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CHAPTER 1

INTRODUCTION
1.1 ALCOHOLISM
Alcoholism, also known as alcohol use disorder (AUD),
is a broad term for any drinking of alcohol that results in
problems. It was previously divided into two types: alcohol
abuse and alcohol dependence.
In a medical context, alcoholism is said to exist when two
or more of the following conditions is present: a person drinks
large amounts over a long time period, has difficulty cutting
down, acquiring and drinking alcohol takes up a great deal of
time, alcoholism strongly desired, usage results in not fulfilling
responsibilities, usage results in social problems, usage results
in health problems, usage results in risky situations, withdrawal
occurs when stopping, and alcohol tolerance has occurred with
use.
Risky situations include drinking and driving having unsafe
sex among others. Alcohol use can effect all parts of the body
but particularly affects the brain, heart, liver, pancreas and
immune system. This can result in mental illness, Wernickekorsakoff syndrome an irregular heart beats, liver failure and an
increase in the risk of cancer, among other diseases. Drinking
1

during pregnancy can cause damage to the baby resulting in


fetal alcohol spectrum disorders. Generally women are more
sensitive to alcohol's harmful physical and mental effects than
men.
Both environmental factors and genetics are associated
with alcoholism with about half the risk attributed to each. A
person with a parent or siblings with alcoholism is three to four
times more likely to be alcoholic themselves. Environmental
factors include social, cultural and behavioral influences. High
stress levels, anxiety, as well as inexpensive easily accessible
alcohol increase risk. People may continue to drink partly to
prevent or improve symptoms of withdrawal. A low level of
withdrawal may last for months following stopping. Medically,
alcoholism is considered both a physical and mental illness.

1.2 STATEMENT OF THE PROBLEM


Alcoholism is a disease where persons lack control of self
by both physical as well as on mental basis. This picture of
disease is present in all the culture and society in India.
Alcohol use can effect all parts of the body but particularly
affects the brain, heart, liver, pancreas and immune system.
Environmental factors include social, cultural and behavioural
influences. High stress level, anxiety, as well as inexpensive
easily accessible alcohol increase risk.

The persons which are addicted to alcohol directly as well


as indirectly affects its family members to make their life
worsens. This disease is spreading in the families of society at a
rapid pace making more in active and they become as a
parasite to the society.
The alcohol user and their families facing many problem
like social problem, family problem, occupational problem,
financial problem, sexual problem, psychological problem,
personal problem and physical problem.

1.3 JUSTIFICATION OF STUDY


From the researcher's clinical experience of working with
alcoholic patients, he realised today one of the main problems
is that family members, including the patients, still do not
understand that alcoholism is a mental disease. It affects the
patients as well as his family in a badly way.
Alcoholism is a type of mental illness that frustrates the
family. The family patients facing many problems like a burden
of feel such as anger, worry, depression, irritation etc because
of the negative relationship between the patient and the family.
The community needs to reasonful on the other hand basic
needs such as family homes, food, clothes and survives to
promote home and community based. This will help patients
and families to meet their needs within the home and the
community.
3

Chapter 2

REVIEW OF LITERATURE
2.1 INTRODUCTION
Alcoholic beverages have been in use throughout the
world for millennia. Although only a minority of consumers are
adversely affected, heavy consumption can cause untold
misery, such as the disruption of the family, long term effects in
the children, wife and the burden on the community as the
drinker's working efficiency and ability to support himself and
his family decreases. "Excessive drinking is liable to cause
profound social disruption particularly to the family, marital and
family tension is virtually inevitable"(Oxford, 1976). The wives
of heavy drinkers are likely to become anxious, depressed and
socially isolated (Wilkins, 1974).
In recent years, rates of excessive alcohol use and alcohol
related mortality have risen sharply in many countries. During
the same period the relaxation of alcohol control measures and
increased affluence have made it easier for people to obtain
alcohol beverages. At the same time the production and
distribution of alcoholic beverages involves the livelihood of
millions of persons and provides very substantial revenues to
Government.

In

looking

for

solutions
4

to

alcohol

related

problems Government will have to face these dilemmas (WHO,


1974). According to WHO alcoholism is the third major killer of
mankind after Heart Attack and Cancer and they pronounced it
as a disease in 1956. Through we know all these facts,
alcoholism was not considered a priority area with immediate
social and public health consequences in our country. The
earlier alcohol researches had referred only to prohibition.
(Encyclopedia of Social Welfare in India, 1968).Research work in
the field alcoholism started sanctity in 1960s and most of the
activities have been surveys of a specific target group, either in
terms of psychiatric morbidity or with regard to ALCOHOL
abuse in general, where alcohol has been included as one of
the incidental ALCOHOLs.

2.2 WHAT IS ALCOHOLISM


The most widely accepted definition of alcoholism is the
one offered by Keller &Mark (1962). Alcoholism is a chronic
illness, psychic, somatic or psychosomatic, which manifests
itself as a disorder of behaviour. It is characterized by the
repeated drinking of alcoholic beverages to an extent that
exceeds customary, dietary use or compliance with the social
customs of the community and that interferes with the drinker's
health or the social or economic functioning.
Alcohol dependency may be physical or psychological.

Physical dependence :- It is a state wherein the body


has adapted itself to the presence of alcohol. If its use is
suddenly stopped, withdrawal symptoms occur. These
symptoms range from sleep disturbances, nervousness
and tremors to convulsions, hallucinations, disorientation,
deliriums, tremens and possibly death.

Psychological dependence :- It exists when alcohol


becomes so central to a person's thoughts, emotions and
activities, that it becomes practically impossible to stop
taking it. The ethos of this condition, is a compelling need
or craving for alcohol.

2.3 ALCOHOLISM AND FAMILY


Alcoholism is often termed the family illness, referring to
the tremendous impact an active alcoholic has on those around
him. According to Patterson and Kauffman (1982) alcoholism is
an economic drain on family resources, threaten job security,
interrupts normal family tasks, causes conflicts, demands
adjustive and adaptive responses from family members who do
not know how to respond appropriately. This situation will
increase tension and stress, which may make the family
members, especially wives and children desperate, angry,
frustrated, nervous, afraid and guilty. In many ways they start
behaving like the addict.

The interaction patterns in alcoholic's families are also


very strained. As a result marital disruptions, disrupted family
rituals,

poor

orientation,

cohesion,
difficulties

expressiveness
in

and

communication

recreational

and

effective

involvement and lack of clean hierarchical boundaries are


common in alcoholics' families.
The adverse effect of alcoholism on wives and children
reveals its evil effects. The wives develop disturbed personality
structure or maladaptive behaviors. They will become neurotic,
psychologically maladjusted, domineering, sadistic, hostile,
frustrated, quarrelsome, agitated. They try to withdraw from
the society, lose interest in life, take all the responsibilities
upon their shoulder. The consistent overburden may lose their
psychological

balance.

Deprived

of

attention

and

love,

children's long for aspirations remain incomplete. Consequently


children may have trauma, stress and will be depressed.
Conduct behavior problems and hyperactivity are usually seen
more among children of alcoholics. Their inner conflicts may
Orient them to express malpractice and even show tendencies
to deviant characters. Moreover, whatever the degree of
dysfunction, emotional abuse is always present.
The real functioning of the family is lacking in all alcoholic
set up, because families of the alcoholics are less cohesive, less
expressive, independent and less structured. Also the families
7

are having male-conflict and being less involved in cultural,


intellectual and communication problems, role difficulties, poor
sexual interaction and aggressive behavior. For this, families
have to go through five stages, namely (1) denial behavior (2)
control attempts (3) disorganization (4) disassociation (5)
making choices, stay with or separate from family unit.
Thus crisis in family becomes system crisis. This crisis and
the response to it are not maladaptive but, in fact, are an
attempt at adaptation serving to ward off deep unconscious
depression, anxiety, or even underlying psychotic processes
(Rappaport, 1970). Besides these psychological consequences,
alcoholism creates physical consequences and most notably
sexual impotence or dysfunction, which in turn produces further
marital conflict (Patterson and Kauffman, 1982). Unsatisfied
strained marital relationship, which forces the wives to
withdraw or disengage from marital bond.

