Alcoholism is the condition whereby, a person consumes alcoholic beverages at levels that puts his physical and mental health in jeopardy and affects social, job and family responsibilities. It is the uncontrollable consumption of alcoholic beverages often to the detriment of the consumer. Research indicates that, some people are more predisposed to alcoholism due to their genetic makeup (Hutchison, 2003). However this theory has not been fully authenticated as research is still ongoing on the subject. Africa and Asia are the two continents where there is a rapid rise in the consumption of alcohol. In Africa for example, consumption of absolute alcohol is as much as six liters per year leading to a lot of harm on an individual and societal basis
Alcoholism in the rural areas of America has had dire consequences on the society at large and on individual basis. For example, research has shown that there is a connection between alcoholism and high suicide rates. More than 20 percent of suicides in America are committed by people with alcohol dependence (Hutchison & Blakely, 2003). New research shows that both attempted and completed suicides occur more in rural areas with greater bar densities. This is because rural areas with lots of bars are depressing places to live in, partly due to isolation and strong social ties. America is predominantly an urban society, meaning that the rural people are usually left to their own predicament. In the United States, alcohol has been ranked the third leading cause of death. This is mostly felt in the rural areas where the people are left to their own devices. Thus, in rural America Alcohol is the most abused substance followed by cigarettes (Cronk, 1997).
The African continent has been plagued by extreme cases of poverty, which is concentrated in the rural areas. Over 70 percent of the continent’s poor people live in the rural areas depending on agriculture as a source of livelihood. Eastern and southern Africa has one of the highest concentrations of extremely poor people in the world (Brian, 2010). The poverty levels and lack of better opportunities in Africa has contributed significantly to an increase in alcoholism, especially among the youthful population. In effect, this has led to a downward trend in the economies of the rural area as the youth, who comprise the bulk of the productive population, spend the better part of their productive time getting inebriated. Alcoholism in the rural areas of Africa has blown out of proportion, affecting even marriage institutions and causing great harm to people, especially the women, children and the elderly. Men have been known to abandon their conjugal obligations in Africa because of “the drink”. Abandoned families are common in Africa - a fact that may be partly attributed to alcoholism among other factors (Brian, 2010).
In Africa, alcohol has been directly linked to community and domestic violence together with neglect of family and children. In the rural areas between 80 and 85 percent of alcohol is unlicensed, meaning that it not under any form of formal control and that the people are left to their own devices to drink as much as they wish. In Kenya, East Africa, for example, the rural areas are notorious for brewing illicit and mostly lethal brews that are very potent and cheap. The brew called “kill me quick” is very lethal and more often than not has been known to cause death and blindness. One dollar is enough to buy four glasses of illicit brew locally referred to as “chang’aa” in East Africa. Recently in Kenya, eleven people have died in two areas within Nyandarua County after consuming an illicit brew. According to Cronk (1997) more than half of all alcohol drunk in Africa is illegal, with Uganda consuming more alcohol per person than any country in the world.
The bulk of the world population lives in Asia. Poverty has been a major thorn in the Asian countries with the majority of the poor people located in the rural areas. Alcoholism is directly linked to poverty, as research has shown that poor people tend to drink more than their rich counterparts (Sloboda etal, 1997). In major Asian countries, 80 to 90 per cent of the poor people live in the rural areas. Poverty is more rampant in Southern Asia than it is in eastern and south eastern Asia. The current Tsunami that hit Southern Asia in 2006 has increased the poverty levels and will do so for the next several years to come. A large percentage of the rural households have larger families, less education and high incidences of unemployment or underpayment. Moreover, basic amenities like clean water, electricity and sanitation are rare, if found at all (Rayman, 2006).
The Asian rural community has found itself in a predicament of extreme poverty, from which they cannot neither detach nor do anything about it. This has lead to high incidences of alcoholism, drug abuse and other social ills like prostitution (Hutchison & Blakely, 2003). Consumption of alcohol in Asia is widespread, especially in the rural areas where people consume illicit alcohol to the detriment of their health. Earning meager incomes, the people are forced to consume cheap liquor, which sometimes has extremely dire consequences (Dempsey, Bird & Hartley, 1999).
