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 International Journal of Science and Healthcare Research
Vol.5; Issue: 4; Oct.-Dec. 2020
Website: ijshr.com
Review Article ISSN: 2455-7587

Alcohol and Alcoholism in India; A Historical

Review
Saji Joseph1, Hemalatha K2
1
PhD Scholar, 2Associate Professor,
Department of Social Work, Christ University, Bangalore, India-560029
Corresponding Author: Saji Joseph

ABSTRACT made microscope by a Dutch draper named

Antonie van Leeuwenhoek who is also
Ancient Sanskrit texts give sufficient evidence known as the father of microbiology. But he
on the presence of alcohol in ancient India. As did not consider them as living organisms
alcohol, including distilled liquors, was widely that are responsible for making alcohol. A
available, overindulgence was part of the
problems of the ancient societies. Exploring
century later, in 1789, Antoine Lavoisier, a
history redefines the notion of seeing the evil of French chemist, explained the chemical
alcoholism as entirely an import from western process of fermentation for the first time.
culture. Alcoholism and related problems were Almost 50 years later, in 1837, a German
existing throughout the history of India. There chemist named Franz Julius Ferdinand
were three distinct approaches used to tackle Meyen isolated a genus of yeast and named
alcoholism; moral-suasion, legal-suasion, and it 'saccharomyces,' meaning 'sugar fungus.'
medicine. Connections can be established Only in 1870, the fermentation was
between some of the current evidence-based demonstrated as a process in which the
approaches with some of the practices from living organisms, yeast, transforming
ancient India. The earliest medical explanation glucose into ethanol by the French chemist,
on alcoholism can be seen in Charaka Samhita,
an Ayurveda text compiled before the second
Luis Pasteur.[4-6]
century AD. Ayurveda, one of the traditional There are various imaginative stories
Indian system of medicine, still remains an on man's first encounter with alcohol. The
unexplored treatment for alcohol other story narrated in Jātaka, the ancient
substance use disorders. This historical review collection of Buddhist tales, goes as
brings clinically relevant insights for the follows; A forester named Sura, who used
present-day addiction professionals and to go to the Himalayas in search of
researchers. merchandise to sell, found a tree with a
hollow as big as a wine jar. When it rained,
Keywords: History, Alcoholism treatment, the hollow was filled with water. Two
Alcohol use disorder Myrobalan plants and a pepper shrub grew
around it, and their ripe fruits fell from in
INTRODUCTION that tree hollow. There was a self-grown
As Keller paraphrased the famous rice field not far from this tree. Birds used to
biblical quotation, "In the beginning there pluck the rice from there and eat sitting on
was alcohol!"[1] Before alcohol, a unicellular this tree. And while they were eating, rice
microorganism called Yeast existed. These and husk fell to the tree hole. The water,
magical creatures belonging to the fungus filled with fruits and rice, fermented and
kingdom had evolved from multicellular turned to blood-red color. In hot weather,
ancestors several million years ago. [2,3] flocks of birds, who were thirsty, drank
However, only in 1680, yeast globules were from it and got drunk, fell to the foot of the
observed for the first time using a home-

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 Saji Joseph et.al. Alcohol and alcoholism in India; a historical review