2.4 HISTORICAL ASPECTS


The ancient and medieval periods:Beverages believed to contain ethanol are mentioned in
ancient Indian literature dating back to the Vedic period around
2000 B.C. (Chopra and Chopra, 1965). Two varieties of drinks
are described-soma and sura-along with their effects and the
harms that might result from excessive consumption. Soma, the

drink of the social elite, was credited with positive qualities. On


the other hand, sura (a fermented beverage made from rice
and sugarcane) was consumed by warriors to enhance their
valour and courage, among other things. Soma receives no
further mention in post-Vedic literature, but sura and its
variants have remained a part of Indian literature ever since
(prakash, 1961). For example, South Indian literature contains
descriptions of fermented palm sap drinks that may be similar
to present day toddy (Dikshitar, 1951). Alcohol was also an
ingredient in many medicinal preparations in the traditional
Ayurvedic
describe

medical
in

system.

detail

the

Ancient

harmful

Indian

effects

medical

of

texts

excessive

or

indiscriminate drinking on the mind and body. For instance,


Charak Samhita (Anonymous, 1949), a 2000-year-old treatise
on medicine, states that " if a person takes it in right manner, in
right dose, at right time, and along with wholesome food, in
keeping with his vitality and with a cheerful mind, to him wine
is like ambrosia." However, "to a person who drinks whatever
kind comes in hand to him, and whatever he gets an
opportunity, this very wine acts as a person."
Despite

the

knowledge

and

availability

of

alcoholic

beverages, they were never a routine part of the diet in India.


Strict rules and guidelines governed who could drink and under
what circumstances. Manu the ancient Hindu sage, strictly
9

forbade drinking by Brahmins, the learned ones. Members of


other social classes were allowed to drink, but only on specific
occasions

(e.g.

wars,

religious

and

festive

ceremonies).

Abstinence was considered virtuous for the common people,


but alcohol consumption by specific groups in a socially
approved manner took place and was tolerated (Tekchand,
1972).
Although the Islamic traditional has stronger prohibitions
against alcohol than the Hindu does, drinking was common
among the Mughal emperors and their subjects (Singh & Lal,
1979). Soldiers were encouraged to drink habitually and other
social sectors were allowed to join in mass drinking at festivals
or other public functions. While it does not favour alcohol use,
the Sikh religion tolerates drinking, especially by the military
class. Therefore it comes as no surprise that Punjab- the
traditional Sikh homeland- has one of the highest alcohol
consumption figures in contemporary India. N contrast to these
other religious traditions, the Buddhist and Jain religious strictly
forbid alcohol use in any form and under any circumstance.
In sum, ancient Indian society had the knowledge of how
to prepare beverage alcohol, but did not support routine alcohol
use and regarded abstinence as a virtue for most people.
Although alcohol never became a part of daily food and drink,
its occasional use was permitted. The available evidence
10

suggests that alcohol use did not pose a significant health or


social

problem

in

ancient

and

medieval

India.

Further

information on these historical aspects of drink can be found in


Singh and Lal (1979), Mohan (1990), and Sharma (1996).

The Colonial Period


India remained under British rule for almost 200 years
before gaining independence in 1947. This period of colonial
rule saw a slow but steady rise in alcohol consumption, with
significant changes in the beverages consumed, the pattern of
drinking, and social attitudes toward alcohol use. Distilled
beverages of a much higher alcohol content gradually replaced
traditional fermented beverages. Better fermentation and
distillation processes and the introduction of new packaging
technology resulted in alcoholic beverages becoming massproduced commercial items.
Improved transportation facilities contributed to wider
alcohol availability everywhere in India. While this played a role
in

increasing

fundamental

alcohol
changes

consumption,
in

the

there

pattern

of

was

more

drinking.

As

conventional rules and guidelines for alcohol use weakened,


drinking changed from ritualistic and occasional to become a
part of routine everyday social intercourse and entertainment.
This European pattern of drinking was accompanied by a

11

change in attitude toward alcohol, which came to be regarded


more positively.
Since the British were more familiar and comfortable with
alcohol than with other intoxicants such as cannabis and
opium, they promoted alcohol use and tried to control local
cannabis and opium consumption (Saxena, 1997). Strict laws
against the latter substances also contributed to a shift in
popular means of intoxication toward beverage alcohol. Besides
giving licenses to big distilleries, the colonial government also
allowed local production of liquor. The cumulative result of
these

developments

was

gradual

increase

in

alcohol

consumption so that when India gained her independence in


1947 alcohol occupied a definite place in many Indian social
strata and was associated with a western way of life (Wig,
1994). It is noteworthy that alcohol prohibition was among the
demands voiced by India's native leadership and prohibition
became one plank upon which the independence struggle was
fought.

2.5 ALCOHOL IN INDIAN CONTEXT


The world alcohol comes from the Arabic term 'al-kul'
meaning essence. Distillation was discovered about 800 A.D.in
Arabia. But in India forms of alcohol beverage has been known
and wildly used for at least 4000 years. Indeed the Rig Veda
suggests

that

the

alcoholic
12

drink

'Soma

ras'

positively

encouraged confidence, fluent speech and bravery when drink


in moderation. Moderate drinking and problem drinking were
clearly distinguished early on. For example, the Samhitha of
Charak a medical treatise, dating from about 300 A.D., which
appears to encourage moderate drinking, contains a chapter on
diagnosing and treating intoxication and addiction.
Only the Buddhist and Jain religions seem equivocally to
have forbidden all use of alcohol. Among the tribal people of
India, home alcoholic beverages and been an integral part of
life and religious activity. Tribal communities have attempted to
hold on to their drinking traditions inspite of the disruptions to
their social structure which followed from decisions by colonial
Government first to license stills and collect excise duty and
later to impose prohibition. Singh and Lak (1979), INA summary
of the development of attitude and behavior over the centuries,
state that, while abstinence may have been regarded as
meritorious among Hindus, and particular groups such as
Brahmins (the priestly class) have been forbidden to drink at
times, there is no cultural traditions in India which is clearly and
unequivocally against the use of alcohol. The majority of Indian
people belong to the Hindu, Muslim and Sikhs (it is also true for
Christian in India) religious and all three of these traditions
contain some acceptance of moderate drinking. Singh and All
conclude that in India's religious traditions there has been wide
13

divergence between religious injunction and actual practice.


Exhortation to abstinence and anxiety about the dangers of
beverage alcohol have co-existed with an acceptance of its
wide use on many festive social occasions.
Today

in

India,

while

commitment

to

abstinence

(particularly among women) is more common than it is in


Western countries, there are many occasions on which drinking
occurs in all sectors of society. If the myth that the great and
the good do not drink persists it will remain difficult for
politicians and planners to examine the situation thoroughly
and

to

develop

appropriate

policies

in

relation

to

the

production, taxation and marketing of alcoholic beverage. It will


also encourage the view that people who drink to excess are at
the opposite end of the spectrum amongst the weak and the
bad, thus creating a stereotype that is as inaccurate and
unhelpful in India at it has been in western countries. In
addition, as long as attention in concentrated on the two ends
of this spectrum it will be difficult to make energy and
resources available to address the mass of people in between
who could make good use of more details information about the
effects of alcohol and about moderate 'safe' drinking.
The vast bulk of Indians (1 billion) live outside the large
cities: most live in villages and probably work at least part-time
agriculture. The beverages they drink are frequently locally
14

made and sometimes have a very high alcohol content. At


times social and economic constraints serve to encourage the
production of illicit liquor and to increase the likelihood of drink
being adulterated with crude spirits and other dangerous
chemicals. The high price of the factory produced drinks brings
financial disaster to the drinker and his family.
Excessive

and

inappropriate

drinking

much

more

frequently leads to social disruption: for example, by creating


even greater financial hardships among the poor, by reducing
the drinkers' ability to work immediately following a binge and
through violence by drunken husbands against their wives.
To enhance more work performance the employers give
alcohol beverages to the employees. Financial, marital and
family problems are also the consequence of excessive drinking
by employees. To treat them give education and short term
counseling at levels and encourage them to take treatment
facilities are not helpful. Development of company wide policies
regarding alcoholism are also helpful to prevent the problem.

