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应对印度酒精滥用危机:通过筛查和简短干预弥合医疗差距的迫切需求。

Addressing India's alcohol misuse crisis: The urgent need for screening and brief intervention to bridge the healthcare gap.

作者信息

Ghosh Abhishek

机构信息

Department of Psychiatry, Drug Deaddiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian J Psychiatry. 2024 Oct;66(10):887-894. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_785_24. Epub 2024 Oct 17.

Abstract

India faces a significant challenge with alcohol misuse, as evidenced by the national survey revealing that 57 million out of 160 million persons with alcohol use exhibit harmful or dependent patterns, necessitating professional assistance. The Global Status Report on Alcohol and Health (2018) indicates a rising per capita alcohol consumption in the Southeast Asian Region, with India contributing substantially. To address this, implementing policies and programs to curb hazardous alcohol use is crucial. Despite a shortage of mental health professionals in India, they remain the primary caregivers for those with alcohol-related issues. Only one in five individuals with problematic alcohol use can access professional help. I argue for adopting Screening and Brief Intervention (SBI) to bridge this healthcare gap. SBI is a concise, structured counseling approach that proves effective and scalable. It can be delivered by various healthcare providers, including doctors, nurses, counselors, and paramedics. Hence, it can be seamlessly integrated into primary care, emergency, and nonclinical settings. The efficacy of SBI extends to electronic formats, providing a scope of expansion through telehealth. The WHO advocates SBI by its SAFER initiative aimed at reducing negative alcohol-associated health and social consequences. SBI is effective across age groups, including adolescents and young adults, constituting most of India's population. Emerging evidence suggests that SBI is acceptable, feasible, and effective in the Indian context. Universal or targeted SBI can be a pivotal tool in achieving the Sustainable Development Goals (2030) and global commitments for noncommunicable diseases, fortifying efforts to prevent and treat alcohol misuse.

摘要

印度在酒精滥用方面面临重大挑战,全国调查显示,在1.6亿饮酒者中,有5700万人表现出有害或依赖模式,需要专业帮助,这证明了这一点。《2018年酒精与健康全球状况报告》表明,东南亚地区人均酒精消费量在上升,印度的贡献很大。为解决这一问题,实施遏制有害酒精使用的政策和计划至关重要。尽管印度心理健康专业人员短缺,但他们仍然是酒精相关问题患者的主要护理人员。在有酒精使用问题的个人中,只有五分之一能够获得专业帮助。我主张采用筛查与简短干预(SBI)来弥补这一医疗差距。SBI是一种简洁、结构化的咨询方法,已被证明是有效且可扩展的。它可以由包括医生、护士、咨询师和护理人员在内的各种医疗服务提供者提供。因此,它可以无缝融入初级保健、急诊和非临床环境。SBI的功效延伸到电子形式,通过远程医疗提供了扩展的空间。世卫组织通过其旨在减少与酒精相关的负面健康和社会后果的SAFER倡议倡导SBI。SBI在包括青少年和年轻人在内的各个年龄组中都有效,而青少年和年轻人占印度人口的大多数。新出现的证据表明,SBI在印度背景下是可接受、可行且有效的。普遍或有针对性的SBI可以成为实现可持续发展目标(2030年)和全球非传染性疾病承诺的关键工具,加强预防和治疗酒精滥用的努力。

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