In India, illicit liquor is a very profitable business, because the bootleggers pay no taxes. They work in homes, mostly in the rural areas, where they can transform a genuine liter of alcohol into 1000 liters of bootlegged alcohol (Rayman, 2006). The concoction is laden with chemicals and additives that usually cause no immediate harm but occasionally may lead to disaster. For example in India, more than 100 people have died after consuming cheap alcohol that was laden with lethal chemicals (Sloboda et al, 1997).
Alcohol consumption is associated with a multitude of health consequences from diabetes to liver cirrhosis, and it is of particular concern for pregnant women, because it affects the growing child. The problem is magnified in the rural areas due to the inadequate health facilities that are mostly ill equipped. In America for example, research has found out that there is a higher prevalence of driving under the influence of alcohol in the rural areas than in the urban ones. This is directly linked to road accidents and other forms of mishaps. There is a direct link between alcoholism and psychiatric disorders, though more research needs to be done on the subject (Cronk, 1997).
The developing world has bore the brunt of the alcoholism menace due to the harsh realities and the people’s unfulfilled dreams, especially in the rural areas. This has forced many youth to either migrate to urban areas or stay and get high for the better part of their life (Rayman, 2006). Many young people in the developing world’s rural areas have fallen into the snare of alcoholism, which is effectively reducing their working and productivity potential. It has also been known to be rampant in some rural areas of West Africa where the men drink so much, until they forget to perform their conjugal rights. Research has shown that an adolescent habituated to alcohol may become impotent sexually as he grows up, thus spoiling the chances of even a normal married life (Fortney, 2004).
Both the rural and urban areas experience alcohol related problems. The consequences are greater in the rural areas due to limited access to substance abuse treatment (Cronk, 1997). The perceived social stigma associated with substance abuse treatment, geographical isolation and financial burden have really curtailed chances of treating alcoholism in the rural areas. In the developing world, some rural areas with a high prevalence of alcoholism do not even have general hospitals; not to mention, specialized hospitals for substance abusers. The lack of access to treatment facilities, high levels of illiteracy and reluctance of the abuser to seek help are some of the major factors leading to prevalence of alcoholism in the rural areas. The regulatory and legislative policy has not been seen to hold water, more so in the developing nations. The level of enforcement of the laid down laws is a mockery to the system, because it is usually marred by blatant cases of corruption. In Kenya, for example, police are known to get bribes from the sellers and in return, they leave them to their vices (Cronk, 1997).
Generally, alcoholism is a major social, economic and health problem in all the continents. It has been associated with innumerable ills; the main among which are accidental deaths, high incidences of suicide and broken homes. It is a malignant cancer that should be checked before it affects the whole society. People who are dependent on alcohol are predisposed to domestic violence, cannot sustain their jobs and usually have problems with the law (Rayman, 2006).
Thus, it is clear that feasible and sustainable community level approach to reducing the level of alcohol use especially among the rural youth should be employed (Hutchison & Blakely, 2003). It should be focused on formalized youth activities meant to educate, engage and improve the self image of the youth so as to reduce the incidence of alcohol abuse. This calls for a multifaceted approach that reflects the diverse backgrounds of the affected population. Moreover, community interventions should be developed with and for the rural communities through the use of local resources. Besides, it should be taken into account that programs that focus on peers are more workable in the rural areas than knowledge based approaches. Once diagnosed, three general steps can be followed in the treatment process. They include: intervention measures, detoxification and rehabilitation (Cronk, 1997).
In conclusion, it is evident that the alcoholism is a major problem that impacts negatively many sectors of the economy and also involves a heavy toll at an individual level (Rayman, 2006). In the rural areas, it is causing great harm to the people in terms of reduced productivity among the rural youth, community and domestic violence, and broken marriages and homes. Therefore, it is of paramount importance to come up with and implement sustainable, workable and long lasting solutions that can cure this malignant disease of alcoholism. Prevention, education, access to care and enforcement of drug laws is the key to curbing the menace of substance abuse in rural areas.