2.6 ALCOHOLISM - A SOCIAL WORK PERSPECTIVE


In the view of social historians, traditional Indian society is
considered to be built up and support by the joint family, the
caste and village. It was a stable structure; behavior patterns
were clearly defined and rigidly enforced. The impact of cross
cultural

influence

and

unsteady
15

economic

and

jobless

conditions, confusions, anxiety, stress etc affected the family


environment. Increase in industrialization and urbanization
which contributed to busy life added frustration and tension
among all walks of life.
The increasing phenomenon of alcoholism is arising from the
need

for

achievement,

success

and

status.

Addictive

substances are used as adoptive devises to feel normal and to


withdraw from painful realities of life.
Addiction can injure human body, mind, soul, family and
society. Selective protection of life is everyone's duty. To
experience optimum level of physical, mental, and spiritual
health everyone have to be educated on the disease aspect of
addiction. Professionals in health care field are to be motivated
to treat addicts in a comprehensive method. Today's handling
of addiction problem requires a wholistic approach. Here the
professional social worker can do many tasks if they are
dedicated to the job in which they are involved.

2.7 TYPICAL CHARACTERISTICS OF ALCOHOLISM

It is a progressive disease : If the alcoholic continue to


drink, the disease inevitably progresses towards greater
and more serious damage and physical deterioration will
be the result.

16

It is a primary disease : All along alcoholism has been


treated as a symptom of psychological disorder.
Alcoholism is a primary disease, i.e., a disease in itself, in
that the person is powerless to stop his drinking. That
cause mental, emotional and physical problems. Once the
primary illness is tackled, all other problems can be sorted
out.

It is a permanent disease : Once a person develops the


disease,

it

will

remain

with

him

unless

he

stops

drinkingAlcoholism can only be arrested and there is no


known cure for it. As long as the person does not drink,
the disease is also under control.

It is a terminal disease : If a person has the disease of


"alcoholism" and if is not arrested, it will lead to his death.

Understanding alcoholism as a disease is useful in caring for


patients with drinking problems. First, it enables the concerned
professionals to use familiar techniques to make a diagnosis,
from a treatment plan, provide patient education and discuss a
prognosis. It helps differentiate alcoholism from bad habits or a
moral weakness from lack of will power and legitimizes
interventions. Most importantly, it obligates the professionals in
this field, to address the problem of alcoholism, and in a nonjudgement way, confront the patient with the truth about his
diagnosis.
17

2.8 TYPES OF ALCOHOLIC BEVERAGES AVAILABLE


Because India has great variety in topography, climate,
vegetation, culture, and traditions, it is unsurprising that
hundreds of kinds of alcoholic beverage are made and
consumed. All of them however, can be grouped into the
following four broad categories.

(i) India-Made Foreign Liquor (IMFL)


This category, created for revenue purposes, consists in
western-style distilled beverages such as wishkey, rum, gin,
vodka and brandy. These are made in India under government
licenses and the maximum alcohol content allowed is 42.8%.
Wishkey is by far the most popular drink in this category, with
hundreds of brands available, at least 20 of which have an allIndia presence. Several dozen brands of rum, gin and brands
are also available. Wines fall under this category of liquor too,
although until recently wine production and consumption in
India was almost nonexistent. Some wines are now made in the
country, and small amounts of wine are imported for select
consumers.

(ii) Country Liquor


These distilled alcoholic beverages are made from any
cheap raw material available locally, e.g. sugarcane, rice, or
coarse grains. Country liquor is produced is licensed distilleries

18

and sold from authorized outlets within the same district.


Common varieties of country liquor are arrack, desi sharab, and
tari (toddy). Excise duties are paid, but since production costs
are low the retail prices are also low. The licensing system and
some

government

monitoring

of

the

production

process

ensures a uniformity in alcohol content (around 40%) and basic


safeguards against adulteration with other harmful intoxicants.
Northern and western India are sugar-producing areas, and a
large amount of molasses is available in these states at a very
cheap price. Consequently, molasses is the main raw ingredient
for country liquor there. In South India, coconut and other
palms are used for the same purpose. In addition, inexpensive
grains are used for country liquor all over India.

(iii) Illicit Liquor


Besides licensed distilleries, a number of small production
units operate clandestinely. The raw materials they use are
similar to those in country liquor, but since they evade legal
quality controls the alcohol concentration in their products
varies and adulteration is frequent. It is common to find
samples

containing

up

to

56%

alcohol.

One

dangerous

adulteration is industrial methylated spirit, which occasionally


causes mass poisoning of consumers who lose their lives or
suffer irreversible eye damage. Since no government revenues
are paid, illicit liquor is considerably less expensive than
19

licensed country liquor, and thus finds a ready market among


the poor. In many parts of India illicit liquor production and
marketing is like a cottage industry, with every village having
one or two illegal operations. In addition to the commercial
production of illicit liquor, home production for personal
consumption also is common in some parts of the country. For
example, in a survey of Punjabi alcohol users Lal and Singh
(1978)

found

production

for

that

45%

their

own

of

them

use.

reported

Home

home

liquor

fermentation

and

distillation are also common in several tribal areas.

(iv) Beer
Beer is a relatively recent arrival in India, which remains
largely a spirits-consuming society. However, beer production
and

consumption

have

grown

rapidly.

Indian

beer

is

manufactured in large licensed breweries and is available under


more than 60 brand names whose alcohol content ranges from
5% to 9%. Beer is available mostly in bottles, but cans have
been introduced recently. Since for the same amount of alcohol
the price of beer is much higher than distilled liquor, beer is a
drink for the middle and upper economic classes. Beer also has
become a favorite beverage of the urban young.

2.9 VARIOUS THEORIES ABOUT ALCOHOLISM


(i) Psychoanalysis

20

Alcoholics have been seen by various psychoanalytic


writers as fixated at, or regressed to each of the three
pregenital psychosexual stages of development: Oral, anal,
phallic ( Blum, 1966). Nevertheless, seeing alcoholics with
some form of fixation at the oral stage is the most common
point of view. According to this view imbibing alcohol is one
means to achieve the gratification that persons fixated at the
oral stage are seeking. Thus consuming alcohol is not only
orally stimulating, but often provides an immediate sense of
psychological well being.
A second, less prominent theme among psychoanalytic
writers

is

that

male

alcoholics

are

characterized

by

homoeroticism, which is assumed often to be latent, or not


directly observable. The homoeroticism of the alcoholic is
presumed to have originated when the male child, frustrated by
his mother during the oral stage of psychosexual development,
develops an emotional attachment for his father.
A third psychoanalytic interpretation of alcoholism is that
of Menninger (1938) who asserted that because of oral
frustrations in infancy, young children become enraged with
their parents, but since they are unable to express their hostile
impulses to their more powerful parents, the impulses become
self-directed. According to this view, alcohol serves two

21

functions: it allows the alcoholics to gratify their oral cravings


as well as their self a destructive tendencies.

