Keywords: Alcohol, Bitters, Alcohol Use Disorder, Addiction, abuse, Alcohol withdrawal symptoms, Nigeria.

Introduction.

Abuse of Alcohol and Bitters – Nigeria.  What is alcohol addiction? How much of alcohol do Nigerians take? What are Bitters drinks?

Alcohol is embedded in the Nigerian culture. It is used as a drink for socialization as well as for prayers and rituals. Alcohol consumption has continued to increase in Nigeria because people believe that it makes them feel happy. They also believe since St. Paul advised Timothy to take a little alcohol for the stomach, it must be good. Drinking out door in groups in pubs and clubs is an in thing for most Nigerians. There is a belief among Nigerians that a man who does not drink is capable of murder. So a man can take two bottles of red wine in a sitting.

Ten years ago, the drinks called Bitters were introduced into Nigeria. Since then, the drink has continued to gain popularity and different brands are now in the Nigerian market.

Most Nigerians, both those who consume alcohol and those who do not, are unaware of the complications of alcohol. Neither are they aware that alcohol comes in different percentages. For most, there is no difference between locally made gins and other forms of alcohol. The only difference there is to them is the price. Thus the need to educate the people about the abuse of alcohol and bitters in Nigeria.

What is alcohol addiction?                                

Alcohol use disorder:

Alcohol abuse, alcohol addiction and alcohol dependence are now known and called Alcohol Use Disorder (AUD). For someone to be said to have AUD, he must have at least 2 from this list. So you can do a self check from this list.

(a) Having to spend longer time than intended to drink. (b) Ever wanted more than once, to reduce or stop drinking. (c) Have spent a lot of time drinking or getting over the after effects of drinking. (d) Wanted to drink alcohol so badly than anything else. (e) Drinking takes preference or interferes with taking care of your family, or caused trouble at school or work. (f) Continued drinking despite the trouble it is causing. (g) Stopping activities that once gave you joy so that you can focus on drinking. (h) Having gotten into trouble because of drinking. (i) Continued drinking despite the health challenges it caused. (j) Having continued to increase the quantity of the drink in order to get the effects wanted (called tolerance). (k) Gets withdrawal symptoms whenever the effects of the alcohol starts to reduce.

What are alcohol withdrawal symptoms?:

When someone who has AUD suddenly stops taking alcohol or reduces the quantity, withdrawal symptoms set in. These symptoms include increased heart rate, raised blood pressure, excessive sweating and tremors or shaking of the limbs and body. There could also be convulsions or seizures and even death.

Apart from the physical symptoms there are also psychological symptoms such as depression and anxiety. There could also be sleep problems, irritability, hallucinations and agitations.

These withdrawal symptoms most often causes the person to relapse back into the drinking. And with the relapse, the dose or quantity will be increased.

What causes AUD?:

Genetic factor –

Here genetics comes to play. There is actually no single gene implicated in AUD, it is due to a combination of many genes. So if a parent, for example a father has AUD, there is likelihood that one of his sons will also have the problem.

Modeling –

 Just being around a family member who drinks often can predispose one to taking excessive alcohol. This is because of the way the alcohol is glamorized.

Age –

The earlier one begins to take alcohol, the more likely that the person will develop AUD. The risk is high if the individual starts consuming alcohol before the age of 15 years.

Mental health conditions –

 Those suffering from mental illnesses are more likely to have AUD. These mental illnesses include depression, anxiety and schizophrenia, as well as Post Traumatic Stress Disorder (PTSD), bipolar disorder, etc. This is because they use alcohol to self medicate the symptoms of the mental illness.

Low self esteem –

Those suffering from low self esteem and the need for approval are at risk of AUD.

Stress –

Those who are stressed also abuse alcohol to help them relax.

Peer pressure –

These will include the adolescents and the older persons. Everyone has a peer group that can form a sort of pressure group.

Trauma from Adverse Childhood Experiences –

These cause mental scars that can predisposed one to AUD. These people have been traumatized in their family setting during childhood. So they abuse alcohol feel better. If parents are unavailable to supervise the child’s behavior, or support the child, the child may feel abandoned. And this may be predisposed to AUD. So growing up from a dysfunctional home is a risk factor.

