Where’s the policy to tackle alcohol abuse?

Dr Leslie Ramsammy
Dr Leslie Ramsammy

-‘self-restraint would do the trick,’ Ramjattan says

Almost three years after President David Granger promised measures to deal with alcohol abuse, a policy appears to be staggering to life but there is no clear idea when it would be fully developed and implemented.

In the meantime, Minister of Public Security Khemraj Ramjattan is urging self-restraint when consuming alcohol and said that people must understand that alcohol is bad for them. Speaking at the Customs Anti-Narcotic Unit (CANU) annual staff training recently, the minister echoed sentiments previously expressed by others. He said that it is time to change the existing alcohol culture which includes binge drinking and even encouraging minors to consume such beverages.

“…It has to do largely with how we cultivate our next generation. We sometimes feel that we could tell our young kids ‘come tek a lil drink’ and we have done two surveys, a school survey and a household survey that proves that children in Guyana start drinking at the age [of] 11 and Guyanese are the biggest binge drinkers in the entire Caribbean. When we tek one, we want two, then three, then four, five and so one. Then we get drunk,” Ramjattan said.

Khemraj Ramjattan

Over the years, there have been countless discussions about government’s approach to excessive alcohol consumption. The scourge has resulted in numerous health and social consequences including fatal accidents, domestic violence and murders. In December 2015, President Granger promised that measures would be put in place to deal with the “evil” of alcohol abuse, but to date, a policy is still to be articulated.

The president recently said that the Ministry of Public Health has in the forefront in the creation of the long-awaited policy. Quizzed about this, Ramjattan told Stabroek News that he was aware that the Health Ministry is working on a plan. He stopped short of saying what input his ministry will be making or has made. Efforts to contact Health Minister Volda Lawrence on the progress made thus far were futile.

There has been some discussion about raising the legal age for purchasing alcohol to 21 years. Ramjattan, when asked about this last year, had said that while he finds favour with such a proposal, it could be a hard sell to the populace.

“Moderate use of it can be allowed and that is the position of this administration but to go and start increasing to 21 [years]…and if we do it still goes on, what we gonna do, increase it to 30? The best policy is always the policy that teaches the individual community member, `hey lemme have self-restraint here’ and that self-restraint is gonna be the reason for the biggest dent in reductions in alcohol related incidents,” he told Stabroek News moments after speaking at the CANU event.

While noting that some find favour in moving the age from 18 to 21, the minister expressed the belief that “self-restraint more than making a new law to amend the law from 18 to 21 would do the trick.”

At present, the law prohibits anyone under the age of 18 from buying alcohol, although it also says that anyone over 16 years can buy or be given alcohol if it is to be consumed with a meal provided in part of the licensed premises that is not a bar. The laws also prohibit anyone under the age of 16 from being in the bar of any licensed premises. Although a significant number of sellers do not adhere to the laws, monitoring and enforcement is difficult for authorities.

The effects of excessive alcohol use continues to take its toll. Within recent weeks, two police ranks who were allegedly intoxicated, were accused of causing fatal accidents.

Asked whether there is any discourse with ranks about them drinking excessively, Ramjattan said that while he is aware of the various commissioners working under him doing so, it is always going to be “difficult to change attitudes and cultures.

“We have to become very disciplined in how we conduct our personal lives too…but then you got the fellow who would take a drink, very unfortunately [but] it happens,” he said. He urged that if a rank has too many drinks, he or she should either take a taxi home or ask another policeman to get behind the wheel. “But do not get behind the wheel in an intoxicated state,” he said. Ramjattan stressed that in “teking a chance,” accidents occur and in some instances, lives are lost.

At the CANU event, Ramjattan also make the point that everyone is “cussing down” when he tries to enforce the 2am curfew and wants to get permission to go beyond that time when there is a big show.

The Private Sector Commission (PSC) had urged several times that the 2am curfew be extended to 4 am on weekends and holidays but this was never entertained by Ramjattan, who had maintained that he was simply enforcing the law.

No strategy

Two Sundays ago, former Health Minister Dr Leslie Ramsammy, pointed out in a letter published in this newspaper that the Ministry of Public Health has no strategy to deal with the rising alcohol-use problem in Guyana. “Not only is there little or no focus on prevention of alcohol-related problems, but the Ministry appears to have abandoned all the education, awareness and treatment initiatives that were in place to deal with alcohol abuse,” he lamented.

Referencing data compiled by the World Health Organisation (WHO), Ramsammy said that because science has shown unequivocally that no amount of alcohol use is safe, he has “long insisted that certain strategies are required for the control of alcohol use.”

He said that besides education, and awareness and prevention strategies, there is need for alcohol taxation, similar to tobacco taxation, as one of the strategies to reduce alcohol use.

“I am hopeful, just as I was decades ago, that Guyana will summon the strength and moral courage to increase alcohol taxation and introduce strict age limits for the purchase and use of alcohol as part of a comprehensive strategy to control the use of alcohol. We need a robust public education and awareness programme, alcohol and substance abuse counseling programmes etc., but these initiatives must be anchored by an aggressive taxation and licensing legal framework for alcohol-use,” he argued.

Noting that he fully and unconditionally supports comments by the President that government will embark on a path to control the use of alcohol, he recalled, that during his time as Minister he had often urged that more be done to control the use of alcohol and to stop alcohol abuse.

Under his tenure, he said, a number of initiatives were developed to tackle alcohol abuse and to introduce prevention and treatment strategies. “But some of the initiatives, like increased taxation, did not find favour in our government, in parliament and in the public. Big alcohol, represented in Guyana by Banks DIH and DDL and other private sector entities, was opposed to some of the prevention strategies, not unlike big tobacco that did succeed in delaying action against tobacco. Just as I did with tobacco, so I am today giving unreserved support to the President and the government for action that control alcohol use in Guyana. He needs to start by demanding more action from his Ministry of Public Health. It is late already, but it is never too late,” he asserted.

According to Ramsammy, there is a responsibility to take comprehensive and aggressive action to minimise the ill-effects of alcohol, including, but not limited to heavy taxation policies. “A number of initiatives in public education and awareness, substance abuse counseling and treatment etc. that were introduced when I was Minister of Health have been thrown by the wayside. I urge the President, if he is serious, to investigate why these initiatives are no longer in place,” he said while adding that the initiatives that he started are not enough, but are a good starting point.

“It took us almost 15 years, but we succeeded last year in finally introducing tobacco control laws. We must do so now for alcohol. I expect push-back from big alcohol, just as we encountered with big tobacco,” he said. According to Ramsammy, no amount of alcohol is safe as its consumption negatively impacts health. “The plain truth is that the risk of mortality far outweighed any potential benefits of alcohol use,” he declared.

Pointing to a study conducted in 2016 which revealed that at least 3.3 million deaths globally are alcohol related, he said that in 2008, it was estimated that alcohol directly accounted for about 700 deaths annually in Guyana. “Alcohol plays an ugly role in deaths caused by suicide, motor vehicle accidents, other accidents, violence, HIV, TB etc. These are outside of deaths because of the potentiating role of alcohol in the non-communicable diseases such as cancers, diabetes, hypertension, hepatitis etc. Note also that alcohol is a major contributor in the transmission of HIV in Guyana and around the world,” he emphasised before adding that alcohol consumption is also linked to seven types of cancers.

Ramsammy disagree with some who say that small amounts of alcohol is healthy. “The widely held view that small amounts of alcohol have health benefits needs reviewing because whatever benefits alcohol use may have is far outweighed by the negative effects. This study makes it clear that the safest level of drinking is none,” he declared.