(ii) Dependency Theories


McCord & McCord (1962) view male alcoholics as having
intense need to be dependent on other people but equally
strong needs to be independent of them. In other words, they
seek care and nurture from people and at the same time are
aggressive and "masculine". Thus they are caught in a conflict,
and

they

attempt

to

satisfy

their

opposing

needs

simultaneously through heavy drinking.

(iii) Tension Reduction


The idea that alcoholics are tense originated from
psychoanalysis, which asserted that alcoholics have high levels
of tension and anxiety stemming from their oral frustrations
and dependency conflicts which they attempt to reduce by
drinking alcohol. This view was supported by cross-cultural
studies which found that the degree to which a society fostered
dependency conflict was correlated, with the frequency of
drunkenness in that society (Bacon, 1974).

(iv) Reactions against Traditional Approaches

22

During the 1960s, major changes in the approach on


alcoholism began to occur. The new genre of research
emphasized experimental techniques for identifying people's
motives for drinking, rather than their personality alone. The
quality of research increased rapidly (Cox & Thornton, 1986)
and the findings caused strong dissatisfaction with traditional
explanations of alcoholism.

(v) Power Theory


McClelland and his associates at Harvard (McClelland,
Davis, Kalin and Wanner, 1972) undertook one of the very first
programs that lead to a new theory of drinking. Based on
naturalistic

observation

of

drinking

behavior,

laboratory

experimentation, and analysis of folktales and of male social


drinker's fantasies recorded from the Thematic Apperception
Test before and after they had drunk alcohol, the McClelland
group reported that male heavy drinkers are often independent,
aggressive and masculine, and that drinking is an activity that
helps them satisfy their need for power.

(vi) Theory of Womanliness


Wilsnack (1974) using methodology that was similar to
that

of

the

McClelland

group

sought

to

determine

if

McClelland's findings were applicable to women. He found that


alcoholic women often have chronic doubts about their

23

adequacy of women - doubts that appear to have arisen from


assaults leveled at their feminine self-esteem, often in the form
of neacological or interpersonal problems. Thus alcoholic
women appear to be motivated to drink in order to acquire
feelings of womanliness.

(vii) Recent Psychological Approaches


Though the basic conceptualization of alcohol abuse has
not changed dramatically, there has been a shift in the
concepts that are emphasized. For instance, there's a current
emphasis on the ego functioning of alcoholics which asserts
that significant impairments in ego structure leave individuals
I'll equipped to weigh, anticipate and assess the consequences
of risk and self damaging behaviour ( like excessive alcohol
intake). Other areas of ego impairment involve problems in
recognizing, regulating, and harnessing feelings states to the
point that conditions of immobilization or being overwhelmed
with affects result, and alcohol are sought to overcome or
relieve such dilemmas (Khantzian, 1981).
A second current emphasis is on the narcissistic conflicts
that

alcoholic

and

other

ALCOHOL

abuser

experiences.

Wursmer (1978) writes: The narcissistic crisis is obviously the


starting pont where the deeper conflicts about self-esteem and
Power get mobilized. Usually, this crisis is the point in time
where the conflicts and defects converge with a particular
24

external situation, wherein, massive overvaluation of self and


pertinent other causes inevitable disillusionment, arousing
overwhelming affects such as rage, shame, envy, loneliness,
etc., which the person tries to face with primitive defenses, fails
in his attempt, and in this narcissistic crisis, with the availability
of the seeming means of solution (the ALCOHOL or alcohol), the
addictive search starts.
Reports of empirical research in the area point to the fact
that personality factors could be antecedent to, concomitants
of, or consequences of alcohol use and abuse, and that they
may interact with biological, psychological, environmental, or
socio-cultural factors to produce different types of problems.
Although the current trend is to view alcoholism in an
integrative, reciprocal and multivariate

framework, factors

derived from person systems continue to hold promise as


pieces in the puzzle of complexities and paradoxes associated
with addictive behaviors (Sutkar & Allain, 1988). The authors
also feel that personality assessment, and treatment-outcome
research may dovetail to advance theoretical and practical
knowledge.

25

2.10 DSM (DIAGNOSTIC AND STATISTICAL MANUAL


OF MENTAL DISORDERS) & ICD (INTERNATIONAL
CLASSIFICATION OF DISEASES)
Organizati
on

Preferred
term(s)

Definition
Alcohol abuse = repeated use
despite

recurrent

adverse

consequences.
Alcohol dependence = alcohol
use combined with tolerance,
withdrawal

and

an

uncontrollable drive to drink.


"alcohol
APA's DSMIV

abuse" and

The term "alcoholism" was split


into

"alcohol

abuse"

and

alcohol

"alcohol dependence" in 1980's

dependenc

DSM-III, and in 1987's DSM-III-R

e"

behavioral
moved

symptoms

from

were

"abuse"

"dependence".

It

has

and
been

suggested that DSM-V merge


alcohol

abuse

and

alcohol

dependence into a single new


entry,
WHO's ICD10

"alcohol
harmful
use" and
"alcohol
dependenc
e

named

"alcohol-use

disorder".
Definition are similar to that of
the DSM-IV. The World Health
Organization

was

the

term

"alcohol dependence syndrome"

26

rather

than

alcoholism.

The

concept of "harmful use" (as


opposed

to

"abuse")

was

introduced in 1992's ICD-10 to


syndrome"

minimize
damage

under
in

the

dependence.

reporting

of

absence

of

The

term

"alcoholism" was removed from


ICD between ICD-8/ICDA-8 and
ICD-9.

2.11 BRANDS OF ALCOHOL IN INDIA


India is one of the most Alcohol consuming countries in
the world. The best part of Indian market is that all liquors have
found a place in the market with overwhelming response. There
are many liquor brands available in the market for the
consumers however only few can be considered as the best.
The liquor brands include all kinds of alcohol like Whiskey, Rum,
Beer and others. Here are the top 10 best alcohol brands in
India.

(i) McDowells' No1


This can be termed as the most popular and best liquor
brands in India. It comes for various liquors like Whiskey, Rum,
Brands and others. The huge market share of the brand gives
the brand immense reputation. McDowells' is available all

27

across the country and is one of the most affordable brands as


well. This is a product of the United Spirits limited.
There are many more alcohol/liquor brands available in
India and many of them are widely popular. It is very hard make
top 10/alcohol brands in India due to the presence of numerous
brands and their immense popularity.

(ii) Kingfisher
This is the undisputed king of the beer market in India.
The strong beer gives the desired taste for the consumers. It is
best known for the strong beers. The brand has huge market
share and considered as the best. It is one of the oldest and
best sold beer brand in India.

(iii) Bacardi
This is a premium brand for the Rum and is considered as
the best Rum in the market. This has wonderful aroma and
aged taste. It is bit costly but within affordable ranges as well.
This is a very old brand and comes with wide range of varieties
and in the business since 1862.

(iv) Officer's Choice


There is hardly anything better than the Officer's choice
when it comes to the whiskey. This is a premium brand known
for taste and aroma. It is highly popular and also available in

28

the market. This is a product of the Allied Blenders and


Distillers.

(v) Old Monk


If you love Rum then you must have tired the Old Monk.
This is the best rum brand in India. This is one of the best in the
market for the old and unique taste. This is also available
throughout India and is very much affordable. This is produced
by Mohan Meakin Ltd in India.

(vi) Old Port


This is a Rum brand that has won many hearts in the
country. This has the unique taste and high popularity among
all the top 10 brands in India. This is owned by Amrut
Distilleries.

(vii) Royal Stag


This is a whiskey brand that gives the consumers feel of
taste and joy. The Royal Stag is considered best for hard
whiskey. This is a common name in the country and is available
for affordable price ranges. This is owned by the French
company Pernod Ricard.

