Attainment of complete mental and social well-being; the need to regulate alcohol consumption in Ghana

In response to the catastrophic events of the 2nd World War, global leaders came together to form the United Nations (UN) in 1945 with a shared goal to prevent future wars and human rights violations.

The UN, recognizing the importance of health in achieving world peace and security, established the World Health Organization (WHO) as a specialized agency responsible for global health.

The Constitution of the WHO, which entered into force on 7th April 1948, embodies the core principles upon which the organization was founded.

Among them are the fundamental right of every individual, without distinction, to the highest attainable standard of health and the recognition of health as a state of complete physical, mental, and social well-being.

Throughout the history of the WHO, society has tended to prioritize physical health over mental health, even though both are equally important. Mental health is central to overall well-being, from childhood to adulthood.

A state of good mental health encompasses a complex relationship of emotional, psychological, and social factors influencing how we think, feel, act, and make decisions.

Good mental health makes us more productive in all aspects of life. Similarly, poor mental health is also caused by a combination of factors.

One common factor that prevents a person from enjoying a high standard of mental health and social well-being is excessive alcohol consumption.

Every country must regulate alcohol consumption because of the array of negative effects it produces. However, most African countries lack robust regulatory frameworks to control alcohol intake.

Although a complete ban on alcohol consumption may be extreme, I argue for stricter regulations to control alcohol consumption in Ghana.

I advocate for carefully crafted and enforced legislation that allows alcohol to serve its social purpose while minimizing the adverse effects of excessive drinking on individuals, families, and society.

Alcohol marketing companies, in the absence of an effective regulatory system, often urge people to drink “responsibly” or in “moderation” without defining what those terms mean in quantities or practical terms.

Understanding Alcohol
Alcohol has different meanings to scientists, especially chemists, compared to the general public. To chemists, alcohol refers to a class of chemical compounds with distinct characteristics.

However, for the average person, alcohol is a social drink that produces specific effects on the body. Among the class of alcohol, only ethanol is associated with drinking.

The other types are not suitable for human consumption. So in this article, the term “alcohol” refers exclusively to ethanol.

Alcohol is a drug as it can alter the functions of a person’s body and mind. In fact, at a certain point in history, alcohol was used for therapeutic purposes.

For instance, Sumerian physician-pharmacists (in modern-day Iraq) prescribed beer for patients around 2100 BC. It remains one of the most commonly abused substances in the world. Alcohol and society have a long-standing relationship.

The significance of alcohol is evident in the variety of customs it is associated with. It plays a central role in social ceremonies such as marriages, births, funerals, enskinment, soothsaying, worship, war, and other celebrations.
Negative Effects of Alcohol .

Misusing alcohol affects not only the consumer but also the health and happiness of the people around him. Harmful use of alcohol constitutes the third leading cause of poor health globally.

More than 200 health conditions such as liver diseases, road injuries, cancers, cardiovascular diseases, suicides, and tuberculosis are linked to the harmful use of alcohol. In 2016, the harmful use of alcohol resulted in approximately 3 million deaths globally.

In 2022, 7.3% of Ghanaian men had alcohol use disorder, a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.

A common misconception about alcohol is that it is a stimulant, as it can make people feel less shy, more pleasant, and more friendly.

However, this is not the case. Modern science has proven that alcohol is a depressant. It depresses brain and spinal cord functions, slowing down brain activity.

People feel and act the way they do when they consume alcohol because it inhibits the part of the brain that controls impulsive behaviour, making them act out of self-control or restraint.

As a nervous system depressant, alcohol negatively affects physical abilities, coordination, mood, behaviour, memory, attention, and clear thinking.

Continued consumption of large quantities may affect other body organs such as the liver, gut, and heart, leading to difficulty in breathing and death.

The physical manifestations of excessive alcohol consumption are decreased productivity, increased accidents and injuries, spousal violence, inadequate parenting, child abuse, neglect, and financial imbalances. Even a single episode of drinking can result in adverse outcomes.

