Liberal culture, cheap liquor, stress feed alcoholism in the army ...

The malaise

The army's top brass has recognised alcohol abuse as a problem.

Studies show that 2 out of every 1,000 officers and 8 out of every 1,000 jawans have alcohol-related problems

Current army orders discourage holistic treatment for alcoholics

Easy access to alcohol at subsidised rates has compounded the problem

What the Army docs order

Set up deaddiction centres in Pune and Delhi.

Adopt a more humane approach. Scrap the army's existing orders that dismiss alcoholics who have had a single relapse.

Decrease the monthly quota of alcohol available through canteens.

Involve self-help groups like Alcoholics Anonymous in the rehabilitation process.

Better man management to curb stress.

An apple a day keeps the doctor away. But that's for the civilians, senior officers would most likely tell young rookies in the army. A soldier needs a peg or two to keep him in good cheer and stay fighting fit. The departing British military left behind even their slang: the chhota and Patiala pegs are part of the folklore of several regiments. Nothing enhances camaraderie in the army like free-flowing liquor—free-flowing because of the subsidised rates it's available at—whether it's on festive occasions like Holi when officers and jawans share a drink, or merry evenings at the mess. Social drinking is considered a stress-buster in a force that often has to operate under considerable pressure in inhospitable conditions.

But what happens if the men in uniform take drinking beyond social levels, and become alcoholics? Old-timers will tell you that there were only stray instances "in their time" when an officer or a jawan would have to be treated for alcohol dependency. Never was it perceived as an area of concern. Now, alcoholism has been officially identified as a "problem", one that the army needs to address on an urgent basis.

The recognition that alcohol dependency among officers and men was increasing at an alarming rate came at the biannual commander's conference last October where the top brass were in attendance. Soon after the meet, the adjutant general's branch at army headquarters—responsible for all welfare measures in the army—shot off a letter (HQ letter No. 76025/GDMS-5A dated December 1, 2006) to the Army Base Hospital, Delhi, asking it to come up with proactive solutions to the problem of alcoholism.

How acute the problem is can be assessed from a medical paper authored by a senior army doctor. The data published therein shows that 2 out of every 1,000 officers are dependent on alcohol while 8 out of every 1,000 jawans showed symptoms of alcoholism. Statistics collated over the last four years clearly establish that the army has the highest number of serving personnel who were hospitalised due to alcohol abuse with the navy coming a close second. The air force reported the least number of cases. The army also had the highest number of officers and jawans who had been "boarded out" (dismissed) because of alcohol dependency.

Official figures, however, seldom reflect the full extent of the problem. Many cases go unreported to army hospitals, and those having a drinking problem do not come forward to seek help. This is because orders issued by army headquarters in 2001 (and then revised for officers in 2004) are pretty cut-and-dried: if personnel are found to be alcohol-dependent, they get only a single chance to kick the habit. In case of a relapse, they are boarded out of the army on medical grounds.

Army doctors, therefore, recommend a less harsh approach which would encourage an officer or jawan to seek medical help at an early stage.

Currently, alcohol dependency is not reported since it is feared it would lead to an officer or jawan being dismissed from service. And when he is finally admitted to hospital he is already at a stage when a relapse is inevitable. Incidentally, once admitted for alcohol dependency, the dreaded AFMS-10, popularly known as 'Form 10', is invoked to isolate alcoholic personnel, and initiate action for immediate dismissal from service if they have a relapse. In other words, it is assumed straightaway that the patient will not recover.

As a solution, the Army Base Hospital, Delhi, came up with a report as a follow-up to the note from the adjutant general's branch. Accessed by Outlook, it details the following three recommendations:

* Scrap the army's existing orders that seek to dismiss personnel who have had a single relapse.
* Reduce the quantity of alcohol issued to officers and jawans at subsidised rates.
* Set up two dedicated deaddiction centres in Delhi and Pune.

The recommendations submitted to army headquarters advocate the need for a holistic solution to the problem. The medical fraternity within the force thinks the army must first accept the causes that lead to alcohol abuse. These have been spelt out thus in the report:

* The permissive culture of the armed forces that encourages a person to drink.
* Service conditions like fighting insurgency, high altitude postings, prolonged isolation from family, inability to attend to domestic issues contribute to depression and over-indulgence in alcohol.
* Easy availability of alcohol at subsidised rates. (Over and above what is consumed in the mess, officers have access to a monthly quota from the canteen which goes up with each rank.)
* Delay in referring persons with a drinking problem for psychiatric help.

The fear of Form 10 is reflected in the sharp fall in the number of cases where army personnel have voluntarily reported their drinking problems. However, the number of cases of forced hospitalisation have gone up. According to the report submitted by the Base Hospital, Delhi, while the ideal way to treat cases of alcohol dependency would be to take into account "the inherent propensity of these disorders to relapse during the course of the illness", the current approach is "mostly adversarial, judgemental, arbitrary and punitive". But these observations are in direct conflict with the existing army rules, which clearly state: "It is not in the organisational interest of the army if a large number of officers are alcohol/drug dependent and still continue to stay".

Senior army doctors welcome the setting up of the two proposed deaddiction centres in Delhi and Pune. This, they say, is an urgent requirement because alcoholism in the army has thrown up a host of other problems that have serious repercussions. "Most of the cases of fragging (killing of fellow soldiers) have been found to be committed under the influence of alcohol. But it is an unwritten policy in the army to keep this fact out of the court of inquiry," a senior officer told Outlook.

Army headquarters is yet to take a decision on the setting up of the deaddiction centres, which insiders say would cost less than Rs 50 lakh each. Meanwhile, other issues need to be addressed immediately. For instance, a mandatory evaluation of personnel with illnesses which are likely to be caused by alcohol abuse and delinking the treatment of alcohol abuse from other psychiatric illnesses to avoid any stigma.

Defence minister A.K. Antony wasn't exactly talking about the alcohol problem in the army when he asked his army commanders "to embrace austerity and shun profligacy" last week. But it could well be applicable. Time-honoured traditions and social drinking are quite alright, as long as you are in a state to say no to that extra Patiala peg.

Outlook India