2020 Punjab alcohol poisoning

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2020 Punjab alcohol poisoning
Date29 July 2020 (2020-07-29)
Location Punjab, India
Deaths121 [1]
Arrests54 [2]

The 2020 Punjab alcohol poisoning was an incident in late July and early August 2020, where at least 100 people died after drinking illegally-made toxic alcohol in Punjab, India. [3] Hundreds of raids were conducted in the three affected districts - Amritsar, Gurdaspur and Tarn Taran - along with several other places in and around the Rajpura and Shambhu border in Punjab. Forty people were arrested in relation to the incident. [4] Seven excise officials, six policemen were also suspended over the incident. [5]

Contents

Background

Prevalence of alcohol in Punjab

Drinking in India has always existed since the Vedic age. [6] According to a World Health Organisation (WHO) report, which revealed that more than 11% of Indians were binge drinkers. In Punjab, the number of people drinking far exceeds the average in India. [7] It is surprising that more than half of Punjabi men drink alcohol and the state also houses the highest proportion of children consuming alcohol. [8] The reasons why this phenomenon is so prevalent are that Punjabi's hold much pride and honour in their family name, they don't want to be seen as having a problem or as being weak, and alcohol is the one thing that helps them deal with everyday life. [9]

Reasons for the making and drinking of toxic alcohol

The WHO reckons that "unrecorded" alcohol makes up more than half of all alcohol consumed in India. Locally brewed liquor, for example, is not recorded or taxed in some states. A survey by the International Alliance of Responsible Drinking in 2014 found a large number of drinkers preferring country liquor or homemade alcohol, often counterfeit and contraband. [10]

One reason why illegal liquor is so popular is the huge unfulfilled demand for alcohol, which drives supply underground into an unregulated industry. India is the second biggest consumer of alcohol in the world, nearly one in every two bottles of whiskey brought around the world is sold there. [11] Because of the difference in the prices of IMFL liquor and illegal liquor, to limit consumption, many state governments impose excessive taxes on alcohol sales. [12] The state controls the alcohol industry in India, where the poor cannot afford licensed trademarks in government stores, but illegal liquor made in backstreet distilleries that sells for just 10 cents a litre, affordable even for the poorest. [13]

Investigation

The initial investigation revealed that the liquor contained methanol. [14] A Ludhiana-based paint store owner, allegedly responsible for the toxic liquor deaths revealed that he supplied the three drums of methanol, which were used to make the illegal methanol-based alcohol. [15]

Response by the government

To criminals

According to The Indian Express , properties of those culprits will be confiscated [16] [17] and the Amarinder Singh government was mulling the death penalty for manufacturers and suppliers of spurious liquor. [16]

Rajeev Joshi

Rajeev Joshi was responsible for the case of alcohol poisoning in Punjab. He was procuring various types of alcohol and spirits from Punjab and Delhi and this time supplied the three drums of methanol, which were used to make the spurious methanol-based alcohol. He was arrested late on 3 August. [18]

Ravinder Singh Anand

Ravinder Singh Anand of Moga had bought three cans of spurious liquor from the Ludhiana businessman. He was arrested before 3 August. [19]

Jaswant Singh and Balwinder Kaur

Jaswant and Balwinder have been notorious for the production and sale of spurious liquor. Jaswant Singh died after consuming his own distillate. Balwinder Kaur was arrested before 4 August. [20]

Harjit Singh and Shamsher Singh

Harjit Singh and Shamsher Singh are two key absconders of father-son duo from Pandori Golain in the hooch tragedy. They were arrested on 7 August. [21]

Other criminals

The number of arrests in the case had gone up to 40 as of 4 August, [18] and it had increased to 54 by 26 August. [22]

To officials

The state government suspended seven excise officials and sic police officials before 1 August. [23] [24]

To victims

On 1 August, the government announced a compensation of ₹200,000 (₹2 lakh) for each of the families of the deceased. [24]

On 7 August, Chief Minister Amarinder Singh announced an increase in the compensation from ₹2 lakh to ₹5 lakh to the kin of the deceased. He also announced a relief of ₹5 lakh to those who survived the tragedy but lost their eyesight. [17] [21]

Besides, Amarinder Singh handed over a cheque of ₹29,200,000 (₹2.92 crore) for 92 victim families of Tarn Taran to the deputy commissioner. [21]