(viii) Tequila EI Agave Blanco Tequila


This is a tequila brand in India. This is known for enriched
taste and the premium finish. The smooth and clear taste of the

29

brand makes it one of the best in the market. This is one of the
most affordable brands in the market for tequila as well.

(ix) Bagpiper
Bagpiper is one of the oldest brands in India and is also
one of the most popular. This is considered as a strong whiskey
brand and is known for the classic taste. This is also readily
available in the market and known for affordable price ranges.
This is a United Breweries product.

(x) Imperial Blue


This is one of the most popular and affordable Whiskey
brand in the Indian market. The Imperial Blue has strong taste
and aroma. There are various variants available in the market.
The best part is that the brand easily available and within
reasonable price. This is owned by Seagram in India.

2.12 AREA OF EFFECTS ON FAMILY


Alcoholism is also known as a family disease. Alcoholics
may have young, teenage, or grown-up children; they have
wives or husband; they have brothers or sisters; they have
parents or other relatives. An alcoholic can totally disrupt
familylife and cause harmful effects that can last a lifetime.
Alcohol leads of a variety of problems like social, family,
personal, sexual, psychological and may lead to certain
financial difficulties.

30

(i) Social Problems :

Aggressive or violent behaviour towards others.


Misbehaving in social gathering, e.g., getting
intoxicated or drunk on parties.
Fight with neighbours.
Lack of social relationships.
Risk of being a perpetrator or a victim of sexual
harassment, physical, emotional and sexual abuse.
Disrupt social or work life.
Lack of participation in social activities like festivals,
marriages, parties.

(ii) Family Problems :

Violence towards family members, especially towards

intimate partner/spouse.
Lack of coordination towards family members.
Emotional hardship to the family.
Squandering financial resources of family/household.
Substantial mental health problems for other family

members, such as anxiety, depression.


Children can suffer stress and anxiety.
Lack of everyday family responsibilities.

(iii) Occupation/Financial/Economical Problems :

Unemployment or loss of employment.


Frequent absences from work or in-between duty
timings.
Expenditure on purchasing alcohol.
Financial burden on the employers or the company due
to under-productivity.
Financial hardships due to loss of employment or poor
performance in the work arena.
Decreased productivity.
Sleeping at work.

(iv) Marital/Sexual Problems :


31

Reducing intimacy and sexual desire.


After use of alcohol increased livido.
Afraid for matrimony future.
Fight with spouse/partner.
Separations and divorces.
May not Fulfil the emotional and sexual needs of his
spouse.

(v) Psychological Problems :

Inferiority complex for family members.


weaked memory.
Difficult to attention in any of work.
Hand tremors and blackouts.
An obsessive desire to drink.
Lack of self motivation and social skills.

(vi) Personal Problems :

Aggressive behaviour - physical or verbal.


Carelessness, missed deadlines.
Weights loss or gain.
Headache and fatigue.
Heart disease, liver and kidney problems.
Mental disorders: problems with attention, learning, and

memory; depression; mood swings; anxiety disorders.


Medical expenditure - money spent on treatment of
various health problems resulting from alcohol use.

32

CHAPTER 3

RESEARCH METHODOLOGY
Methodology is very important in any scientific study. It
reveals about the nature of study, different methods used
enabling one to understand the subject matter of study. It
would also function as precursor for related area. This chapter
will briefly highlight the need for the present study, the aims
and objectives and the method adopted for the study. This
chapter is organized under the sub headings statement of
problem, aim and objectives of the study and hypothesis.

3.1 AIM, OBJECTIVES AND HYPOTHESIS


(i) Aim
The main aim of this study is to analyze the family
problems among alcoholism in slum dwellers in, Agra.

(ii) Objectives:
The objectives of this study are:
1. To study the socio-demographic status of the alcoholism.
2. To study the social,cultural & economical factors involved
in the issue of alcoholism.
3. To study the pattern profile of alcohol user.
4. To develop social work intervention plan to reducing his
problems for alcoholism in this family.

33

(iii) Hypothesis :
A hypothesis is a statement that one has reason to believe
true but for which adequate evidence is lacking (De Vos,
1998:42).
1. There will be the status of socio-demographic factor
influence the alcoholism?
2. There will be social, cultural & economical factors involved
in the issue of alcoholism?

3.2 RESEARCH DESIGN, UNIVERSE OF THE STUDY AND


SAMPLE SIZE
(i) Research Design:A retrospective case study and descriptive method has
been adapted fir purpose of exploring and assess the level of
problems.

(ii) Universe of the study:The study was conducted in the slumps of Agra.

(iii) Sample size:The whole sample size of the study is 100 Alcohol users
and their families from slums in , Agra.

3.3 METHOD OF SAMPLING


Sample were selected by proposive sampling methods.
(A) Selection of slums .:

34

I selected slums because my house I near one of the slum


so I frequently

see alcoholics fighting with there families for

money and how there families suffer due to alchol consumption


A total of 100 alcohol user and their family were taken for the
study from the various slumps in , Agra suitable for study
according to inclusion and exclusion criteria.
(B) Selection of respondent:
100 respondent from residents of Agra city and suburbs
were selected, only follow up cases were covered. List if 100
diagnosed to have substance abuse as per I.C.D.-10 criteria.

3.4 INCLUSION AND EXCLUSION CRITERIA


(i) Inclusion criteria:1. Only male.
2. Age range (18-50).
3. Duration of use of alcohol more than two years.
4. ICD-10 diagnosis of substance abuse.
5. Alcohol user with no active psychopathology.
6. Person should be cooperative for data collection.
7. Residence of Agra city and suburbs.

(ii) Exclusion criteria:1. Significant head injury.


2. Mental retardation.
3. Organicity.
4. Patient with co morbid medical disorders.

35

3.5 SOURCES & TOOLS OF DATA COLLECTION


(i) Source of data collection:Data were collected from both PRIMARY and SECONDARY
sources.
(A) Primary source: for collection of data from primary
sources.
1. Interview.
2. Questionnaire.
3. Observation.
(B) Secondary source: secondary data refers to the data
which has been collected and analyzed by someone else.
1. Case Study.
2. Official Record.
3. Journals.
4. Internet.

(ii) Tools of data collection:Data

collected

has

been

classified

on

the

basis

homogeneity of the variables and have been presented through


tables and bar- diagrams. The data was collected from following
tools are-

3.6 SOCIO-DEMOGRAPHIC AND ALCOHOL


PATTERN DATA SHEET

36

This was designed by the researcher and included the


following sections(i) Socio-demographic data:- It includes alcoholic Age, Sex,
Education,

Religion,

Martial

status,

Employment

status,

Domicile, Type of family, Income.


(ii) Alcohol pattern data:- It includes are
1. Age of onset.
2. Duration of alcohol use.
3. Quantity of alcohol (in a day).
4. Brand of alcohol.

3.7 SEMI STRUCTURAL INTERVIEW SCHEDULE TO


ASSESS PROBLEMS OF ALCOHOL USER AND
THEIR FAMILY
This tool prepared by investigator in following areas. This
tool is composed of 07 areas with a total 45 items.
1. Social problems - (07 items)
2. Family problems - (08 items)
3. Economical/Financial problems - (07 items)
4. Marital/Sexual problems - (08 items)
5. Psychological problems - (07 items)
6. Personal/Physical problems - (08 items)
7. Others
Scoring items were scored 3, 2, 1 for the responses YES,
SOMETIMES, NEVER respectively, which further divided
37

among the categories of MILD, MODERATE, SEVERE of


problems.