tree and, after sleeping for a while, flew death, causing misery to humankind. This
away chirping happily. It was the same for polarity of views towards alcohol can be
wild dogs, monkeys, and any creatures who seen throughout history. There were times
drank from it. On seeing this, Sura said: when alcoholic beverages were considered
"They would have died if it were poison, but the safest drink in some parts of the world.
they woke up after a short sleep and were Most European doctors warned of the
just fine; It is not poison." And he himself dangers of drinking water during AD 1500-
drank from it, and when drunk, he felt like 1800 and recommended total abstinence
eating meat, and then, setting the fire, he from water.[10] Alcohol was used as currency
roasted roosters and partridges and ate. in different parts of the world.
Enjoying the newly found drink and meat, There are probably no other
he stayed there for one or two days. There substances than alcohol that received the
was an ascetic named Varuṇa not far from amount of praise and condemnation from
here. He often visited him, and now he humankind. If alcohol prevailed in ancient
struck with the thought, "I will drink this societies, the chance is rare that they were
with the ascetic." He filled it in a bamboo not troubled by alcohol-related problems.
pipe and took it with some roasted meat; he Throughout history, there have been various
approached the ascetic and said:" Holy sir, attempts to understand and treat alcoholism
taste this." They both drank it along with the and other addictions. Addiction or
roasted meat. So, due to the fact that Sura Substance Use Disorders (SUDs), as it is
and Varuṇa discovered this drink, this drink known at present, is a convoluted problem.
was called by their names, surā and vāruṇī. Its complexity is such that even after
The story continues narrating about them centuries of research, scientists and
sharing it with other people and the king, clinicians are still unable to arrive at an
and later making it on their own.[7] agreeable conclusion on its basic nature
This story seems set in a civilized itself. This paper makes an effort to explore
society, but in reality, this happenstance how alcohol and alcoholism were viewed
might have occurred long before and treated throughout the history of India.
civilization. It is logical to conclude that
alcoholic beverages were discovered in Alcohol and alcoholism in ancient India
prehistoric times. The man might have Some historians suggest that ancient
savored alcohol accidentally for the first South Indians had knowledge of toddy
time when he ate some unattended fruits tapping.[11] Furthermore, the art of
that were fermented by the invisible wild distillation could be the gift of India to the
yeasts and soon endeavored to make it world.[12] Around 1500 BC, before the
wilfully. Archaeological findings traced the arrival of Aryans, the inhabitants of ancient
presence of alcohol thirteen millennia ago. India used to make the earliest distilled
A team lead by Li Liu from Stanford alcohol called pariśrut.[13] It must be
University traced the evidence of brewing in emphasized that the Indo-Aryans indulged
Raqefet Cave in Israel 13000 years ago.[8] in spirituous liquors, perhaps excessively.
There are various evidence for brewing and The potteries found during the Indus Valley
fermenting during the Neolithic period. A excavations indicate that Harappans had the
Chinese treatise from the eleventh century knowledge of distilling long before the
on wine concludes, "as for who was the first arrival of Aryans. [14,15] Whether the
one who invented wine, I can only say that knowledge of making spirituous liquors
it was a certain wise person."[9] There were existed prior or brought by Aryans, their use
times when alcohol was considered divine quickly became part of their ceremonial
and used as a medicine to treat almost all rites and rituals of every clan and tribe.
illnesses. The same alcohol was blamed for Soma, the spirituous liquor that is associated
various illnesses, social disorders, and with the Moon deity with the same name,

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 Saji Joseph et.al. Alcohol and alcoholism in India; a historical review

