Some 21% of men in Nepal are regular drinkers, but only 1.5% of women. The annual per capita alcohol consumption among Nepalis is 2.2 litres, but increases to 28.8 litres among drinkers (36.2 litres in men). Nearly 1% of Nepalis suffer from alcohol dependence, according to WHO, but this seems to be an underestimate as it does not count homemade alcohol.
“There has been an increase in alcohol consumption in Nepal and it is a bigger risk factor than smoking, air pollution or adulterated food. Plus it leads to an increase in crime rate,” says psychiatrist Rabi Shakya at Patan Hospital.
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The challenge is that cultural drinking is accepted, people use it as self-medication, and social drinking has become the norm. Sale of alcohol shoots up during festivals like Dasain and Tihar.
“Alcohol-related problems are a common cause of hospital admissions, and it is rising with liver cirrhosis and mouth cancer and infectious diseases,” says Buddha Basnyat, a physician at the Patan Academy of Health Sciences.
Binge drinking during festivals like Dasain are worrisome because that is when cured alcoholics are most susceptible to suffer relapse.
“Dasain is a trigger, a temptation for all the recovering alcoholics like us,” admits Samir Timilisina, Chair of Alcoholics Anonymous in Kathmandu. AA began in Nepal in 1970s and holds meetings six days a week at Patan Hospital, Teaching Hospital and Lazimpat. There are currently 60 regular members.
Timilsina himself struggled with addiction for 25 years and has been sober for the past 14 months. “AA meetings are for those who have realised their problem, want to quit but are unable to do so. We share each other’s stories and draw inspiration from that,” he explains.
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Senior cardiologist Prakash Regmi at Bir Hospital is busiest this time of the year. Patients with Holiday Heart Syndrome, a condition with abnormal and high heartbeat due to excessive drinking, crowd his clinic. They need immediate treatment, or may die due to heart failure or stroke.
“Our mentality that festivals cannot be celebrated without booze needs to be wiped out,” says Regmi.
Mark Zimmerman has been practicing medicine in Nepal for 32 years, and has found alcoholism to be common, but difficult to treat.
“It is a disease, but excessive drinking is considered a habit, a coping mechanism to deal with stress, and therein lies the biggest problem,” explains Zimmerman, who has noticed a rise in female alcoholics among his patients.
“At any given time, up to 10% of patients here are alcohol related, and most have damaged 3-4 organs due to excessive drinking. But this is just a tip of the iceberg because those are only who come to hospital,” he adds.
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