3.8 VALIDATION OF THE STUDY TOOLS


The semi structural interview schedule to assess problems
of the alcohol user and their family prepared by investigator
was distributed among a group of experts in the field of
psychiatry; Psychiatric social workers, Psychiatrist and
Clinical psychologists who conducted face and content
validity of all items.

3.9 METHODS OF DATA COLLECTION


All the questionnaires were read, explained and the choice
were

recorded

by

the

investigator.

Each

alcoholic

was

interviewed individually for about 30-45 minutes. Also, patients


file was used to help in completion of needed information.
A total of 100 alcohol user and their family were taken for
the study from slmps in , Agra suitable for study according to
inclusion and exclusion criteria was taken for the study. Sociodemographic data and semi structural interview schedule were
taken from alcohol user and their family.

3.10 ETHICAL CONSIDERATION


Ethical consideration were taken from the participants and
informed about the purpose of the study and voluntary
participation and confidentiality were ensured. They were also
38

informed about their rights to refuse to participate or withdraw


at any time.

39

CHAPTER 4

PRESENTATION OF DATA AND ANALYSIS


4.1

SOCIO-DEMOGRAPHIC

AND

ALCOHOL

PATTERN PROFILE OF ALCOHOL USERS


Table 1 : Socio-demographic profile of the respondents.
Variables

Education
Domicile
Marital
Status

Type
Family

Percentage

78
12
07
03
62
38

78.0
12.0
07.0
03.0
62.0
38.0

1000 5000
5000

10
22

10.0
22.0

10000
10000

68

68.0

Hindu
Muslim
Sikh
Christian
of Joint
Nuclear

Total Income
(Monthly)

Number of
Respondent
s
100
00
44
56
71
29
47
53

Male
Female
Illiterate
Literate
Rural
Urban
Married
Unmarried

Sex

Religion

Area

to

above

40

100.0
00.0
44.0
56.0
71.0
29.0
47.0
53.0

Table-1 reveals the Socio-demographic characteristics of


male respondents. Shows that, (44%) of respondent were
illiterate and (56%) respondent were literate.
Table-1

reveals

that

majority

(71%)

of

the

male

respondent hails from rural area and (29%) of male respondent


hails from urban area.
Table-1 reveals that (47%) of male respondent were
married and (53%) were unmarried.
Table-1 reveals that majority (78%) of male respondent
were Hindu, (12%) respondent were Muslim, (7%) respondent
were Sikh and (3%) respondent were Christian.
Table-1 reveals that (62%) of male respondent belongs to
joint family and (38%) respondent belongs to nuclear family.
Table-1 reveals that (10%) of male respondent were (10005000) monthly, (22%) respondent were (5000-10000) monthly
and (68%) respondent were (10000 to above) monthly.

41

Table 2 : Alcohol pattern profile of the respondents.


Variables

Category

Number
of
responde
nts
04
73
23
32
53
15
63
33

Percent
age

04

04.0

09
03
05
32
04
03
17

09.0
03.0
05.0
32.0
04.0
03.0
17.0

02

02.0

12
13

12.0
13.0

upto 20 years
Age of onset 21 40 years
41 years to above
Duration of up to 1 year
1 5 years
alcohol use
5 yrs to above
Quantity of up to 2 units
2 5 units
Alcohol (in a
5 units to above
day)
Mc Dowell's No. 1
Kingfisher
Baccardi
Officer's Choice
Brands
of Old Monk
Old Port
Alcohol
Royal Stag
Tequila EI Agave
Blanco Tequila
Bagpiper
Imperial Blue
Note : One Unit of alcohol is 25 ml.
Table-2

shows

that

alcohol

pattern

04.0
73.0
23.0
32.0
53.0
15.0
63.0
33.0

profile

of

male

respondents. Age of onset of alcohol, (4%) were up to 20 years,


(73%) were up to 21-40 years and (23%) were 41 years to
above age.
Table-2 shows that duration of alcohol use, (32%) were up
to 1 years, (53%) were up to 1-5 years and (15%) were 5 years
to above.

42

Table-2 shows that quantity of alcohol (in a day), majority


(63%) were up to 2 units, (33%) were 2-5 units and (4%) were 5
units to above (One unit of alcohol is 25ml).
Table-2

shows

that

brands

of

alcohol,(9%)

were

McDowells', (3%) were Kingfisher, (5%) were Bacardi, (33%)


were Officer's Choice, (4%) were Old Monk, (3%) were Old Port,
(17%) were Royal Stag, (2%) were Tequila EI Agave Blanco
Tequila, (12%) were Bagpiper and (13%) were Imperial Blue.

43

4.2 PROBLEMS OF ALCOHOL USER AND THEIR


FAMILIES
Table

Showing

social

problem

among

the

respondent :
Variable
Social Problem

Number of
respondent
s
37
60
03
100

Level of
Problems
Mild
Moderate
Severe
Total

Percent
age
37.0
60.0
03.0
100.0

SOCIAL PROBLEMS

Level of Problems

The above table/figure shows the severity of problems in


social area, (37%) of male respondent have mild level of
problems, (60%) respondent have moderate level of problems
and (3%) respondent have severe level of problems in social
area.

44

Table

Showing

family

problems

among

the

respondents.
Variable
Family Problem

Number of
respondent
s
32
63
05
100

Level of
Problems
Mild
Moderate
Severe
Total

Percent
age
32.0
63.0
05.0
100.0

FAMILY PROBLEMS

Level of Problems

The above table/figure shows the severity of problems in


family area, (32%) of male respondent have mild level of
problems, (63%) respondent have moderate level of problems
and (5%) respondent have severe of problems in family area.

45

Table 5 : Showing occupational/Financial / Economical


problems among the respondents :
Variable
Occupational/
Financial/
Economical
Problems

Mild
Moderate

Number of
Respondent
s
35
51

Severe

14

14.0

Total

100

100.0

Level of
Problems

Percent
age
35.0
51.0

OCCUPATIONAL FINANCIAL / ECONOMICAL PROBLEMS

Level of Problems

The above table/figure shows the severity of problems in


occupational/financial/economical

area,

(35%)

of

male

respondent have mild level of problems, (51%) respondent


have moderate level of problems and (14%) respondent have
severe level of problems in occupational/financial/economical
area.

46

Table 6 : Showing marital/ sexual problems among the


respondents : (only for married couples)
Number of
Respondent
s
14
28
05
100

Level of
Problems

Variable

Mild
Moderate
Severe
Total

Marital/ Sexual
problem

Percent
age
29.7
59.5
10.5
100.0

MARITAL / SEXUAL PROBLEMS

Level of Problems

The above table/figure shows the severity of problems in


marital/sexual area (only for married couples), (29.7%) of male
respondent have mild level of problems, (59.5%) respondent
have moderate level of problems and (10.6%) respondent have
severe level of problems in marital/sexual area.
Table 7 : Showing psychological problems among the
respondents :
47

Number of
Respondent
s
27
60
13
100

Level of
Problems

Variable

Mild
Moderate
Severe
Total

Psychological
problems

Percent
age
27.0
60.0
13.0
100.0

PSYCHOLOGICAL PROBLEMS

Level of Problems

The above table/figure shows the severity of problems in


psychological area, (27%) of male respondent have mild level
of problems, (60%) respondent have moderate level of
problems and (13%) respondent have severe level of problems
in psychological area.

Table 8 : Showing personal / physical problems among


the respondents.
Variable

Level of
48

Number of

Percent

Problems
Personal / Physical
problems

Mild
Moderate
Severe
Total

Respondent
s
28
58
14
100

age
28.0
58.0
14.0
100.0

PERSONAL / PHYSICAL PROBLEMS

Level of Problems

The above table/figure shows the severity of problems in


personal/physical area, (28%) of male respondent have mild
level of problems, (58%) respondent have moderate level of
problems and (14%) respondent have severe level of problems
in personal/physical area.