was praised throughout Rigveda Saṃhitā. surā.[19, 20]Kautilya lists twelve kinds of
Rigvedahas hymns that state that soma was alcoholic drinks, whereas Charaka's list
consumed by people freely and kept in contains at least 84 kinds.[15, 21] Two sūktas
leather bottles.[16] Having the same name for from Paippalāda-Samhita of Atharvaveda
the deity and the liquor, meaning having are entirely designated to explain the
both identified with one symbol, also preparation as well as the effects ofsurā.[22]
hinting towards our ancestors' passion Yajurveda also gives recipes for a few other
towards the spirituous liquor. The Rigvedic intoxicating beverages such as pariśruta and
hymns praise soma as 'celestial nectar' with masara. Pariśruta is prepared by fermenting
divine characteristics. Thus the very first certain flowers and fruits, whereas rice and
impression Aryans had might be that spices were used to ferment masara.[23]
alcohol is divine. Soma is considered the Though there are positive references
holiest offering in the ancient Indian towards alcohol in the ancient texts, the later
worships. The preparations for the Soma Vedic period prohibited drinking alcohol for
ritual known as somayāga begins with the gratification of the senses, stating, "wine
collecting the moon plant.[17] is unfit to be drunk, unfit to be given, unfit
"The plant, plucked up by the to be accepted" and sanctioned only
roots, collected by moonlight on the ceremonial use.[24] This shifting attitude
mountains, is carried on a car drawn towards alcohol from the divine to evil and
by two goats to the place of sacrifice, implementing strict rules on its consumption
where a spot covered with grass and during the later Vedic period itself is an
twigs is prepared, crushed between indication that habitual drunkenness or
stones by the priests; and is then alcoholism existed in Ancient India. A 2nd-
thrown, stalks as well juice, sprinkled century Tamil poem in the Sangam
with water, into a sieve of loose literature titled Maturaikkāñci mentions
woolen weave, whence, after the about the drunken villagers tottering on the
whole had been further pressed by the roadside.[21] Intriguingly, alcohol
hand, the juice trickles into a vessel or consumption was widespread among
kettle which is placed beneath. The women, and the available sculptural
fluid is then mixed with sweet milk evidence makes it indisputable that
and sour milk, or curds, with wheaten excessive drinking was common among
and other flour, and brought into a women in ancient India. As Varadpande
state of fermentation; it is then offered states;
thrice a day and partaken of by the "In ancient India, women used to
Brahmans. …It was unquestionably drink various kinds of wines and
the greatest and holiest offering of the liquors to enjoy themselves, celebrate
ancient Indian worship. …The Gods an occasion, enhance the pleasure of
drink the offered beverage; they long lovemaking and give company to their
for it; they are nourished by it and lovers, as a part of fun and
thrown into a joyous intoxication. merrymaking, even magico-religious
…The beverage is divine, it purifies, it rituals and worship of certain
is a water of life, gives health and deities."[25]
immortality, prepares the way to
heaven, destroys enemies, etc."[18] Early attempts to address alcoholism
It was not just soma, but there were Probably, habitual drunkenness was
several kinds of wine and liquors available approached first through moral-suasion
to them. The ancient Sanskrit literature has followed by legal suasion. As seen earlier,
mentions of different kinds of intoxicating the later Vedic period prohibited
beverages such as medhaka, prasana, recreational use of alcohol and sanctioned
maireya, ásava, arishta, madhu, soma and only for ceremonial purposes. A step

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 Saji Joseph et.al. Alcohol and alcoholism in India; a historical review