Socioeconomic factors –

 These include poverty, loneliness, etc. Such are factors for alcohol abuse. Poverty increases risky drinking while those in the high economic level are more at risk of alcohol abuse. This is because the rich can afford it and can have better access to media.

Cocktails –

Young people may mix alcohol with other substances of abuse. One such mixture is made of codeine, cannabis, tramadol, vodka, and juice or water, called gutter water.

The media –

These information outlets can pressurize young people into AUD. This is because they make use of young people in the media information and the glamorize drinking.

How much alcohol do Nigerians take?

Nigerians enjoy partying and when there are no parties to attend, they gather in clubs to drink alcohol and relax. Nigeria thus has a high level of the population who abuse alcohol. About 34.3% of Nigerians abuse alcohol. And men are twice more likely than women to abuse it. Even those in the rural areas are more likely to abuse it than the urban dwellers. So Nigeria ranks 27th globally, when it comes to adult alcohol drinking. Nigerians are also second in Africa among African countries for heavy episodic drinking. And alcohol is the most commonly used or abused drug in Nigeria.

Students:

Among students in a university in the north central region of Nigeria, 43.6% has consumed alcohol. But students in previous studies who had consumed alcohol ranged from 56.5% to 72%.  It is important to know that studies done in the northern states of Nigeria will give low prevalence of alcohol abuse. And those done in the southern parts of Nigeria will give high prevalence due to religious issues. Islam forbids alcohol.

In Delta state, 25% of their adolescents are dependent on alcohol, while in Portharcourt 30.6% of their secondary students abuse it.

Commercial drivers:

Among commercial drivers alcohol abuse is very high. The prevalence among these set of people in Nigeria is as high as 67.2%. And among these, 47% are heavy drinkers. In Lagos state 60% to 70% of commercial drivers drink and drive.

Among tanker drivers, 71.6% abuse alcohol. In a study in 2011, 32% of long distant drivers confirmed that they take alcohol before driving. At motor parks, these alcohol substances are sold as herbal concoctions against malaria, or treatments for back pains.

Locally produced alcoholic drinks:

These so called medicines containing alcohol are known as opachin, paraga, or fidibodi. Locally produced alcohol from the north are called pinto and burukutu. And from the south, they are called ogogoro, kaikai, akpuru achia and sapele water.

These local gins are consumed more by vigilantes, rebel groups operating in the Niger Delta areas, those involved in insurgencies, etc. Even commercial transport workers use them, where they are sold in motor parks.

What are Bitters drinks?

Ten years ago, the drink called bitters was introduced into the Nigerian market and has soon gained popularity.

Content:

The drinks labeled as bitters are made from very high dose of alcohol, different roots, herbs and flowers. The bitters drinks also contain tree barks and other plant parts.

Functions:

Bitters are claimed to treat malaria, suppress appetite, gives energy, increases libido, erection and sexual performance, etc. Some of these bitters are locally produced while others are imported.

Bitters are actually used in Chinese medicine and in other cultures that use herbs and roots for treatment. For the claims made by the manufacturers of Bitters, some are true. But for many of the claims, more research needs to be done to confirm them. And some of the herbs used maybe harmful to the human body, especially when combined with other medications.

Many Nigerians take the Bitters for the claims and because it is relatively cheap for what it does. Compared to one bottle of beer, one small bottle of Bitters can be bought for between 100 Naira to 500 Naira. And this one bottle of Bitters can intoxicate as 5 bottles of beer. So it is easily available to students, artisans and commercial drivers as it comes in small bottles of 100ml to 750mls. But some people take the bitters because they have AUD, they can easily hide the bottles and take them on daily basis.

Brand labels:                                                        

The bitters that can be found in Nigeria include Alomo, Action, Agbara, koboko, Baby Oku, etc.  Then there has always been the Campari spirit drink, that is drank by elderly people, and also Orijin bitters.

Adulterated:

Unfortunately many of these Bitters are adulterated. These adulterated versions contain ethanol and caffeine. And some may even contain cannabis as well. Ethanol is a toxic chemical that can cause cancer, coma and death.

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