49

Chapter 5

CONCLUSION
5.1 RESULTS AND DISCUSSION
Alcoholism is a disease where persons lack control of self
by both physical as well as on mental basis. This picture of
disease is present in all the culture and society in India.
Alcohol use can effect all parts of the body but particularly
affects the brain, heart, liver, pancreas and immune system.
Environmental factors include social, cultural and behavioral
influences. High stress levels, anxiety, as well as inexpensive
easily accessible alcohol increase risk.
"Excessive drinking is liable to cause profound social
disruption particularly to the family, marital and family tension
is virtually inevitable" (Oxford, 1976). The wives of heavy
drinkers are likely to become anxious, depressed and socially
isolated (Wilkins, 1974).
The persons which are addicted to alcohol directly as well
as indirectly affects its family members to make their life
worsens. When a member of family suffers from alcoholism this
disease

impacts

negatively

on

the

family's

interaction,

relationship and functioning. The family experiences many


problems such a loss of employment, social isolation and also
50

faces a burden because they find it difficult to deal with such a


person and his unpredictable behavior.
Part 1: Socio-demographic and alcohol pattern variables
Present study shows that the total sample comprised of
100 male respondents of alcohol user and their families.
Concerning the education table-1 shows that (44%) of
male respondent were illiterate and (56%) respondent were
literate.
Table-1

reveals

that

majority

(71%)

of

the

male

respondent hails from rural area and (29%) of male respondent


hails from urban area.
Concerning the marital status table-1 reveals that (47%) of
male respondent were married and (53%) were unmarried.
Majority table-1 reveals that (78%) of male respondent
were Hindu, (12%) respondent were Muslim, (7%) respondent
were Sikh and (3%) respondent were Christian.
It is also clear from table-1 reveals that (62%) of male
respondent belongs to joint family and (38%) respondent
belongs to nuclear family.
Table-1 reveals that (10%) of male respondent were (10005000) monthly, (22%) respondent were (5000-10000) monthly
and (68%) respondent were (10000 to above) monthly.
Majority (73%) of male respondent were belonging to 2140 years in age of onset indicated table-2.
51

Majority (53%) of male respondent were having duration


of alcohol use 1-5 years found in table-2.
Majority (63%) of male respondent were having quantity
of alcohol (in a day) up to 2 units in table-2.
Table-2

shows

that

brands

of

alcohol,(9%)

were

McDowells', (3%) were Kingfisher, (5%) were Bacardi, (33%)


were Officer's Choice, (4%) were Old Monk, (3%) were Old Port,
(17%) were Royal Stag, (2%) were Tequila EI Agave Blanco
Tequila, (12%) were Bagpiper and (13%) were Imperial Blue.
Part 2 : Psychosocial problems in Alcoholism

Regarding the social problems (Table-3) : The result


were found that in social area, (37%) of male respondent
have mild level of problems, (60%) respondent have
moderate level of problems and (3%) respondent have
severe level of problems in social area.

Regarding the family problems (Table-4) : The result


were found that in family area, (32%) of male respondent
have mild level of problems, (63%) respondent have
moderate level of problems and (5%) respondent have
severe of problems in family area.

Regarding the occupational / financial / economical


problems (Table-5) : The result were found that in
occupational/ financial/ economical area, (35%) of male

52

respondent have mild level of problems, (51%) respondent


have moderate level of problems and (14%) respondent
have severe level of problems in occupational/ financial/
economical area.

Regarding the marital/sexual problems (Table-6) :


The result were found that in marital/sexual area (only for
married couples), (29.7%) of male respondent have mild
level of problems, (59.5%) respondent have moderate
level of problems and (10.6%) respondent have severe
level of problems in marital/ sexual area.

Regarding the psychological problems (Table-7) :


The result were found that in psychological area, (27%) of
male respondent have mild level of problems, (60%)
respondent have moderate level of problems and (13%)
respondent have severe level of problems in psychological
area.

Regarding the personal/physical problems (Table8) : The result were found that in personal/physical area,
(28%) of male respondent have mild level of problems,
(58%) respondent have moderate level of problems and
(14%) respondent have severe level of problems in
personal/ physical area.
As above findings indicated that in all areas i.e. social,

family, occupational/ financial/ economical, marital/ sexual,


53

psychological

and

personal/physical,

alcohol

user

having

moderate of problem in the majority of person.

Part 3 : MAJOR FINDINGS AND INFERENCES

(i) Major Findings


The finding of the study indicated that the alcohol user
and their families have problems in all the areas i.e. social,
family,

occupational/financial/economical,

psychological

and

personal/physical.

marital/sexual,

Moderate

level

of

problems were observed among the majority of the alcoholic.


Psychosocial

attitude

modification

followed

by

skill

training, employment, help for family were the major needs


perceived by the alcohol user and their families.

(ii) Inferences : Justification The Hypothesis


The hypothesis proposed by the researcher before the
study was following :
There will be the status of socio-demographic factor
influence the alcoholism.
There will be social, cultural & economical factors involved
in the issue of alcoholism.
This is justified the propose hypothesis in our study

54

Chapter 6

LIMITATIONS AND FURTHER


SUGGESTIONS
6.1 LIMITATION OF THE STUDY
As we all known very well that for social science
researcher the whole environment in his laboratory. So there
are many factors which affect his research. This includes
climatic condition, geographic conditions, region, language,
culture etc. Moreover the topic of the research also counts, this
means that in which way it should be performed. So in the
present study also the researcher had to face some problems in
completing his study. The limitations are as follows:
Alcoholism is a family disease. There is social stigma
attached to this illness. The patient facing many problems
like a burden of feeling such as anger, stress, depression,
anxiety, etc. So in this way a alcoholic patient is ignored
by the society.
During data collection is happens that one or the other
member of the family is not Present in the alcoholic's
residence. In these conditions correct information can't be
gathered, and in some cases the alcoholic himself is not
present in the house.
This study is limited only to male patient of slums. as the
study of the male patient by a female researcher is very
55

difficult because the Indian masses have a very little


knowledge about "Sexual awareness" and male patient
hesitate to tell about their problems to the female
researcher.
Sometimes alcoholic's family or the alcoholic himself
become uncooperative and do not want to give the proper
information about the alcoholic and the family. This
creates obstacles in the path of the researcher to know
about the alcohol user
Most of the study in this field were with limited view and
area

investigated

has

been

the

ability

of

general

population to recognize mental illness. However, the


findings of this study cannot be compared to some other
studies as such.
Another limitation was observed due to the cultural
variations. The result of the study may not be universality
for every part of the country as every cultural setting has
a different cultural heritage to deal with the medical and
health problem.
The sample size in the present study was not equally
distributed

across

the

various

diagnostic

groups

of

substance abuse.
The literature study included national and international
reading

material

and

focused

more

on

psychiatry,

medicine and psychology as opposed to social work. The

56

lack of social work literature in the field of study


emphasises the importance of this research.
Due to the small size of the research sample, the findings
cannot be generalised to the entire population. In addition,
the medical terms used in the study do not exist in
different Indian languages which posed a further challenge
to the researcher.

6.2 FURTHER SUGGESTION


Research should be conducted on the impact of substance
abuse, including alcoholism, on the level of problems of the
family and alcohol user. As a guideline, the following suggestion
for such a research study is made:
The alcoholic's other relatives (not only the caregiver) as
well as close should be interviewed.
More than one field should be consulted when collecting
data, in particular from the social workers, but also from
other inter-disciplinary team members.
Guidelines for social workers with regard to family
intervention programmes targeting the alcohol user, the
family and the community, should be provided.
Follow up assessment may be done to know the outcome
of treatment and there level of psycho-social problems.
Study should be replicated on large sample.
It is better to study the level of problems on different
subtypes of alcohol.