further, later, Sage Manu favored abolishing (Convolvulus pluricaulis) for five days (MS,
alcohol rather than confining its use. He 11.147).
opposed even ceremonial use and laid down Condemning alcohol and advocating
strict rules and severe penalties for drinking. to abolish it can be seen in other ancient
Removing the religious importance of scriptures. Similar rules and penance for
alcohol was a thoughtful step by Sage drinking spirituous liquors can be seen in
Manu. Manusmṛiti (MS)imposed severe the Dharmasūtras of Apastamba, Gautama,
restrictions for the twice-born (those Baudhāyana, and Vāsiṣṭha. Dharmasūtras
belonging to upper castes) on drinking are compilations of general laws or codes of
spirituous liquor.[26] Manu's expiation for a behaviors.[27] As in Manusmṛiti, these
twice-born who drank surā intentionally ancient law books are also puritanical
was to drink the same liquor boiled-hot till towards alcohol and impose strict rules and
his body gets completely cauterized to be severe punishments for drinking. Indulging
freed from the guilt of drinking (MS, 11.90). in drinking was seen as an activity of the
Also, for a Brahmin, deluging with Śūdras(the lowest-ranked caste).Liquor, as
spirituous liquor even once would forsake well as the herbs used for making liquor, are
his Brahminhood and become Sudra (MS, considered forbidden food for those
11.97). Manu warned that a Brahmin who belonging to the upper castes, and drinking
indulges with surā, after being through liquor makes them outcasts or sordid.
dreadful hells for long years, would be Similar to Manusmṛiti, the penalties for a
reborn as small or large insects that feed on man who is drunk include making them
ordure (MS, 12. 54 &56). drinking burning hot liquor and branding his
Drinking spirituous liquor was forehead with a tavern. Dharmasūtra of
considered one of the six causes of women's Gautama considers even smelling the breath
ruin (MS, 9.13). Manu permitted a husband of a drunken man as undesirable. If
to marry another woman if his wife drinks someone gets the smell of it, he is supposed
(MS, 9.80). Women were prohibited from to hold his breath and consume ghee.
drinking even at the festivals; if found, they Baudhāyana considered liquor breweries as
were fined six krishnalas (MS, 9.84). Manu impure while all the other factories as pure.
was against those who sell spirituous Vāsiṣṭha stated that half the body of a
liquors; he instructed, "let the king instantly Brahmin becomes outcast if his wife drinks
banish the sellers of spirituous liquors from liquor.
his town (MS, 9.225). Drinking surā was Though these codes of laws laid
considered by him a mahapapa meaning down such severe rules on drinking, it failed
mortal sin (MS, 9.235). If the drinker of to uproot the drink; however, they
surā unwilling to perform penance for his succeeded in bringing down drinking from
sin, he would be punished by marking the its sacrosanct status to an evil and
sign of a tavern on his forehead with a hot pernicious activity. [24] The problem of
iron (MS, 9.237), and Manu warned that the drinking continued, and indulging in alcohol
natural physical appearance of the drinker was looked down on as a moral failure.
would be changed as a consequence of the Another early landmark in addressing
crime of drinking (MS, 11.49). Even alcoholism in the country was the approach
touching the liquors was an acceptable act. proposed by the Buddha. The Buddha also
Manu also forbade eating food or water that propagated against alcohol and advocated
is kept near to spirituous liquors or in a total abstinence. One of the five precepts of
vessel used for storing the liquor. He Buddhism is
mandated that those who drink water kept in "Surāmerayamajjapamādaṭṭhānā veramaṇī
a jar that stored liquor in the past shall drink sikkhāpadaṃ samādiyāmi," meaning the
only milk boiled with Sankhapushpi pledge of abstaining from intoxicating
drinks. The eight-fold path taught by the

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 Saji Joseph et.al. Alcohol and alcoholism in India; a historical review