Poisioning

In late July and early August 2020, 80 deaths [14] were reported in Tarn Taran district alone, followed by 12 from Amritsar and 11 from Gurdaspur's Batala in Punjab, India due to toxic alcohol poisoning. [3] The first deaths were reported in Amritsar district's Muchhal village on the night of 29 July 2020. [5] By 31 July 2020, the Punjab state had reported 39 deaths. [3] By 3 August, the death toll from poisoning linked to toxic liquor rose to 105. [14]

The number of dead reached 121 on 7 August, which included 92 from Tarn Taran district, 15 from in Amritsar district and 14 from Gurdaspur district. [1]

Impact on health

Methanol poisoning

Acute alcohol poisoning has high morbidity and mortality and needs to be considered seriously and instantly managed. Delay in treatment may cause complications, permanent damage, or death. [25]

Methanol is a sedative for central nervous system (CNS) which is potentially toxic. [26] Once people ingest excessive methanol, it will lead to methanol poisoning and severe consequences for health. Because it produces poisonous metabolites, it has many adverse effects on vision, and central nervous system, and the liver. Toxic metabolites accumulate more and have a more significant impact on health and sometimes poison to death. [27] According to the autopsy, methanol is stored in body fluids such as cerebrospinal fluid and bile. These fluids are in organs of the brain, spleen, and lungs. [28] Therefore, these organs are vulnerable to excessive ingestion of methanol.

Short-term health effects of methanol poisoning

The short-term manifestations of methanol poisoning begin within 0.5 to 4 hours after ingestion, increased heart rate, and the possibility of heart failure, including typical symptoms of gastrointestinal diseases such as vomiting, diarrhea, nausea or abdominal pain, and CNS inhibition (confusion and sleepiness). [26] The following are the physical symptoms of mild central nervous system poisoning. Patients manifest different symptoms such as headache, dizziness, blurred consciousness, balance disorder, convulsions, stiffness, coma-induced apathy, and worsening pronunciation and memory impairment. Severe poisoning manifests mainly in CNS. In the brain, methanol can cause diffuse edema, necrosis white and grey matter, atrophy, cerebral and intraventricular haemorrhage, optic haemorrhages, nerve lesions, and convulsions that may occur after edema of the brain. In severe cases, seizures of the brain can cause a coma. [27] [29]

Depending on the absorbed dose, decompensated metabolic acidosis occurs after a latent period of 6 to 24 hours. [27] It can also result in Visual disturbances such as blurred vision, enlarged pupils. With photophobia, diplopia, early or late blindness, and less commonly, nystagmus. [27] [29]

Complications

Complications of methanol poisoning include: [30]

  1. Metabolic acidosis
  2. Permanent visual deficits
  3. Parkinson-like disease
  4. Coma
  5. Respiratory failure
  6. Circulatory failure
  7. Complications associated with dialysis
  8. Death

Long-term health effects of methanol poisoning

Methanol poisoning damage is likely permanent. [31] Even after treatment, severe methanol poisoning can leave survivors with long-term complications, most of which involve the eyes or the central nervous system.

Long-term visual sequelae of methanol induced toxic optic neuropathy

Because of their high energy dependency, retinal ganglion cells and their axons, which compose the optic nerve, are particularly sensitive to histotoxic hypoxia induced by formic acid suppression of mitochondrial cytochrome C oxidase. The biochemical and morphologic alterations caused by formate poisoning are also seen in retinal photoreceptors, Müller cells (retinal glial cells), and cells of the underlying retinal pigment epithelium. The symptoms of ocular toxicity develop after a latency period of 8–48 hours or more in acute methanol poisonings, depending on the amount of methanol consumed, probable ethanol co-ingestion, and other circumstances. [19]

However, the symptoms of long term visual damage may persist in10-30% of patients. [18] This can involve peripheral constriction of visual fields and central scotoma, as well as diminished visual acuity, loss of colour vision, and blindness in severe instances.

