Who seeks treatment for alcohol problems? Demography and alcohol-use characteristics of patients in taboo and non-taboo drinking groups attending professional alcohol services in Nepal
A newly published result based on data from Nepalese inpatients receiving treatment for alcohol-related problems show that early debut to alcohol consumption, hazardous drinking and delayed treatment seeking are common in Nepal. Nepalese society has ambivalent attitude towards alcohol consumption- people high in the caste system have a social taboo about drinking, whereas use of alcoholic beverages is banal in the lower castes. The current study identified subtle differences between these groups. Notwithstanding taboo, people from the higher castes, and those high in socio-economic stratum were found to over-represent alcohol-treatment populations.
Only few individuals with alcohol problems seek help; those who do have not been described adequately. Here, we summarize the demographic and alcohol-related features of inpatients attending professional alcohol services in Nepal and examine differences between patients with and without social taboos about drinking.
Fully structured interviews including the Composite International Diagnostic Interview and the Alcohol Use Disorder Identification Test were administered to 177 men and 21 women consecutively admitted to eight alcohol treatment centres in Kathmandu.
Altogether, 164 patients (83%) had alcohol dependence and 24 patients (12%) had alcohol abuse. The sample had a mean age of 35.3 years (SD 10.1) with a time lag of 16.8 years (SD 9.8) from start of habitual drinking to first entry into treatment. Most (62%) were married, lived in urban areas (72%), had above-average income (57%), received adequate social support (71%), and belonged to social groups in which drinking is taboo (57%). Individuals in non-taboo group more often lived in urban areas, had lower socioeconomic status, more often reported parental problem drinking and started drinking at a younger age, whereas individuals in the taboo group more often had late onset, risky drinking, and waited longer before seeking treatment (P < 0.05).
Traditionally alcohol non-using castes and people with higher socioeconomic status over-represent professional alcohol services in Kathmandu. This, and high levels of hazardous and harmful alcohol use, indicate changing trends concerning social tolerance towards alcohol in Nepalese society in recent times and a heavy burden associated with alcohol disorders.
- Forfattere: Sudan Prasad Neupane & Jørgen G. Bramness
- Publisert online: Asian Journal of Psychiatry, DOI: 10.1016/j.ajp.2014.06.017 (20 Juni 2014)