Buddha forbids selling alcoholic drinks as a alcohol sold depended on the character and
livelihood.[28] However, Buddha's approach the nature of the buyer, and only those with
was entirely different from Manu or the a reputation of having a good character were
other previous moralists. Instead of allowed to take alcohol out from the shop.
criminalizing and punishing the drinker, He ordered to arrest if anyone was observed
Buddha introduced a new tactic; with spending on liquor beyond their
approaching them with compassion. While financial capacities. Kauṭilya's Arthaśāstra
Dharmasūtras prescribed drinking hot made provisions to maintain liquor shops
boiling liquor to a drinker, Budha's against becoming crime spots. It was the
prescription was 'love'. As stated by responsibility of the tavern owner to
Hassan[24]; maintain order in his shop. He was supposed
"…Needless to say the guiding to observe carefully every visitor coming to
and propelling force of this crusade the shop. The tavern owner was held
rose from the teaching, the life, and responsible for compensating the loss in
the example of the Budha himself. case of any theft happens. A 5% tax was
And what were the weapons with levied on those who deal with alcohol other
which this crusade was waged? Were than that of the king. The superintendent of
the weapons those of terrorism, and liquor was entrusted to collect a daily tax
strict penances, and unending fasts, from those who were permitted to
and the drinking of hot boiling water manufacture on special occasions. [29]
or milk as prescribed by Manu? What The first-ever medical model of
cruel laws were imposed or what alcoholism was proposed by the 2nd-century
deterrent punishments threatened? We Indian medical scholar named Charaka. He
have seen how Manu and other made a clear distinction between excess and
legislators had failed to stamp out the moderate drinking. He supported drinking in
drink evil; how was it then that the moderation and warned about the harmful
followers of Buddha succeeded? What consequences of overindulgence. Charaka
witchcraft or black s Found magic did stated, "if the person takes it in the right
they use to cast such a spell over the manner, in the right dose, in the right time
people as has lasted to this day? It and along with wholesome food, in keeping
must be confessed that where the with his vitality and with cheerful mind, to
terrorism of Manu failed, the love of him, wine is like ambrosia."[23] Charaka
Buddha succeeded, for the weapons of named the disease of excessive drinking as
this crusade were the very essence of Madātyaya and Charaka Saṃhitā, the
Buddhism-a spirit of toleration with medical text that he compiled, has an entire
the erring; of sympathy with the weak; chapter (chapter 24) for the treatment of
a spirit of humanity, of love for all." alcoholism. [30]
Kauṭilya, the minister of Emperor Charaka neither moralizes
Chandragupta (321- 297 BC) framed alcoholism nor does any fear mongering. He
extensive laws to control the manufacturing, explains the benefit of moderate use of wine
sale, and use of alcohol in the state and and the harm accompanied by intemperance.
appointed Superintendent of Liquor. [29] The If someone wishes to drink, he suggests
superintendent was left with the power to drinking in 'wholesome,' i.e., "drink best
centralize or decentralize the sale of both wine along with various suitable fruits,
distilled and fermented alcohol. Liquor wholesome green vegetables, salted and
shops were allowed to function only in the seasonal food items; various roasted meat of
center of the cities. Kauṭilya has introduced terrestrial, aquatic and flying animals and
fines and taxes on alcohol. The offenders of birds and various edibles prepared by the
the law were charged with a fine of 600 team of cooks" (Charaka saṃhitā, 24:11-
panas (ancient Indian coin). The quantity of 19). To reduce the harm, he prescribes

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 Saji Joseph et.al. Alcohol and alcoholism in India; a historical review

different drinking methods to different types reduction approach where he opened several
of personalities based on tridoṣa (the vital bars under administrative supervision, and a
humors). He describes three stages of register was maintained to record the
intoxication, and at reaching the third stage quantity of alcohol sold to every
of intoxication, "the person becomes individual.[23] With regard to the drinking
motionless like a cut wood, his mind being habits of India during the Mughal period,
covered with narcosis and confusion, though Sing and Lal conclude with the following
living he appears as dead. He does not statement; "young and old, Hindu and
perceive the pleasurable senses nor does he Muslim, rich and poor, freely indulged in
recognize his friends. He does not get the two vices (wine and women) indifferent
enjoyment for which wine is taken..." to religious prohibitions or consequences, as
(Charaka Saṃhitā, 24:48-51). Charaka far as their means and health permitted
states, "In wine, there is etiology of them."
confusion, fear, grief, anger, death along During British rule, there was a slow
with insanity, narcosis, unconsciousness, and steady rise in the availability and
epilepsy and convulsion. ...That is why consumption of licit alcohol.[32]Excise
those knowing the defects of wine despise it policies implemented by the colonial
with all efforts" (Charaka Saṃhitā, 24:56, government significantly resulted in
58). increased consumption of alcohol. In the
There are three types of alcoholism year 1790, the English government began its
according to Charaka; Vātika Madātyay, excise regulations in Bombay.[33] During
Paittika Madātyay and Kaphaja Madātyay that time, a quart of mahua spirit cost only
and specific treatment for each of them are half a penny. The British imposed a tax on
explained in Charaka Saṃhitā. The it, justifying that an increased price for
treatment is designed based on the tridoṣa liquor would result in reduced consumption.
theory, and the major portion of the However, as stated by Bishop John F Hurst,
treatment includes medicated wines and a in his article, the real object of the British
specific pathya based diet that includes government in India was to "grind money
meat, vegetables, fruits and herbs. Charaka's out of a vice, and not to pulverize the
treatment was primarily moderation-based. vice."[33] With the aim to fill the treasury of
The treatment suggested by him was aimed the empire, they established government
at reducing ethanol consumption and distilleries called 'Sudder Still system'.
promoting the patient's overall health.[31] A However, this system failed to bring the
detailed description of alcoholism and its revenue the government wanted. Hence, the
treatment gives a clear indication that a new abkari system called Out Still is
considerable number of people during that introduced in 1876. The right of setting up
time were affected by alcoholism and Out Stills (stills outside government control)
related issues.[23] was sold to the highest bidders in auctions.
During the post-Gupta period (AD This new system was successful, as the then
750-1200), the habit of drinking has further Commissioner of Revenue exclaimed in his
spread to a significant portion of Indian report; "The expansion of revenue under this
society. Later, during the 13th century, system has been marvelous." The direct
emperor Alauddin Khalji tried to implement result of this system was increased
prohibition but failed as people found availability and consumption of alcohol as
several ways to procure it illegally. the number of distilleries increased, and the
Alcoholism continued to spread further, and successful bidders were allowed to distill
during the 16th century, the third Mughal anything and in any quantities. [33] Later,
emperor Akbar implemented a more efforts led by Mahatma Gandhi facilitated
practical way of regulating the consumption. mass temperance movements in India, and
His plan of action was that of a harm prohibition was found a place in the