Long-term central nervous system sequelae of methanol poisoning

Damage to the nervous system

Bilateral necrosis of basal ganglia, mostly of the putamen, with or without haemorrhage, and haemorrhagic lesions in the subcortical white matter are typical CT and MRI findings in acute methanol poisoning. [18]

Among other less typical MR findings in methanol poisoned patients there are also necrotic changes and haemorrhagic lesions in the globus pallidus, nucleus caudate, thalamus, cerebellum, brainstem, pons, cerebral cortex, and optic nerve atrophy. [18]

Cognitive impairment

Methanol poisoning is associated with executive dysfunction and explicit memory impairment, due to basal ganglia dysfunction and disruption of frontostriatal circuitry proportional to the number of brain lesions. [32]

Local and international criticisms

Local criticisms

Although the government had made a series of responses shortly, problems have not been solved from the root causes. There are some criticisms from the local congress and other parties. After a few days of this tragedy, two Congress Rajya Sabha MPs had condemned their party, and criticizing Amarinder Singh's responses was a "clear-cut failure". [33] In addition, Bishop Agnelo Rufino Gracias is the auxiliary bishop emeritus of Bombay and apostolic administrator of Jalandhar Diocese. In a report in UCA News, He said, "It's a tragedy that could have easily been avoided without relevant authorities being alert. It is a manufactured tragedy". [22] As we can see, the handling of the matter by the local government was highly controversial. Moreover, the opposite Aam Aadmi Party (AAP) had held several local protests, criticising the government's indifference to the plight of the people. And its malfeasance in causing the alcohol poisoning, of which most of the victims were the poor population. [22]

International criticisms

Since 1992, an average of around 1,000 people have died from drinking alcohol illegally, which has caused much international concern. [34] The Guardian UK reported in 2019 on a similar tragic incident in India, in which 200 people died. It also presented that the danger of that type of fake alcohol was the addition of formaldehyde to it by unscrupulous traders. [35] Despite many reports on local and international news platforms, hopefully serving as a warning to the people, it did not prevent the disaster in Punjab 2020. In addition, Chinese Journalists analyzed the reasons for recurrence incidents. The Indian government passed a bill act in 2009 to prevent illegal alcohol. However, the situation still has not improved. The journalist pointed out two ways to solve this problem: for the Indian government to open up the alcohol license and lower taxes to reduce the price of wine. [34]

Lessons learned from the disaster

This contamination in illicit alcoholic drinks leads to deaths has been a global problem, chiefly in developing countries (WHO,2014). [36] India seems to be among affected in the worst list and the main reason is policing issues disregarded by the state. [37] From the plenty of sociologists’ analyses and comments, so what can be done?

Regulated the product and sale industry

The bulk of the responsibility lies with the government, which needs to formulate effective strategies to manage Industrial production to prevent methanol addition. Indeed, the laws exist (eg: stipulated minimum life imprisonment and a maximum hanging sentence in 2009) but need enforcing. [34] [37] In the southern states, the rate of poisoning accidents had declined with the excise departments' stringent (2015). [37] It is necessary to improve the edibility criteria although the implementation of public health policies is a barrier of vested. [38]

Financial for welfare and technological

Illicit liquor stem from the high cost of legally produced and the poor cannot afford it with exorbitance taxes and excise duties. ‘Traditional’ alcohol (homebrew) is one low-cost distilled beverage with poor quality that results in variable concentrations of methanol, which is the main factor of poisoning. [37] [39] However, this type is still permitted in some fewer welfare areas by license holders for making money. Methanol is the factor of death that causes fatality rates over 30% (WHO,2014). [40] It will be metabolized to formaldehyde and formic acid which can cause tissue damage and death. [36] Meanwhile，high death rates also result from early unspecified symptoms and lack of specialty drugs like fomepizole resulting in a delay in seeking medical attention. [41] Therefore, Fund may require further support in the welfare and technology area.

Diet health defences and interventions

"We must use every possible avenue to communicate the hazards of alcohol dependence to the public, including mass media, television, and community" said Pavan Sonar (BMJ). So it is humanitarian action to add diet health defences and interventions which can prevent and alleviate this industrial accident.

Related Research Articles

The 1992 Odisha liquor deaths took place in May 1992 in Cuttack, Odisha State, India. More than 200 people died after drinking illegally brewed poisonous liquor; another 600 people were hospitalised. It was one of the biggest tragedies of its kind in India.

Surrogate alcohol is a term for any substance containing ethanol that is intentionally consumed by humans but is not meant for human consumption. Some definitions of the term also extend to illegally produced alcoholic beverages.

The Gujarat alcohol poisonings occurred in July 2009 in Gujarat, resulting in the death of 136 people from consumption of bootleg liquor.

<span class="mw-page-title-main">Alcohol prohibition in India</span> Prohibition of alcohol in Indian states

Alcohol is prohibited in the states of Bihar, Gujarat, Mizoram, and Nagaland. All other Indian states and union territories permit the sale of alcohol.

The 2012 Odisha alcohol poisonings killed at least 29 people in the Indian state of Odisha in February 2012.

