Minister of Social Development Bathabile Dlamini. Picture: Supplied
Minister of Social Development Bathabile Dlamini. Picture: Supplied

Drinking is dangerous

By Bathabile Dlamini Time of article published Oct 10, 2011

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The alcohol and advertising industries have recently circulated a petition aimed at pressuring government to abandon its intended ban on advertising alcohol.

Their view is that while alcohol as a product has disastrous effects on individual users, families and communities, government should not focus on advertising or other strategies to reduce the demand and supply of alcohol. Instead, we should focus on the underlying factors driving alcohol abuse.

To them, the driving factors are solely the high levels of poverty, joblessness and the more vague notions of family issues.

We welcome their acknowledgement that alcohol has significant negative impacts, but we are committed to using evidence-based strategies to reduce the harm caused by alcohol use and abuse.

Before looking into strategies to reduce alcohol-related harm, it is useful to discuss the product itself.

Beneath the fancy bottling, packaging and slick advertising linking alcoholic products to sporting prowess, business savvy and overwhelming sexiness, lies a drug called ethanol.

Ethanol is the drug found in beer, wines and spirits similar to the active ingredient Tetrahydrocannabinol (THC) that is found in the plant marijuana.

Like THC, ethanol when ingested – as a cold beer, in wine and in a shot of even the most expensive whisky – impacts negatively on the physiology of the drinker and impairs his or her senses.

The drinking of ethanol in its fancy packaging has been identified as a leading risk factor for death and disability globally. In an article due to be published in the journal Addiction, entitled “Alcohol Consumption and Non-Communicable Diseases: Epidemiology and Policy Implications” by Charles Parry, Jayadeep Patra and Jurgen Rehm, the role of alcohol as a risk factor in the spread of Non-Communicable Diseases (NCDs) is outlined clearly.

They found that alcohol accounted for 3.8 percent of deaths globally and 4.6 percent of Disability Adjusted Life Years in 2004. Alcohol was found to be the fifth highest risk factor for deaths in middle income countries. In terms of Disability Adjusted Life Years lost in 2004, alcohol ranked first in middle income countries. With South Africa being a middle income country, the scale of the problem is clearly a cause for alarm.

Parry et al also cite the International Agency for Research and Cancer which asserted that there was significant evidence for a causal link between alcohol and cancer of the oral cavity, pharynx, larynx oesophagus, liver, colon, rectum and female breast. These cancers showed evidence of what is known as dose-response relationship.

That is, the more people drink ethanol through their brand of choice, the higher the risk of getting any of these life-threatening illnesses. This research is backed up by similar evidence garnered by the World Health Organisation and medical research done here and abroad. Alcohol is not just another consumer product, but impacts negatively on the health of those who consume it and places an enormous strain on the health system.

The relationship between alcohol and social disorder may be worse. The South African Health Information network, using research by the Medical Research Council, indicates that alcohol intoxication is associated with morbidities arising from intentional and non-intentional injuries, with increased risk of contracting sexually transmitted diseases. It impacts negatively on the criminal justice system as the evidence indicates a significant association between drinking and committing or being a victim of a crime.

Mortuary statistics for 2002 indicate that alcohol played a role on average of up to 46 percent of transport-related deaths and homicides. The picture was more alarming in the metro areas where for example, in Port Elizabeth, alcohol accounted for 63 percent of transport-related deaths and 69 percent of homicides. The figures for the other major cities were equally startling.

In addition, research conducted by the Crime Research and Statistics component of Crime Intelligence over the past decade, has confirmed that about 70 percent to 80 percent of murders, 60 percent of attempted murders, 75 percent of rapes and 90 percent of all assaults involve victims and perpetrators who know one another.

The analysis indicates that alcohol, and to a lesser extent other drug abuse, frequently played a role in these crimes. This is why the five crimes in question are referred to as social contact crimes. The latest research indicates that roughly 65 percent of murders are associated with social behaviour fuelled by alcohol abuse.

The evidence related to the negative impact of alcohol on the health of South Africans and the social fabric shows that we have to be robust in reducing the harm caused by alcohol. This means we have to implement measures that will reduce exposure of young people and the general population to advertising that falsely portrays carefully packaged ethanol as being cool and successful.

We have to ensure that we raise the price of alcohol to make it less accessible. We have to ensure that we regulate the number of licensed outlets so that we limit access. We have to put in place measures that will raise the legal age for buying alcohol so that we can protect our youth and become very strict with regard to drink driving.

These strategies are regarded as common sense and serve as guidelines for good policy by the World Health Organisation.

The alcohol and advertising industries on the other hand would want us to ignore best practice and evidence garnered from local and international experts and have us focus on the one area that has been shown in research to be the least effective, that is, public education.

Public education and awareness campaigns are only successful if accompanied by legislative measures such as the restriction of advertising and increasing the price of alcohol. We intend to implement all these measures and not just one or two.

We are aware that alcohol consumption has occurred for thousands of years and is seen as part of “our culture”. However, many of its varied health effects have been discovered fairly recently. Notwithstanding this relatively new evidence of the link between alcohol consumption and its negative health and social consequences, we have to battle a well-resourced industry tasked with saving its bottom lines and preserving alcohol as part of a cultural identity that makes it an acceptable drug.

We hope that the public sees the difference between our attempts to promote public health and social integrity and the attempts of the industry to maintain the unhealthy status quo.

I would like to re-tell a story published by James Siddall, on his struggle with addiction. He tackles the myth related to drugs that asserts that “if it’s legal, it can’t be that bad”. He quotes William L White, author of the book Pathways From the Culture of Addiction to the Culture of Recovery: A Travel Guide for Addiction Professionals, who writes that society celebrates alcohol, tolerates nicotine and prohibits other drugs such as marijuana and cocaine.

White suggests that what separates legal from illegal substances is, to a huge degree, society’s perception (culture).

White further writes that anyone using prohibited drugs is painted as bad and worse. Alcohol, on the other hand, is part of the warp and weft of Western society. Never mind that, more than any other drug, it attacks every single organ and tissue in the body and has incalculable social costs.

He emphasises the dangers of alcohol by pointing out that alcohol is one of the few substances whose withdrawal can kill. Not even heroin shares that dubious quality.

Dlamini is Minister of Social Development

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