of initiation of alcohol :
23 years in 1950 to 1960,
19 years in 1980 to 1990
17 years in 2006
 Lifetime abstainers (89.6%).
 The female population 98.4% as lifetime
abstainers.
 Taxes generated from alcohol production and
sale : approximately Rs.35,000 crores (2000)
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6. GENERAL OUTCOME – IF
UNTREATED
Trauma, violence, organ system damage,
cancers, unsafe sexual practices, premature
death and poor nutritional status of families
with heavy drinking fathers are associated
with alcohol use.
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7.  15 to 20% of traumatic brain injuries were
related to alcohol use.
 37% of injuries in a public hospital were
related to alcohol.
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8.  20 % of psychiatric emergencies were
caused by alcohol
 34 % of those who attempted suicide were
abusing alcohol
 20 % of absenteeism and 40%
of accidents at work place are
related to alcohol.
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9.  85 % of men who were violent towards their
wives were frequent or daily users of alcohol.
 > 50% of the abusive incidents were under the
influence of alcohol.
 Domestic violence reduced to 1/10th
of previous levels after alcoholism
treatment
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10.  3 to 45 % of household expenditure is
spent on alcohol.
 Use of alcohol increases
indebtedness and reduces the ability
to pay for food and education of
children
 Alcohol abuse leads to separations
and divorces and causes emotional
hardship to the family.
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11. ALCOHOLISM
NEED FOR HOLISTIC
APPROACH
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12. WHAT DO YOU MEAN
BY HOLISTIC ?
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13. HOLISTIC
 HOLISTIC HEALTH IS A CONCEPT IN
MEDICAL PRACTICE UPHOLDING THAT
ALL ASPECTS OF PEOPLE’S NEEDS,
PSYCHOLOGICAL, PHYSICAL AND
SOCIAL SHOULD BE TAKEN INTO
ACCOUNT AND SEEN AS A WHOLE
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14. WHAT INCLUDES HOLISTIC
APPROACH ?
 DISEASE MODEL OF ALCOHOLISM
 MEDICAL TREATMENT
 PSYCHOSOCIAL INTERVENTIONS
 RELAPSE PREVENTION STRATEGIES
 MOTIVATION ENHANCEMENT
 INVOLVING THE FAMILY
 IDENTIFICATION AND TREATMENT OF CO-MORBID
PSYCHIATRIC DISORDERS
 CHANGING THE SOCIAL NORMS
 CHANGE IN GOVERNMENT POLICIES
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15. ROLE OF MEDICAL SPECIALIST
 MANAGEMENT OF MEDICAL PROBLEMS
 MANAGEMENT OF WITHDRAWAL STATE
 MOTIVATE PATIENT AND HIS FAMILY TO
UNDERGO COMPLETE DEADDICTION
PROGRAM
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16. ROLE OF PSYCHIATRIST
 DETOXIFICATION
 IDENTIFY CO-MORBID PSYCHIATRIC
ILLNESSES
 CUSTOMISED PLAN FOR EACH PATIENT
 PRIMARILY RESPONSIBLE FOR THE
DEADDICTION PROGRAM
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17. THE SUPPORTING TEAM
 PSYCHIATRIC SOCIAL WORKER
 NURSING STAFF
 NGO’s
 SELF HELP GROUPS
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18. ROLE OF RELIGION
 VERY IMPORTANT ROLE
 CHRISTIANS – SOCIAL DRINKING
 COMPARATIVELY LESS PROBLEM DRINKING
 MUSLIMS – LESSER PERCENTAGE OF
PROBLEM DRINKERS
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19. MAGICAL REMEDIES AND FAITH-HEALERS
 ACCEPT OR DON’T ACCEPT
THEY DEFINITELY PLAY A ROLE !
 EDUCATING THE SOCIETY IS THE ONLY WAY
OUT
 GOVERNMENT HAS TO PLAY AN IMPORTANT
ROLE TO PREVENT THIS MENACE
`
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20. HOW LONG SHOULD BE THE
PROGRAM
 FOLLOWING ALL STAGES ESSENTIAL
 DETOXIFICATION - 2 TO 7 DAYS
 DEADDICTION - MINIMUM 7 DAYS
- IDEAL ONE MONTH
 CHARTED FOLLOW-UP PROGRAM
- IDEAL ONE YEAR
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21. ONCE
AN ALCOHOLIC
ALWAYS
AN ALCOHOLIC
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22. APPPROACH TOWARDS RELAPSES
 ALCOHOLISM IS A DISEASE
 IT IS GOING TO HAVE ITS OWN COURSE
 RELAPSES ARE PART OF NATURAL COURSE
IN A DISEASE CALLED ALCOHOLISM !!
 ACCEPT THEM – IT WILL MAKE EVERYBODY
COMFORTABLE !!
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23. TTHHEE FFIINNAALL
AAIIMM IISS ……....
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25. TThhaannkk yyoouu
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