New Delhi, April 23: When social distancing means no social drinking, not even a convivial beer or glass of wine, and lockdown translates to no alcohol at all with bars and retail outlets firmly shut, spirits take a nose dive mild depression for some and outright despair for many others. COVID-19 being the great equaliser, the nationwide lockdown, which began on March 25 and is set to go on till at least May 3, has been a sobering experience for millions of Indians in villages and cities going without their everyday or occasional tipple.

While the once-in-a-while drinkers are missing saying 'cheers' as often as they'd like, there has been a surge in withdrawal cases. Those with problems of alcohol dependence are most seriously hit with no access to alcohol or de-addiction centres and support groups such as Alcoholics Anonymous that help them cope with their addiction. With all watering holes and liquor stores shut only stores selling essentials are open in the lockdown period -- even the affluent with bars stocked with premium gin, vodka and single malts are running low on stocks. Liquor Sellers Seek Permission For Online, On-Call Sale of Alcohol During Coronavirus Lockdown.

I have maintained a good stock over the years I won't tell you the quantity but it was more than enough. But then the lockdown and now the extension took all of us by surprise and for once even I am worried my booze stock will run dry, said Amit Mahajan, a Delhi businessman. Many, even among the affluent, are rationing their drinks and borrowing from others who might have some extra bottles stashed away.

According to a 2019 report by the National Drug Dependence Treatment Centre, AIIMS, 14.6 per cent of the population (between 10 and 75 year of age) in India consumes alcohol about 16 crore people in total. Of these, nearly one in five alcohol users suffer from alcohol dependence and need urgent treatment, said the report titled Magnitude of Substance Use In India.

A 38-year-old in Amritsar who said he had been an addict for 10 years and was undergoing therapy is among those most affected. The prolonged shutdown disrupted his therapy and the social isolation has exacerbated his problems. I got agitated without any trigger factor, couldn't sleep for long and there was shivering too. I tried contacting my friends and some close family members, asking them if they could help me with a bottle or two but no one helped.

Earlier, I was going through therapy Since I am showing what my doctor tells me are withdrawal symptoms' I have again been put on therapy, he explained. Ramesh Banerjee in Kolkata said all his stocks have dried up and he ison mild anti-depressants. "I have been a alcoholicfor last 20 years Right now I am having one pill a day so I can have sound sleep every night," Banerjee said.

There are tragic consequences too. In Kerala, which has a per capita annual consumption of over eight litres, the highest in the country, at least nine people reportedly ended their lives. The state government had directed the excise department to provide liquor to those with a prescription from a doctor. The move, which faced a backlash by doctors, was later put on hold by the Kerala High Court.

The non-availability of alcohol can be an additional reason for stress and anxiety for a person suffering from withdrawal symptoms, but in that case what needs to be addressed is the possible dependence or addiction. Instead of considering alcohol as an essential, it would be more helpful if people with alcohol dependence seek psychiatric/therapeutic intervention, said Ann Philipose, a psychologist.

In Tamil Nadu, three men died in Chengalpattu after consuming varnish mixed with water as they could not obtain alcohol from the government-owned local TASMAC outlet, closed due to the lockdown to stem the spread of coronavirus. Before that, in Pudukottai district, three men died after they mixed soft drinks with after shave lotion in the hope of a high.

S Nambi, a Chennai-based psychiatrist, called for addressing the problem at the primary healthcare level before it assumes alarming proportions. "The non-availability of alcohol all of a sudden will cause withdrawal symptoms. While craving and mild trembling can be seen in normal cases, nearly 15 percent will develop complicated withdrawal symptoms and tend to become irritable, go into delirium or experience severe anxiety or restlessness," he said.

Ajit Magdum, director of the Anvay De-addiction Centre in Navi Mumbai, said they have started counselling addicts over the phone. This lockdown is also an opportunity for parents and spouses of people suffering from addictions to engage in fruitful conversations and bring theaddictson the right track, he said. Some centres opened their doors for emergencies.

Disha Foundation in Bhubaneswar, for instance, had shut down its de-addiction centre but admitted a 30-year-old man, said Pratap Kumar Mohanty, who runs the centre. Following a request from the private hospital we allowed his admission in our centre. The man,addictedto liquor as well as ganja, developed withdrawal symptoms marked by psychiatric problems as he was unable to get his supply due to the lockdown, he said.

And sometimes, desperation knows no bounds. From Hubbali in Karnataka came a report of chemists stopping the sale of chemical-based sanitisers after people, chasing a high, were found to be buying large amounts and drinking the liquid.

There have also been numerous reports from different parts of the countries of desperadoes breaking into liquor shops to steal whatever they could lay their hands on. Those with time, tech and access to varied ingredients are taking the matter in their own hands. So, during the March 22-28 week, how to make alcohol at home was a trending topic on search engine Google.

From homemade mead to wine fermented from rice, tipplers are trying it all to put an end to their sobriety period. Producers and manufacturers are hoping for a quick end to the seemingly endless dry days. The All India Brewers Association (AIBA) and the Confederation of Indian Alcoholic Beverage Companies (CIABC) have written to various state governments and the Centre to allow beer and alcohol sales to resume with adequate safeguards incorporated.

According to AIBA, March-June accounts for 50 per cent of annual beer sales and that they have already lost over 25 per cent of sales for the year a loss of nearly Rs 15,000 crore. The beer sector is disproportionately impacted because this is season time for us and all of us are sitting on a lot of inventory that can expire," said Ankur Jain, founder CEO of Bira 91 and member of the board of directors AIBA.

The CIABC said in its letter that alcohol is one of the most important sources of revenue for state governments. By shutting down retail shops, states are depriving themselves of the tax revenues that are so vitally required in fighting the coronavirus pandemic, it said.

"... Alcohol compromises the body's immune system and increases the risk of adverse health outcomes. Therefore, people should minimize their alcohol consumption at any time, and particularly during the COVID-19 pandemic," the WHO has in an advisory.