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 Saji Joseph et.al. Alcohol and alcoholism in India; a historical review

Directive Principles of the state policy with health aspects of the country, and alcohol
the approval of the Constituent Assembly of use constitutes the major cause for
independent India.[34] admission to medical facilities.[39]
Article 47 of the Constitution of
India entrusts the states to take measures to Development of evidence-based
implement prohibiting the use of all harmful institutions and treatment
intoxicating drinks and drugs except for Earlier, individuals struggling with
medicinal purposes. However, the path addiction were treated in non-specialty
paved by the British- filling the treasury by centers such as prisons and asylums in most
taxing alcohol- was followed by many countries. The first mental asylum in India
Indian states. It is estimated that around 10- was built during the 15th century by
15% of the state's own tax revenue comes Mahmood Khilji in Madhya Pradesh.[40]
from liquor taxes, making it the second- During the colonial period, lunatic asylums
largest source of own tax revenue.[35] The and mental hospitals were built in Bombay
governments are also blamed for being (1745), Calcutta (1787, Madras (1794) and
influenced by a powerful alcohol lobby Bihar (1795).[41] The Bangalore Lunatic
through party memberships or exorbitant Asylum was established in 1847. As part of
donations.[36] At present, only in the states of the attempt to embrace the paradigm shift to
Mizoram, Nagaland, Gujrat and Bihar and treat mental illness as a medical condition,
the union territory of Lakshadweep have the asylum was renamed as 'Mysore
alcohol prohibition in force in India. Government Mental Hospital' in 1925,
which is now known as the National
Alcohol and alcoholism in Modern India Institute of Mental Health and
The National Mental Health Survey Neurosciences (NIMHANS, Bangalore).
(NMHS 2016) conducted by NIMHANS in The department of psychology was
2016 reported a prevalence rate of 22.4% established in 1954 and the Department of
for Substance Use Disorders in India. Psychiatric Social Work was started in
NMHS 2016 also reports a 4.6% prevalence NIMHANS in the year 1963. The De-
for Alcohol Use Disorders.[37] The Institute addiction center (now known as 'Center for
for Health Metrics and Evaluation, in its Addiction Medicine') started to function in
2017 report, ranks alcohol as the 8th most NIMHANS in 1992, i.e., after 145 years of
driving factor for disability and deaths its inception.[42] Another premier mental
combined in India. The most recent survey health institution, the Central Institute of
report published by the National Drug Psychiatry (CIP), Ranchi was established in
Dependence Treatment Centre, AIIMS, 1918, still does not have a specialization or
New Delhi (NDDTC) at the beginning of department of de-addiction/addiction
2019 states that 14.6% of the Indian medicine (according to the CIP website).
population uses alcohol, and the men to All India Institute of Medical Sciences
women ratio is 17:1.[38] The statistics (AIIMS) started a de-addiction centre in
published by them are alarming; it reports 1988.[43]
that almost 1 in every 5 Indian alcohol users A major breakthrough in the
needs professional help; in other words, 5.2 treatment of alcoholism was the
% of the Indian population between the age introduction of Alcoholics Anonymous
group of 10-75 needs urgent treatment. This (AA) in 1935 in Ohio by Dr. Bill Wilson
survey reports that 2.7% of the Indian and Rob Smith. AA provided a program
population is alcohol dependent. The based on mutual aid and spiritual principles.
findings from the 2016 and 2019 national The main components of AA were the
survey reports suggest that alcohol, along Twelve Traditions, Twelve Steps, Concept of
with other substances, has a significant Higher Power, Meetings and Sponsorship.
adverse effect on the social, economic and AA has promoted the disease concept of

