Hungama Hai Kyon Barpa ?

 

 Hungama Hai Kyon Barpa ?

Part 3 

From the perspective of a health care professional:

Recent studies point out that even such limited and occasional use of alcohol as I am used to is bad for health.

 

But realistically, people are not likely to give up their favorite wine or cocktails even with that warning. 

Discretion !! That’s the word to bear in mind !

 

One must know red flags!

One must know when it is time for Hungama!

One must also remember that there is a big difference between taking alcohol and alcoholism. 

Part of my work in Preventive Medicine is to help people overcome alcoholism.

 At my OPD in Pune recently I saw a gentleman in his early sixties referred to me on insistence by his wife. At the end of the appointment when I was completing the encounter notes I put the diagnosis “ Behavioral Disorder related to alcohol”. The young counselor assigned to work with me asked me “ Madam, why do you call it behavioral disorder?” 

This is indeed the million dollar question!

When does use of alcohol become a disorder?

What is the difference between alcohol related physical illness and alcohol related behavioral disorder? 

This gentleman had squandered away all family fortune due to his alcohol addiction. He had strained relations with his wife, son and rest of the family. In a household with young impressionable grand kids he was drinking all day long. He was in denial about the abuse or the dysfunction it was causing in his home. 

At the time I had no evidence of the physical harm his alcohol use had caused if any. Whether his liver had developed cirrhosis or he had fatty liver etc. But I would hardly be surprised to find these after testing.

At the point when alcohol begins to harm the body and/or your functioning it becomes a disorder.

 Human beings seem to have a vulnerable trait to cause self destruction, either to themselves or to their species. And alcohol is the most common and one of the readily accessible sources to bring about this destruction. 

Primary prevention is when young minds are counseled to be aware of what alcohol can do and hence stay in control around it. 

Secondary prevention is when a person is already drinking more than advisable or being controlled by alcohol and we help him/her to regain self control. To get their lives back. There are lot of professionals dedicated to helping in these issues. Primary physicians, psychiatrists, psychologists, counselors nurses, social workers. There are meditation techniques, pastoral and other religious/ spiritual counselors, and other holistic approaches for the problem. There are outpatient services as well as inpatient facilities for treatment. There are toll free numbers to call for help and several Alcoholics Anonymous groups to reach out to.

Let’s come back to the ghazal: 

हंगामा है क्यूँ बरपा थोड़ी सी जो पी ली है 
डाका तो नहीं मारा चोरी तो नहीं की है 

Three key concepts to take home out of the message in this first verse

Social Rejection and Maladjustment 

Denial / Lack of Insight 

Crimes related to alcohol 

Most alcoholics are brought to the clinic by family members who are tired of their addiction. Rarely do these patients themselves come seeking help because they have a desire to quit. 

It is a much too familiar scenario socially and professionally that family is disgusted with the alcoholic and there is an uproar about it in the household for obvious reasons. 

It is also a common place experience for us professionals to see these affected individuals deny their habit. We almost never get an honest answer from them about the actual amount they drink each day and how many days a week they drink. 

Thodisi jo pee li hai !! 😃

That’s a joke! 

They try to pull wool over everyone’s eyes. Their family, friends, well wishers, employers, professionals. 

The gentleman I saw the other day first told me he does not have an alcohol problem. When I insisted on details he tried telling me he drinks only two days a week. The family member who accompanied him told me first thing each morning, instead of tea or coffee, he needs whiskey !

So that thodisi pee li hai excuse from any alcoholic must be taken with a bucket of salt. 

Next excuse, Daka toh nahi dala, Chori toh nahi ki hai!!

They may not always be looting a bank but sneaking money and valuables to feed the habit of alcohol is seen frequently. 

Even more serious crimes occur as a result of alcoholism. Fatal accidents related to driving under influence, domestic violence, homicides, fraud, and more. 