Regulation of Alcohol Consumption
The regulation of alcohol dates back to ancient times. The Code of Hammurabi, the oldest known legal code on alcohol, regulated drinking establishments in Babylonia around 1770 BC. In recent times, the WHO, in recognition of the need to limit alcohol consumption and promote social and mental well-being, launched a global strategy in 2010 to address excess consumption of alcohol.

The strategy underscored the responsibility of Member States to formulate, implement, monitor, and evaluate public policies to reduce the harmful effects of alcohol.

Despite global efforts, domestic rules governing alcohol consumption are inadequate. The current law, the Liquor Licensing Act (Act 33), was enacted about fifty-five years ago.

It is no longer suitable to deal with contemporary challenges. About seven years ago, the Ministry of Health launched the National Alcohol Policy (2016).

The policy established an alcohol commission to regulate alcohol consumption in Ghana. But little progress has been made after the launch.

The Ghanaian market is replete with various alcoholic drinks including locally brewed beverages, beers, wines, and spirits with varying alcohol content.

For instance, spirits and whiskies can contain up to 90% pure ethanol, while even the locally made drinks like pito, brukutu, and palm wine, which are mainly consumed in rural and periurban settings and considered less intoxicating usually contain 2–4% pure ethanol, sufficient to alter the state of mind of a person. Akpeteshie may contain up to 45% of pure ethanol!

Strategies to Regulate Alcohol Consumption
The WHO has prioritized the implementation of alcohol control policies as a tool to reduce alcohol-related harm and improve public health outcomes.

Strategies such as alcohol pricing and taxation, controlling physical availability, regulating alcohol marketing, and implementing drink-driving policies have been proven effective in controlling alcohol consumption, as explained below.

Firstly, high taxes on alcohol will lead to an increase in the price of alcohol, at least beyond affordability for minors.

Secondly, regulating the place and number of sale points for alcohol offers the double advantage of reducing the density of alcohol outlets and preventing the establishment of outlets near institutions such as schools and hospitals.

In Ghana, alcohol can be sold, bought, and consumed on any day and at any time and place. Limiting the number of places, days, or hours that alcohol can legally be sold, purchased, or served and consumed will effectively reduce physical access to alcohol.

Thirdly, holding businesses that retail alcohol to high standards of responsibility and accountability by enacting laws that fix liability on them for injuries, harm, or death caused by intoxicated customers will have a cascading effect on reducing excessive alcohol consumption.

Finally, enacting and enforcing laws that prohibit the sale of alcohol to minors, pregnant and lactating women, and drivers of motor vehicles and tricycles can limit access to alcohol.

The minimum legal drinking age in Ghana is 18. Considering that children aged 18 are still in school, it should be revised upwards to at least 21.

These strategies, when implemented effectively, adapting them to suit the local environment, will drive demand downward, consequently reducing consumption levels.

Challenges to Alcohol Regulation
Despite the benefits attributable to alcohol regulation, several obstacles must be overcome, such as resource constraints, inadequate legal regimes, lack of support for policy implementation (especially at the local level), low priority given to policy implementation by responsible agencies, and insufficient skills among law enforcement officers.

The good news is that these challenges can be minimized by enacting progressive laws, establishing monitoring systems, generating local evidence to support policy implementation, and engaging implementing partners at an early stage.

Conclusion
The harmful use of alcohol can wreak havoc on individuals, families, and society. It is a substance that should be strictly regulated.

Despite the challenges that alcohol regulation may pose, the benefits are immense. Government, parliament, civil society, and all stakeholders must spearhead the implementation of effective alcohol control laws and policies, in fulfilment of the requirement for member states of the WHO to stem the harmful use of alcohol in their countries.

Regulating excessive alcohol consumption is the sine qua non to the achievement of sound mental health and social well-being for everyone living in Ghana.