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 Saji Joseph et.al. Alcohol and alcoholism in India; a historical review

alcoholism and the fellowship has grown Commission to assess the functioning of
internationally. It has helped not only the government and private mental hospitals in
people affected, but also helped in how different parts of the country. As per the
alcohol is viewed by the present report submitted by them, only 12 out of 37
generation.[44] Over the year, the fellowship state-run mental hospitals had separate
has grown to become the most known and substance misuse services.[50] In the 1999
universally available self-help organization. report, a suggestion put forward was to
Its basic text, The Big Book, has been build separate de-addiction units in the
translated into 70 languages from the government mental hospitals, but the
original English version, and the AA interim observation in 2006 and 2008 found
activity has reached over 120 countries with no further action being taken on it.[51] The
a total estimated number of 120300 assessment in 2916 reported that more
groups.[45] Several mutual support groups hospitals had specialized de-addiction
for other substances and fellowships for services but were understaffed, lacked
special populations emerged from the AA resources, and reported oversight from the
influence, and many of them are approved monitoring bodies.[52] The Ministry of
by Alcoholics Anonymous to use their Health and Family Welfare, Government of
twelve traditions and steps.[46] In India, the India, established the Drug De-Addiction
first meeting of Alcoholics Anonymous Program in the year 1988, through which
took place in 1957, in Mumbai. The Big dead diction centers were started in various
Book is available in twelve Indian government hospitals.[53]
languages.[47] At present, meetings and Currently, in India, the Ministry of
services of AA is available in almost every Health and Family Welfare and Ministry of
corner of India Social Justice and Empowerment are
The development of modern entrusted with leading the demand reduction
scientific psychiatry in India began in the measures, which also include treatment and
1960s, and it was highly influenced by the rehabilitation of individuals with substance
British and later the American psychiatry.[48] use disorders. As of 2017, there are about
The early psychiatry textbooks are from 398 Integrated Rehabilitation Centres for
England. Though substance use disorders Addicts (IRCAs) in the country.[54] Also, de-
were one of the leading public health issues, addiction services are available in most of
the various governments of independent the medical colleges and several district
India had ignored it for decades. However, hospitals. Outnumbering the government
alcohol and drug abuse have gained media facilities, several privately owned addiction
attention in the 1970s and 80s and created treatment facilities are operating in the
public awareness. The apparent need for country. The current system of addiction
community-based rehabilitation services led treatment in India involves out-patient based
to the development of several mental health brief interventions, medical detoxification,
NGOs like TTK foundation in Chennai in residential rehabilitation, substitution
1980 and TRADA-Total Response to therapies, and community-oriented
Alcohol and Drug Abuse in1987 in Kerala, interventions, and it relies mainly on
and few others in other parts of the country. interventions developed in the west.
The National Mental Health Treatment comprises pharmacotherapy,
Program was launched by the government individual psychotherapy, group-oriented
of India in 1882, aiming to make mental interventions and family therapy. There are
health services accessible to all, and in only three medications currently approved
1996, the District Mental Health program by the FDA for the treatment of alcohol use
was launched as an instrument to achieve disorder; Acamprosate and Disulfiram and
the NMHP goals.[49] In 1999, the supreme Naltrexone. [55] Psychosocial interventions
court entrusted the National Human Rights include motivational interviewing, cognitive