True, drinking alcohol is not a crime by itself and certainly not as serious as burglary or theft. As long as it is in moderation and not consumed before or while driving or operating machinery or at the job, it is ok. 

Although it is likely to soon have a health warning like there is on tobacco products, people will continue to drink for recreational use. It can probably never become a banned substance. 

It is a personal responsibility to know how much is too much and when it is inappropriate. It will have consequences if you ignore these rules of caution. Sadly most alcoholics have become alcoholics because they don’t know what is too much and are blind to consequences. It is the family that can see the consequences and therefore creates the uproar.

उस मय से नहीं मतलब दिल जिस से है बेगाना 
मक़्सूद है उस मय से दिल ही में जो खिंचती है 

Behavioral Issues and Stress

A large portion of alcoholics will give reason of taking refuge in alcohol to forget harsh realities of life. They say they don’t drink for the kick but simply to withdraw from the outside. 

Wish the outside circumstances ever would go away by doing this ! Or life get rosier! 

Who doesn’t have stress in their lives? I had my share and still do. But there is enough insight to know that alcohol is not going to take away the stress. 

Alcoholism is very commonly associated with depression, anxiety and personality disorders. It is also associated with increased incidence of homicides and suicides. 

ना-तजरबा-कारी से वाइ'ज़ की ये हैं बातें 
इस रंग को क्या जाने पूछो तो कभी पी है 

 Rejection of authority

Refusal for intervention 

Alcoholics nod in agreement and smile at each ghazal program when they hear this verse! They feel the poet is validating their feelings. They accuse anyone who advises them to quit as being ignorant. That they are advising because they don’t know how good alcohol makes one feel.

When you know poison kills, a wise man doesn’t try to experience it to know firsthand. So here the argument that people who advise regarding quitting alcohol have not experienced it is invalid. If my patient says you have no experience I can say, oh yes, I have experience and my wake up call came early and I’m grateful for that. 

If I take the liberty to tell family, friends or patients to refrain from alcohol beyond occasional use it is because I know what it will do to them, because I have seen people die from liver failure, bleeding, cancer and intoxication. And mostly because I care. 

That’s what I told the gentleman I saw in my clinic the other day in Pune. I am not getting paid to see you. If you continue to drink it will make no difference to me. If you stop drinking I will not get accolades or bonus. But if you stop you will get a second chance at life and your family situation will improve. You will all see better days. I will just get satisfaction to see that. That’s all. 

ऐ शौक़ वही मय पी ऐ होश ज़रा सो जा 
मेहमान-ए-नज़र इस दम एक बर्क़-ए-तजल्ली है 

 Defiance

Delirium

Destruction 

You can imagine how an alcoholic would interpret this verse! 

For them again there is a validation. Go ahead enjoy your drink. Let it knock off your senses. 

Such moments are times for revelations as well as revelry ! Enjoy the delirium!

The defiance to family and rest of the world is only strengthened with such interpretation. But at whose expense? Alas! Their own !! 

वाँ दिल में कि सदमे दो याँ जी में कि सब सह लो 

उन का भी अजब दिल है मेरा भी अजब जी है 

Transferred Blame

They look at the world as enemy and believe they themselves are victims. There is self pity and self condoning of their habit. 

In some sense they are victims. But not always victims of other people. They are victims of their genetic vulnerabilities. These predispositions make it easier for alcohol to take control of them more than it does for other people. 

Therefore social isolation and mistreatment compounds the problem rather than help things get better. 

हर ज़र्रा चमकता है अनवार-ए-इलाही से 
हर साँस ये कहती है हम हैं तो ख़ुदा भी है 

Struggle to regain social acceptance 

Again these lines are taken out of context by alcoholics. When everyone is equal in the eyes of God why is my family and everyone hating me? I am human too. Why can’t anyone understand me ?

 

Um, true, but are you allowing people to get through to you ? Are YOU listening ? Are you even listening to the God inside you ? If you were, you would not be destroying your body and life with alcohol.