57

Study should also to see the nature and severity of their


problems.

58

Chapter 7

RECOMMENDATIONS
Based

on

the

results

of

the

study,

the

following

recommendations can be deducted.


The social worker must have knowledge and experience of
alcoholism as a type of mental illness so that he can
empower the alcoholic and the alcoholic's family in
dealing with alcoholism.
Social workers should

attend

seminars,

workshops,

conferences, in-services training and meeting in the field


of mental illness as part of their continuous education.
The alcoholic's relatives as well as the alcoholic whose
condition is stable should be members of the multidisciplinary team.
The social worker has a role to play in removing the
stigma attached to alcoholism within families and the
community.
The social worker should organise and encourage supports
groups for both alcohol user and their families.
The alcohol user and their families should receive some
education in the form of booklets/brochures and other
material, which explain alcoholism as a type of mental
illness. All official languages should be used when writing
these booklets and materials.

59

To severe the alcoholic patient and his family effectively,


social workers should receive specific training at university
level.
The social work guidelines as outlined in this study should
be implemented and adapted or refined.
The social worker role in family psycho education needs to
be fostered with the aim of improving their perception of
disease, well being, and decreasing burden, expressed
emotions, stigma feelings of alcoholic and their caregivers,
and reducing their psychosocial problems.
Increase community awareness about substance abuse
through the coordination of knowledge and mass media.

60

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Society

and

Human

APPENDIX B
SOCIO-DEMOGRAPHIC DATA SHEET
1. Reg. No. : ______________

2. Date : ______________

3. Name : _________________________________________________
4. Age : __________________________________________________
5. Sex :

(i) Male

(ii) Female

70

6. Education :

(i) Illiterate

(ii) Literate

7. Domicile :

(i) Rural

(ii) Urban

8. Marital Status :

(i) Married

(ii) Unmarried

9. Religion :

(i) Hindu

(ii) Muslim

(iii) Sikh

(iv) Chistian

10. Type of family :

(i) Joint

(ii) Nuclear

11. Total income :

(i) 1000 5000

(Monthly)

(ii) 5000 10,000


(iii) 10,000 to above

71

APPENDIX C
ALCOHOL PATTERN DATA SHEET
1. Age of onset :
(i) upto 20 years
(ii) 21 40 years
(iii) 41 years to above
2. Duration of alcohol use :
(i) upto 1 year
(ii) 1 5 years
(iii) 5 years to above
3. Quantity of alcohol : (in a day)
(i) upto 2 units
(ii) 2 5 units
(iii) 5 units to above
4. Brands of alcohol :
(i) Mc. Dowell's No. 1
(ii) Kingfisher
(iii) Bacardi
(iv) Officer's Choice
(v) Old Monk
(vi) Old Port
(vii) Royal stag
(viii) Tequila EI Agave Blanco Tequila
(ix) Bagpiper
(x) Imperial Blue

72

APPENDIX D
PROBLEMS OF ALCOHOL USERS AND THEIR FAMILIES IN
slups , AGRA
PROBLEMS ASSESSMENT SCHEDULE
This is a semi structural interview schedule to assess the problems of Alcohol
user and their family prepared by investigator in following areas:
ALCOHOL USERS DATA
1. Name of the user..............................................................................
2. Age.............................Sex.....................................Education......................
3. Occupation................................................. Income................................
4. Marital Status..................................................................................
5. Religion...........................................Cast..................................................
6 I understand That you are Alcoholic
Yes No (If yes then ask)
7. Who introduce you to alcohol?
A. Your friends
B. Your family members
C. Your colleagues
D. Your relatives
E. Your classmates
F. Any other
8. At what place you took it first?
A. In school/ college campus
B. In hostel
C. In your own Home
D. In relatives house
E. In hotel
F. In a temple
G. In a party
H. Any other place (Specify)
10. At what age did you get familiar with Alcohol?
A. Before the age of 10 years
B. Between the age of 11- 20 years
C. Between age of 21- 30
D. Between age of 31- 40 years
E. After age of 39
F. Dont remember
11. At what time in the day or night, Do you normally take Alcohol?
12. Why do you take these Alcohol?
A. To get relief from tension
B. For company sake
C. For enjoyment
D. Any other (specify)
13. Do you take Alcohol alone or with someone?
A. Alone
B. In the company of others
C. Both alone & in the company of others
14. From where you get these Alcohol?
15. Where do you when you dont take Alcohol?
A. Restless
B. Inactive
C. Agitated
D. Depressive
E. Lethargic
F. Any other (Specify)
73

16. How much amount do you spend per month on this habit?
17. Are you able to meet your expenses on Alcohol out of your income?
A. Yes
B. No (if No, what do you do)
18. Were there occasion when you sold your household articles for buying
Alcohol?
A. Yes
B. No
(If yes, when was that? What actually happened?)
19. Do you borrow money from Friends, Relatives or any other persons?
A. Yes
B. No
(If Yes, How much debt do you have on you?)
20. Do you feel your standard of living is being affected by your habit of
Alcohol use?
A. Yes
B. NO
(If Yes, in what manner.)
21. What will you call yourself?
A. Habitual Alcohol user
B. Casual user
C. Any other (specify)
22. Apart from Alcohol use, do you also have the habit of A. Buying lottery tickets
B. Pick pocketing
C. Gambling
D. Stealing
E. Indulgence in criminal activities (Specify)
23. Do your family members know about your habit?
A. Yes
B. NO
C. Dont know
24. Is there history of Alcohol use in your family?
A. Yes
B. NO
(If Yes, who has/ had in this habit?)
25. Is this habit making your marital life unhappy?
A. Yes
B. NO
C. Not applicable (Not married)
If yes, give details. Because of this habit, are you neglecting?
Your SpouseYour Children
Your Parents
A- Yes
B- No
C- NA
26. How will you rate your relation with your family members?
A. Congenial
B. Uncongenial
C. Indifferent
D. Unable to assess.
27. Do you think your children will also develop this habit because you have the
habit?
A. Yes
C. Dont know

B. NO
D. Not applicable (No Children)

74

28. Do you think people avoid meeting you because they know you take
Alcohol?
A. Yes
B. NO
C. Dont know
(If yes how do you react?)
29. What is the effect of your habit on your social life?
A. No affect
B. Improvement
C. Decline
D. Dont know
30. Is this responsible for poor performance in school/ college?
A. Yes
B. NO
C. Dont know
31. Alcohol use is responsible for lower efficiency, absenteeism, low pay &
strained relations with the employer. What is your experience?
32. Is there any history of meeting road or other accident because of Alcohol
use?
A. Yes
B. NO
33. Do you find it difficult to drive a vehicle when you are under the influence
of Alcohol?
A. Yes
B. NO
C. Not applicable (Doesnt Drive vehicle)
(If Yes, What kind of difficulty do you feel )
34. Have you ever suffered from any disease?
A. Yes
B. NO
(If yes, define what kind of disease you suffered.)
35. Do you feel guilty while using Alcohol?
A. Yes
B. NO
C. cant say
36. Do you want to get rid of this habit?
A. Yes
B. NO
(If yes, have you ever tried & what did you actually do?)
37. Have you ever felt to develop any symptoms/ complaints after regular use of
Alcohol?
(If yes, define what kind of symptoms you feel?)
38. Are you aware of the treatment facilities available for Alcohol addicts?
A. Yes
B. NO
(If yes, tell me what these facilities are )
39. Have you ever contacted these facilities?
A. Yes
B. NO
(If yes, what is your experience?)
40. Interviewers comments on the efficacy of interview.

75

Name of Researcher
M.S.W. (IV Semester)

76