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 Saji Joseph et.al. Alcohol and alcoholism in India; a historical review

behavioral therapy, relapse prevention, community acknowledges that having a

trauma-focused work, dialectical behavioral holistic approach towards SUDs increases
therapy, twelve-step facilitation and the odds of a successful outcome.
recovery coaching. Recently, the wellness Interestingly, this shift has been brought by
aspects such as nutrition, exercise, and western researchers, as the Indian SUD
several holistic therapies are incorporated researchers focussed primarily on adopting
into the treatment. the western practices in the treatment
system of the country.
CONCLUSION An unexplored area that would
Reflecting on history confirms that significantly impact the treatment outcomes
hard-drinking is not entirely an import from is incorporating Ayurveda in managing
western culture. There is a general notion alcohol and drug addictions. Undoubtedly,
that the evil of alcoholism is a concomitant the oldest medical model of addiction is
of modernization and globalization. Though from Charaka Saṃhitā. What is more
they played a role in the recent changing interesting is that Charaka Saṃhitā is still
trends in alcohol consumption, there is considered one of the primary reference text
evidence of habitual drunkenness in ancient for modern Ayurvedic practitioners, and
India, and it has been prevailing in one form most of the treatments and procedures
or the other in our culture. It would be explained in it is still being part of the
logical to conclude that India had witnessed current practice. The traditional knowledge
alcoholism long before America and even of yoga and mindfulness has not been on the
Europe, as distilled liquors were part of country's mainstream addiction treatment
ancient India's recreational drinking long menu until recently. The main reason for it
before the western world acquired the art of is that Indian psychiatry was mostly, if not
distilling. Strict restrictions on drinking totally, influenced by western practices.
were imposed on drinking spirituous liquors Indian clinicians probably introduced yoga
early in India. Regulations such as imposing and meditation in the treatment centers after
liquor taxes existed on and off since the it is being tested and implemented in
time of Kauṭilya. Attempts were made to western countries. Currently, the Indian
prohibit alcohol during the time of Sage scientific community emphasizes yoga and
Manu. Charaka, during the pre-second meditation as supplementary therapies for
century CE, proposed the first-ever medical addiction treatment.
compilation of explaining and treating The central insight from this
alcoholism. Interestingly, his contributions historical review is that future research
are still considered classic and practiced in a should focus on exploring what Ayurveda
branch of medicine called Ayurveda in India can contribute to treating alcohol and other
and many other parts of the world. substance use disorders. The current
The approach to addiction has medical model has its challenges, such as
shifted from the war-on-drugs to the war- poor prognosis, the possibility of cross-
on-recovery and from a medical model to a addiction with prescription pills, and a high
holistic model. The western world has relapse rate. An Ayurvedic model of
already embraced this shift. Most of the addiction treatment can be reintroduced or
founding stones of the holistic approach to developed with research that would benefit
addiction are from ancient Indian the individuals and families who are
knowledge. The efficacy of ancient troubled with addiction and related issues.
practices such as Yoga and Meditation on The AYUSH Ministry of India has more
addiction is undisputable now. The latest in roles in initiating and supporting such
the list is a technique that is taught by the efforts.
Buddha called Vipassanā or, as it is known
now, mindfulness. Finally, the scientific

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