Alcohol use in women in India has been on the rise owing to the changing sociocultural milieu.[1
] It is increasingly being recognized as a serious threat to their health and well being due to their unique, gender-based, physiological vulnerability factors.[2
] However, there is a gross disparity in our knowledge about the problem alcohol use in Indian women for want of literature focusing exclusively on them. The dearth is more deeply felt for the rural sector, where, apart from urbanization, factors such as culture play a major role in the use of alcohol. The current prevalence of alcohol dependence in men, as quoted by a National Household Survey (2000–2001) is 21%.[6
] On the other hand, the statistical data for women remain vague and unclear. It has been consistently reported to be less than 5%.[7
] But the unrecorded consumption and expenditure on alcohol remains still higher. Hence, addressing this issue in the rural women, a morbidity which is reversible, especially from the rural areas, becomes the need of the hour. This study attempts to highlight the problem alcohol use among the rural Telangana women, where many unique cultural beliefs exist in the background.
When we look at some of the rural studies on alcohol in the last four decades, we see a predominant representation of male use.[8
] A comprehensive analysis in both the genders, of the pattern of alcohol use and the socio-demographic details, was done in two phases in a rural study from Rajasthan in 1984.[14
] To the best of our knowledge, the first ever detailed work-up on female alcohol use was done by a Bangalore based study (1994) where a definite fourfold increase in the female registries with problem alcohol drinking has been documented.[15
] However, the women in the sample were mostly from the urban locale. A recent large epidemiological survey from Karnataka (2003) gives an elaborate account of female alcohol use in India, drawing the sample from both urban and rural districts. 58.6% of rural women in their sample were in the heavy drinking category compared to 40.4% of urban women. Overall, hazardous drinking was recorded in about 28% of women.[16
] A retrospective analysis of substance abusing women from North India (2005) has reported alcohol as the second commonest drug of abuse in their sample in which the majority were urban.[17
] To sum up, the above review brings to light the paucity of literature on rural female alcohol use despite the fact that heavy drinking is comparatively much higher among them. Based on our experience of attending on women with alcohol problems during the liaison with the medical speciality in our teaching hospital, which is located in a rural district of Telangana region, Andhra Pradesh, we started the work with the aim to identify the extent of the problem in the women of this region where Toddy use is culturally accepted. The dearth in the studies on problem alcohol drinking in rural women further motivated us to analyze the alcohol habit in this unexplored population. We also intended to observe the effect of intervention in the form of psycho-education regarding the problems of alcoholism. Telangana region of AP has 10 districts and has a population of about 24 million of which 73% lives in the rural areas.[18
] Our medical college hospital offers predominantly secondary and tertiary level of care catering to a population of about 50,288 from 38 villages under 9 subcenters around a radius of about 100 km.
To evaluate the prevalence of dependence and problem drinking among the rural women residing in the villages around our hospital, to observe the factors that led to dependence in this group and also to assess the role of brief intervention on their treatment seeking behavior.