We Have to Talk About Alcohol

We Have to Talk About Alcohol

By Elsabé Brits

Excessive consumption of alcohol is common in South Africa. About one-third of South Africans aged 15 years and older consume alcohol, and in terms of the volume consumed per drinker, the country ranks sixth highest in the world.

But we drink responsibly, you would say. No, we do not.

The harmful use of alcohol has a considerable impact on South African society. For example, in a national survey, 65% of women reported physical, sexual, or emotional violence when their husbands or partners were reported to often be drunk.

Alcohol intoxication also accounts for at least 27% of all driver-error attributed fatal crashes, with a high overall road crash fatality rate of 33 deaths per 100,000 – nearly double the global rate. Excessive drinking patterns are further evident in mortality statistics showing the average blood alcohol concentration of vehicle drivers at three times the legal threshold for driving.

An astonishing 10–12% of the country’s gross domestic product is spent on the consequences of alcohol harm. All these statistics are from a study published the most recent edition of the South African Journal of Science.

Proof of this epidemic is what happened during Covid-19 when there was a ban on the sale of alcohol, and the impact it had on hospitals and other systems. There some 60% fewer injuries from road traffic crashes and assaults reported at several health facilities during the first two weeks of the lockdown.

Conversely, a surge in trauma cases and hospital admissions was noted following easing of the lockdown and a lifting of the alcohol ban.

“In a bid to free up hospital beds for potential Covid-19 patients during the first wave of the pandemic, sales and public consumption of alcohol was banned again from in August 2020, and from December 2020 to February 2021.

“One week following the lifting of the last ban, spikes in trauma admissions were observed once again – for example, five Western Cape hospitals registered a combined increase of 105% in trauma cases,” according to the study.

Now, we are back again, with trauma rooms overflowing, especially during weekends and holidays, due to alcohol-related incidents.

I have personally seen the effect of alcohol-related injuries on hospitals, other patients, and healthcare workers by spending night shifts with trauma teams, witnessing how knife wounds, gun violence, assaults, and road accidents – fuelled by intoxication – overwhelm the healthcare system. You can smell the alcohol on these often-belligerent patients.

Mortuary surveillance data indicate that approximately half are alcohol related.

Studies have found that the larger the container in which the alcohol is, the more the person drinks. Experts in this country has been advising for years that bottles and boxes should be smaller, as it does have a huge impact on how much people drink.

Beer containers in South Africa often contain two or more standard drinks (i.e., 750ml and 660ml containers. There are also one-litre bottles. Increased wine container sizes are associated with increased alcohol consumption and symptoms of alcohol-related problems.

The South African Medical Research Council has proper plans on how to reduce this, and it can be done if the government listens. They state: there is often pessimism that much can be achieved; one just has to look to how Russia turned around declining mortality from 2002 using, among other things, a basket of alcohol control measures.

These included:

  • gradually raising taxes on alcohol;
  • introducing a minimum unit price policy on vodka as far back as 2003, and then increasing the minimum price over the years, before expanding this policy to other alcoholic beverages;
  • introducing a real-time tracking system on the production and sale of alcohol;
  • beginning a comprehensive night ban on off-premise sales of alcohol nationally, with even stricter availability in some regions; and
  • strict policies on alcohol-free public space, and alcohol marketing

But there is also another negative effect. Globally, there has been a debate on the causal role of alcohol in gender-based violence, due to concern that alcohol misuse is used as an “excuse” for perpetration of violence.

However, experts have advanced in their understanding of this association and numerous studies globally and in low-to-middle-income countries, where drinking alcohol is common, found that alcohol is a key driver of gender-based violence. Specifically, evidence found from southern Africa found that harmful alcohol use is inextricably linked to intimate partner violence. This was found in a review done by the Southern African Alcohol Policy Alliance and the South African Medical Research Council.

One of the women who took part in the review said the following: “My partner drinks on a daily basis; just look around you what can you expect? Beer is everywhere, look at these shebeens, it is even sold at some homes illegally. For me, my worst experience is one time he went away for days and he came back very drunk he demanded to sleep with me. So, when I refuse, he just physically beat me.” (Rosia) (33)

Her truth is not unique. She is the voice of hundreds of thousands of women who suffer the same fate.

The views shared are the guest blogger’s own. 

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