The Sangrampur methanol poisonings occurred when a methanol-tainted batch of illegal alcohol killed 143 people at Sangrampur village in Magrahat I CD Block of Diamond Harbour subdivision in December 2011, affecting mainly manual workers of South 24 Parganas district in the Indian state of West Bengal.

The 2008 Karnataka-Tamil Nadu alcohol poisonings was an incident in the southern Indian states of Karnataka and Tamil Nadu in May 2008 in which 180 people reportedly died after consuming illicit liquor. This incident is considered to be the worst methanol poisoning in the country since at least 2000.

<span class="mw-page-title-main">Methanol toxicity</span> Medical condition

Methanol toxicity is poisoning from methanol, characteristically via ingestion. Symptoms may include a decreased level of consciousness, poor or no coordination, vomiting, abdominal pain, and a specific smell on the breath. Decreased vision may start as early as twelve hours after exposure. Long-term outcomes may include blindness and kidney failure. Blindness may occur after drinking as little as 10 mL; death may occur after drinking quantities over 15 mL.

Cholai is an illegal alcoholic beverage made in India, equivalent to "hooch" or "bootleg" alcohol. Usually made from rice, it is sometimes mixed with industrial alcohol or methanol, which has resulted in several hundred deaths.

In June 2015, at least 102 people died after drinking contaminated alcohol in the Laxmi Nagar slum in Malad, located in Mumbai, India. Another 45 people were hospitalised as a result of the incident. The incident has been described as the worst of its kind in over a decade.

Alcohol prohibition in Tamil Nadu is governed by the State Prohibition and Excise department as per the Tamil Nadu Prohibition Act, 1937. TASMAC, a state government-owned company, controls the wholesale and retail vending of alcoholic beverages in the State. On 24 May 2016, after her swearing-in, J. Jayalalitha announced the closing of 500 liquor shops and the reduction of the business hours of State-run liquor shops across the State. On 20 February 2017, the first office order signed by the Chief Minister Edappadi K. Palaniswami was the closure of 500 liquor outlets owned by the public sector TASMAC. This is in addition to the 500 liquor outlets closed down by late Chief Minister J Jayalalithaa in May 2016.

The 2016 Bihar alcohol poisonings killed 16 people on 16 August 2016 in Gopalganj town of Bihar, India. The victims had consumed hooch and complained of nausea and stomach ache.

The Azamgarh alcohol poisonings resulted in the deaths of 39 people in the city of Azamgarh in Uttar Pradesh, India, in October 2013, due to consumption of moonshine mixed with methanol. This was considered one of the worst alcohol poisonings in the state. The locals have contested the death toll, claiming over 40 people had died in the incident.

In December 2016, 74 people died in a mass methanol poisoning in the Russian city of Irkutsk. Precipitated by drinking counterfeit surrogate alcohol, the Associated Press news agency called its high death toll "unprecedented in its scale".

In February 2019, at least 168 people died after drinking toxic bootleg alcohol in Golaghat and Jorhat districts in Indian state of Assam. The incident occurred two weeks after 100 people died by drinking toxic alcohol in the northern states of Uttar Pradesh and Uttarakhand.

<span class="mw-page-title-main">2022 Gujarat toxic liquor deaths</span> Mass poisoning in Gujarat, India

On 25 July 2022, at least 42 people died and more than 97 were hospitalized in a methanol poisoning incident in Gujarat, India. The victims had consumed undiluted methyl alcohol (methanol), assuming it to be alcohol. The spurious liquor was then sold to more than 100 people in the villages of Ahmedabad, Botad and Surendranagar.

<span class="mw-page-title-main">Consequences of Prohibition</span> Effects of alcohol prohibition in the United States

The Consequences of Prohibition did not just include effects on people's drinking habits but also on the worldwide economy, the people's trust of the government, and the public health system. Alcohol, from the rise of the temperance movement to modern day restrictions around the world, has long been a source of turmoil. When alcoholic beverages were first banned under the Volstead Act in 1919, the United States government had little idea of the severity of the consequences. It was first thought that a ban on alcohol would increase the moral character of society, but a ban on alcohol had vast unintended consequences.

On 14 December 2022, an alcohol poisoning took place in Bihar, India. The poisoning resulted in the death of 73 people. The victims consumed hooch, that is qualitatively different from the standard alcoholic products. It is the highest death toll in Bihar, since liquor prohibition in state in 2016.

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