|Ahead of print publication
Family support is key to overcome alcohol dependence: A social case study
Aditya Singh1, Konark Thakkar1, Niraj Pandit2
1 SBKS MIRC, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
2 Department of Community Medicine, SBKS MIRC, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
|Date of Submission||10-Apr-2020|
|Date of Decision||08-Jul-2020|
|Date of Acceptance||21-Sep-2020|
Department of Community Medicine, SBKS MIRC, Sumandeep Vidyapeeth Deemed to be University, Piparia, Vadodara, Gujarat
Source of Support: None, Conflict of Interest: None
Alcohol dependence is a complex medical, social, and psychological problem. It affects the family life adversely. However, if family takes the lead role, this problem is easily controlled at home level with medical support. A middle-aged male, the only breadwinner of the family, had alcohol dependence for more than 20 years. With family support, he overcame the dependence. The management of this illness has the greatest role of the family and society in addition to medical. Symptomatic management of alcoholism is only a tiny part of the treatment. Once the patient's symptoms are managed, the arduous journey to prevent relapse banks upon the persons own resolve and the support offered by their family. This is a peculiar case where medical aid and family support are playing an important role in the elimination of alcohol dependence. The family support models will helpful to the primary health-care physician to reduce alcohol dependence.
Keywords: Alcoholism, family bonding, family health, social support
| Introduction|| |
Indian society is changing from traditional to modern society in context to the use of alcohol in daily life. According to the National Drug Dependence Treatment Center, AIIMS report 2019, about 14.6% of the Indian population (10–75 years) consume alcohol on a regular basis. The problem is especially worrisome in rural areas, where there is an easy accessibility of locally brewed illicit liquor, paired with a general unawareness of the adverse effects of alcoholism on health. Alcoholism causes physical, social, and mental problems to individual and family. The study has reported that alcohol dependence can destroy the family relations. They have lower marital satisfaction and higher chance to divorce. It also diminished the parenting skills, and such parents have poor communication with children. Not only this, the children of alcoholic parent have more study-related problem. Thus, alcohol dependence is not only affecting individual health but also more affecting family and children social and psychological health. If the family takes the leadership role in overcoming of alcohol dependence, it will be a true path for the society.
| Case Report|| |
The patient, Mr. XYZ, 42-year-old male, married for the past 20 years, has two children aged 8 and 10 years, respectively, both of whom are studying in a local school. The patient is the sole breadwinner of the family. He runs a small shop in his village and manages to make a modest living for himself and his family.
The patient has a history of alcohol dependence for the past 20 years. It began when he was initiated into the habit by his friends, at the age of 21. Initially, he started drinking, just for the fun of it, without an awareness of the harm and damage alcohol consumption can cause to the body. As time progressed, his dependence worsened, to the point that he could not get through even a single day without taking alcohol. The patient admitted that whenever he tried to abstain, he would feel stressed to the point that his day to day functioning would be severely impaired. One noteworthy point in this case is the, despite heavy drinking, the patient never physically abused his wife or children, even when under the influence of alcohol. He is in deep love with his family.
This family bonding helped him to take the decision to quit alcohol, and he took the decision 2 months back. Initially, he tried for week resulted in he had experienced alcohol withdrawal. He started exhibiting tremors of the upper limbs along with an altered sensorium. He was taken to a local hospital, however there he was treated symptomatically, without a proper and thorough investigation of his history. He was discharged once his tremors stopped, and he regained his mental capacity. Neither the patient nor anyone in his family was counseled about the ill effects of alcohol abuse and dependence and how the situation can be managed further. The patient relapsed into his old habit of alcohol, a mere 3 days after his discharge. This continued for another 20 days after which he tried to quit drinking once again, and again he went into withdrawal, exhibiting tremors of the upper limb. This time, he was admitted to the department of psychiatry, at medical college attached hospital for further management in March 2020.
The patient was kept under observation for 4 days with required medical management. During this time, not only the patient but also his wife and children were extensively counseled about the ill effects of alcohol use and how to prevent him from relapsing into his old habits. On discharge, he seemed to be highly motivated and enthusiastic about continuing to abstain from drinking.
Another follow-up was scheduled a week later. It was evident during this appointment that the patient had maintained the same level of motivation he had, when he was discharged, and he might successfully manage to quit his drinking habits altogether.
| Discussion|| |
Alcohol dependence is also known as alcohol use disorders (AUD) which is the next biggest consumption in India following tobacco. The AUD is a big and complex medical and social problem. The role of medical treatment is limited unless it should have long-term psychosocial support system. In psychosocial support, the family can play a very important role. As it was observed in current case also. In our case also, the decision to quit alcohol is fully supported by the family. In study of Suresh Kumar and Thomas also found the role of family in quitting alcohol and also in Bailey et al. study found family helping even controlling chronic disease risk behavior. A big limitation of our case study was the limited service at the village level. The patient has tried to quit alcohol 2–3 times, but due to no proper guidance at the village or primary health level, he started again. Thus, it is high time to incorporate various home-based psychosocial models are suggested by various authors, [6,7] in the primary health-care level. In these models, they found that the role of the family is effective and efficient to deal with AUDs.
| Conclusion|| |
Alcoholism is a clinical and social problem. Individuals, especially young adults, are inducted into this habit either by mimicking their elders or under social pressure by their peers. Once addicted, they are able to maintain this habit due to the passive role of their family. In addition, the poor awareness about alcoholism tends to worsen the issue.
The management of this illness has the big role of the family and society in addition to medical. Symptomatic management of alcoholism is only a small part of the treatment. Once the patient's symptoms are managed, the arduous journey to prevent relapse banks upon the persons own resolve and the support offered by their family. Hence, it is high time to incorporate various home-based models to incorporate at primary health care so primary physician and family can handle such cases with guidance of tertiary care.
The authors are grateful to Dr. Lakhan Kaataria, Professor and Head, Department of Psychiatry, Dhiraj Hospital and Smt. B.K. Shah Medical Institute and Research Center, Sumandeep Vidyapeeth, Vadodara, India, for the case we visited.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
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