Earlier this month, 36 people died in Cuttack, Orissa after consuming liquor that contained dangerous levels of a toxic substance.
In December 2011 at least 150 people died in West Bengal and 15 in Andhra Pradesh — all after drinking liquor that was made illegally. Dozens of people are still in hospital in Orissa, some in critical condition and many others blind, thanks to what they drank.
What is Illicit Liquor or Hooch?
In India, the production of alcohol is heavily regulated. The alcohol industry has two sectors — Indian Made Foreign Liquor (IMFL) made by large, industrial houses and Indian Made Country Liquor made by small manufacturers. Both these sectors are licensed and regulated by the government. Illicit liquor is any alcoholic beverage that is made under unlicensed conditions.
What are the Alcohol Regulations in the Country?
Alcohol is highly taxed in India. Often, the tax is up to 50 per cent or more of the purchase price. The logic is that just as a smoker needs cigarettes and will buy them however expensive they are, so a drinker will buy alcohol regardless of the price. In most states, taxes from alcohol form about 10 per cent of the state’s total revenue. This makes legal liquor quite expensive, thereby creating a demand for cheaper alcohol.
Why do People Drink Hooch?
Illicit liquor is significantly cheaper than liquor sold in government outlets since there is no excise duty paid on it. A packet of hooch generally costs `10 for roughly half a litre, while legitimately produced alcohol would cost least `50 for the same quantity. For a daily wage earner, legal alcohol would cost about half his day’s wage, making it completely unaffordable.
Hooch is popular across the country, notably in Karnataka, Andhra Pradesh, Orissa, UP, Maharashtra, Bihar and West Bengal. With the drinking population rising every year, there is a huge demand that illicit liquor manufacturers are meeting. Farmers, daily wage and agricultural labourers, hawkers, construction workers and many others drink illicit liquor that is sold locally in or near their villages. The liquor goes under various names, depending on the part of the country it is made in.
How is it Manufactured and Sold?
Alcohol is made by fermenting a sugary or starchy substance. This is followed by distillation, to increase the alcohol concentration. In India, liquor is distilled into ethanol (the intoxicating agent) from sugar molasses, a residue of sugar production.
Illicit liquor is generally made in small batches in towns and villages across the country. Due to the necessity of avoiding the authorities and keeping costs to a minimum, sub-standard ingredients are usually used in the production of this alcohol. It is usually sold in polythene packets for easy transportation and distribution. In the recent Orissa case though, it is believed that the liquor was mixed with cough syrup and other medicines (Epee-carm and Concentrated Cinnamon) obtained from a pharmaceutical company.
The liquor is also often spiked with other chemicals in an attempt to make it more intoxicating — and this is where the trouble arises.
So What Causes Illness and Death?
Ethanol (or ethyl alcohol) is the active ingredient in alcohol — it is the intoxicating agent. It is a volatile, colourless, flammable liquid. A similar liquid called methanol (methyl alcohol or wood alcohol) is also sometimes produced during the fermentation process.
All human beings are exposed to methanol in some form or the other. It is the amount of exposure or consumption that can be tricky, as methanol is highly toxic to humans. For example, apple juice has about 0.2 to 0.3 per cent of methanol. But if pure methanol is ingested, as little as 10 ml can cause permanent blindness and 30 ml can be fatal. The minimal lethal dose is believed to be one milligram per kilogramme of body weight.
Manufacturers of alcohol usually take a great deal of care to remove methanol during the distillation process. But sometimes, makers of illicit liquor do not remove the small quantity of poisonous methanol that is produced, due to either lack of knowledge or inadequate facilities. Some makers deliberately add a mixture of ethanol and methanol (denatured spirit) to the alcohol to cut costs and in the mistaken belief that it will increase potency.
This is not always the case — many people drink illicit liquor and suffer no ill effects. But when people do drink illicit alcohol that has high levels of methanol, they fall violently sick.
How is Methanol Poisoning Diagnosed?
People who have consumed methanol through illicit liquor, may not realise they are ill at first. Initial symptoms are similar to those of intoxication, and many people do not seek medical help early on. Usually, symptoms occur 12-24 hours after consumption. The person may experience, headaches, dizziness, vomiting, stomach aches, lack of coordinated movement, blurring of vision and drowsiness. In some cases, seizures can occur. In the worst cases, the person can go blind or even die.
How Does This Happen?
When methanol is ingested by the body, it is broken down first into formaldehyde. The body then converts this formaldehyde into formic acid. The formic acid accumulates in the optic nerve — the nerve that carries visual information from the eye to the brain. It causes major damage to the nerve and this leads to blindness.
In some people, the poisoning can lead to heart failure, breathing problems, coma and death — as in the West Bengal case last year. Death can occur within 10 to 30 hours of consumption.
In the Cuttack hooch tragedy, at least six people suffered from vision problems and doctors said it was likely a few would become completely blind.
How is it Treated?
Prompt medical care is essential to treat methanol poisoning. Bicarbonates are given to the patient. These can sometimes help reverse vision problems, and also help decrease the amount of formic acid formed by the body. Antidote therapy and hemodialysis (to remove the methanol and formic acid from the body) are also used.
Methanol is not the only additive that is put into illicit liquor. Makers sometimes put in other chemicals such as organo-phospherous compounds, sulphur and ammonium chloride, metals such as lead and arsenic and even sedatives such as barbituates. In a few instances, even battery acid has been added to the liquor.
What has the Government Done?
India is one of the few countries that has prohibition (the banning of all alcoholic/intoxicating beverages) incorporated in the Constitution as part of its directive principles of state policy.
Article 47 asks the state to “endeavour to bring about prohibition of the use except for medicinal purposes of intoxicating drinks and of drugs which are injurious to health.”
Over the years, several states (including Tamil Nadu) have tried to bring about total prohibition, but all, except for Gujarat, have withdrawn it. One of the reasons for withdrawal in many states has been a drop in revenue.
Many states (the southern states and Maharashtra) have now banned the sale of country liquor, but implementation of this is far from perfect.
Makers of illicit liquor operate clandestinely, often out of village homes, warehouses and forests, making it difficult to prevent production and sales. In most parts of the country, making illicit liquor is almost a cottage industry, with practically every village having one or two illegal operations. The whole operation is kept low key to avoid visibility.
In West Bengal, at least 12 people were arrested in connection with the tragedy.
In Orissa, excise minister A U Singhdeo resigned, accepting moral responsibility for the tragedy. Several government officials were suspended, and at least eight people arrested in connected with the manufacture and distribution of the brew. The authorities also raided pharmacies across the district and seized bottles that were thought to contain illicit liquor
In the WB case the victims were mostly masons, daily wage labourers, hawkers and farmers, while in the Orissa case, they were mostly brick kiln workers.
It is estimated that over two-thirds of the alcohol consumed in the country is illicit hooch.