BURDEN OF ALCOHOL IN PATIENTS WITH ALCOHOLIC LIVER DISEASE [ALD] AND THEIR FAMILIES IN ODISHA

BACKGROUND There is no information on the social, economic, health and psychological impact of alcohol use in ALD patients and their families. The aim of the study is to estimate the burden of alcohol use, in patients with alcoholic liver disease and their families, in Odisha. MATERIALS AND METHODS Demographic and socioeconomic data were collected from hospitalized ALD patients (cases) and Chronic liver disease (CLD) patients with aetiology other than alcohol (controls) using a self-designed non-validated questionnaire and results were analysed. RESULTS Study subjects included 400 consecutive CLD patients. 350 patients had CLD of alcohol aetiology (cases), 50 patients had CLD of aetiology other than alcohol (controls). In alcoholic groups, 98% were male, 02% were female, in control groups 80% were male, 20% were female. In alcohol groups 60% were between 30–50 years, literate (69%), either businessmen (39%) or employed (30%) and belonged to middle socioeconomic class. In control groups 62% were above 50 years, 82% belonged to low socioeconomic groups. 90% cases started alcohol use before age 30 years and half before legal age of drinking (below 21 years). 80% cases consumed mixed alcohol (both foreign and country liquor), with average alcohol intake of 190 ml/day and mean duration of 20 years. 60% consumed alcohol daily, 70% consumed alcohol outside home. Family history of drinking present in 63% in alcohol groups and 16% in control groups. Concomitant tobacco abuse was noted in 80% in alcohol groups but 25% in control groups. Average expenditure on alcohol was INR 2000/month. Average hospitalizations for ALD related problems was 4.9 times/year with average expenditure of INR 30,000 during each hospitalization, but in control groups average hospitalization was 4.6 times/year with average expenditure of INR 45000 during each hospitalization. For treatment expenses, 86% (cases) and 94% (controls) borrowed money from friends/relatives, 36% (cases) and 18% (controls) used saving deposits, 28% (cases) and 22% (controls) used Odisha state treatment fund and 4% (cases) and 26% (controls) sold personal belongings, .43% (alcohol groups) and 14% (control groups) had children deprived of education. Besides, 52% (cases) and 08% (controls) had disturbed social and family life. In alcoholic groups, 34% abused their family members, 20% suffered accidents, 37% indulged in physical violence and scuffled with police, 5% faced legal consequences and 3% had attempted suicide. CONCLUSION Alcohol drinking is widespread in younger age group and high income groups. Alcohol causes severe social disruption. Children suffer the most. It causes huge financial burden on both family & state.