Taking aim at alcohol abuse

The government will try to reduce excessive drinking in Japan, according to a draft plan to be endorsed by the Cabinet in May. The government says it will establish at least one medical institution specializing in alcoholism in each prefecture, while setting numerical targets to reduce the lifestyle-related diseases that result from heavy drinking. The initiative, while welcome, comes late in a country where alcohol-related health problems are all too common.

The government plan is good, as far as it goes, but remains insufficient to counter the devastating effects of widespread alcohol abuse. A health ministry survey in 2013 estimated that 800,000 people are seriously addicted to alcohol and nearly 10 million people have a potential dependency problem. The number of those receiving treatment is less than 50,000.

The government wants to reduce the percentage of excessive drinkers among male adults to 13 percent by fiscal 2020, down from 15.8 percent in 2014. It also seeks to lower the percentage of female heavy drinkers to 6.4 percent from 8.8 percent. These targets are achievable, but far from enough.

Alcohol is involved in approximately half of all traffic deaths every year. Among middle-aged men (45-54 years old), 34 percent of all sudden or violent deaths are alcohol-related. Heavy alcohol consumption contributes to liver disease, esophageal cancer, diabetes and cardiovascular disease. The government targets would make only a small dent in these problems.

Better funding for local mental health and welfare centers is an important start, but the government needs to ensure that more local health centers specialize in alcohol treatment, or are equipped to help patients get the treatment they need. Family members, colleagues, classmates and friends are usually the first to intervene with heavy drinkers, but they need convenient, accessible facilities where they can bring those in need of treatment. Greater research into effective treatment programs, drugs and therapies, as well as a larger database on alcohol-related issues must be built, so that treatment can become more effective.

Universities also need to ensure that excessive drinking doesn’t become a habit among students, who gain the right to drink at age 20. Recently, cheaper chain restaurants, where student drinking parties usually take place, have started to check the age of young drinkers more strictly. In the past, almost all students could drink freely from the age of 18. That is a welcome change, but universities should ensure that their student activities are more about socializing and less about heavy drinking.

Alcoholism and heavy drinking are a huge burden on the health care system. This long-term cost could be reduced through better treatment facilities and public education. The government needs to set stricter targets and find sufficient funding if it is really going to reduce the problem.

  • Christina Tsuchida

    I wish people would DEFINE “heavy drinking.” I know what alcoholism is, but some websites say heavy drinking is anymore than 2 drinks (viz., two 350 ml beers, or two glasses of wine, or two high-balls) per day, where as others give a far laxer definition. Both versions happened to be from USA.

    • solodoctor

      The World Health Organization defines heavy, problematic drinking as any intake which causes problems in an individual’s social, occupational, psychological, or physical functioning. These include such things as conflicts with friends or family or an arrest related to alcohol intake (social); absenteeism or poor work performance; mood swings, depression, decline in mental functioning like memory blackouts (psychological); health problems like an ulcer or liver damage.

      Any ONE of these is enough to consider that the individual is a ‘heavy’ or problem drinker. The amount he ormshe drinks is only of secondary importance. Itmismthe impact of the drinking onnthe person’s life which is primary.

      • Christina Tsuchida

        This is like my uncle’s response to our childish request to teach us how to sort male and female kittens:
        “You call it and if HE comes, it is a male; if SHE comes, it is a female.”
        Viz., it begs the question.
        Solodoctor fails to give the clues for catching not alcoholism, but heavy drinking before it gets too bad. If someone’s liver is already bad, that is an obvious sign of too much alcohol. IF however one does not yet have proof of ill organs, or psychic problems (exc. normal ageing forgetfulness), how much should he reduce his intake? If he can work one night without any drinking, is he free of alcohol-dependency?
        In Japan, sake is praised in unfettered songs! Elderly relatives say it is good without question, even as they criticise prescription medicine!
        Many conditions have multiple causes: headaches and insomnia, to give just 2 examples, MAY be linked to sake, or not. If one has no guidelines as to what constitutes heavy drinking exc. AFTER the diagnosis, what can one do on one’s own? How can family help?

  • arne bartzsch

    Promoting facililties to help people with alcoholism certainly is a good thing. However, again this discussion seems to avoid the real root of the problem: the Japanese culture of alcohol and social drinking! Why picking on student`s desire to get wild sometimes (of course, this too IS a problem), when huge parts of the Japanese society are celebrating their daily drinking-routines – in private, with family, with collegues…
    You can see whole neighborhoods with permanent alcoholic level. Alcoholism in Japan is absolutely widespread, common, normal – and not being talked about !!!
    Maybe it-s time to face this fact. To put this problem on prominent place in media. To change societies attitude towards alcohol(ism). And start with banning beer-advertizement in public…for example.

  • solodoctor

    Alcoholism is a progressive and chronic disease. This means that it evolves and worsens over time if it is not treated.. The earlier in the progression that it is recognized and treated the greater the likelihood that treatment can succeed. Thus the greater the savings for society in terms of things like domestic violence, health problems like GI and liver disease, lost hours at work, and depression leading to suicide.

    Front line responders include spouses, employers, and medical personnel. If people are better informed about what to look for and how to intervene, they can often motivate the alcoholic to get treatment. This requires very active and ongoing programs of education via public service announcements, television dramas, etc. Medical personnel need a lot of training on how to evaluate and refer individuals abusing alcohol to treatment.

    All of these things require time and money. Is the government willing to invest in efforts that will gradually but ultimately reduce the costs that alcohol abuse inflict on society?

  • Dan

    Err nomi hodai? Encouraging first time 20 year old drinkers to drink as much as they can in 90 minutes and providing a vomitarium is not exactly setting them up for a lifetime of responsible drinking.

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