सूरज में लगे धब्बा फ़ितरत के करिश्मे हैं 
बुत हम को कहें काफ़िर अल्लाह की मर्ज़ी है 

Delusion 

This is one of the commonly seen effects of alcoholism. These people often have delusions of grandiosity. I am powerful, I am a self made man, I am virtuous, I have done so much for everyone but nobody has gratitude or respect for me. 

Oh well, this is how the world is !!

They don’t see that in their case they are bringing upon the bad name through their own actions. The whole world is not crazy to point fingers at them for no reason. 

It is a very complex situation. Lot of patience and compassion is needed from the support systems ( family, friends, professional team) and insight, willingness and compliance with treatment needed from the affected patients.

Facing Reality

For the persons who are using more than healthy amounts of alcohol I would ask a few questions. They can answer honestly to themselves.

What does alcohol mean to you ?

How were you different when you were not drinking alcohol? Do you ever feel like being that person again?

Does alcohol make you really happy? How much time in the day are you truly happy?

Do you ever get the thought to break free from the habit? 

If yes, what is stopping you?

 What do you fear most about seeking help?

Do you really think you have been successful in hiding the habit from the world? 

I will answer the last question. The whole world knows when a person turns alcoholic. If you face your own reality and seek help you needn’t worry about revealing the truth to those who don’t care for you. They don’t matter. Those who care would never look down upon you. In fact they would be happy if you seek help and make efforts to recover from the habit. You are not alone in this struggle. There are people who love you and who will help you. But they can’t help you to feed the habit. Their love for you will not permit them to allow you to destroy your own life. 

So wake up and get your life back !! 

A Few Facts About Alcohol : 

Some brains are genetically wired to be more vulnerable than others to alcoholism. In other words, it is not entirely their fault. Therefore more understanding and compassion is necessary when treating them. 

Alcohol initially causes a feeling of high but eventually depresses the brain. It can destroy brain cells with excess and long term use.

Alcohol can cause both acute injury ( major organ damage in a very short time) or chronic injury ( with persistent use over a long time). In short one can die from a one time heavy use or you can suffer and die over a period of time.

Alcohol can cause acute intoxication ( when we say a person is drunk). Best to seek medical attention in this situation.

It can also cause symptoms of withdrawal if after persistent use it is suddenly stopped. In such cases also it is advisable to get medical help.

Alcohol use in pregnancy can lead to serious abnormalities in the baby or fetal death.

Kids of alcoholics are at much higher risk of becoming alcoholics themselves.

Alcohol can lead to injury to liver which can progress to end stage liver disease called cirrhosis with portal hypertension, esophageal varices, bleeding from these varices. It can also cause liver cancer. 

Besides liver cancer, alcohol is also shown to cause breast cancer, colon cancer, mouth and throat cancer, cancers of esophagus and stomach.

Alcohol can depress the heart muscle and cause heart failure.

Alcohol can cause severe vitamin deficiencies and resultant neuropathies. 

Alcohol can interact with a number of medications and illicit substances and often leads to fatal overdose. 

Alcohol related accidents and deaths are a major cause of mortality in the USA.

If a friend has been drinking at a party do not let them drive that day. Have a designated driver or offer to be one if you haven’t had a drink.

Alcoholism and alcohol related illnesses are preventable disorders if help is sought early. 

If you know a friend or family member who has issues with alcohol please try to get them timely help. 

In my observation, people in India drink much more alcohol on a routine basis than I see in the USA. Sadly, even doctors do the same. It is something I can probably never understand. Why knowledge never penetrates deeper to become understanding and manifest in action? 

Keeping Hope Alive

Despite all the frustrations and barriers , optimism is necessary in the struggle to free our loved ones from the clutches of such monsters like alcohol. 

Whoever seeks help there is plenty help out there. Just the desire must come from within to want to quit. 

May the Light shine within them. 

Talking of overdose, here’s another double ikat in cotton from Telangana. 

Now I need to detox, and probably you too 😃