Winter marks the beginning of the much-anticipated wedding season in Sikkim. Urban and rural Sikkim comes alive with festivities as families unite to celebrate love. Music fills the air, and bonfires provide warmth during chilly evenings, fostering a sense of community. A notable part of these celebrations is the presence of alcoholic beverages, with chang or tongba—traditional fermented millet drinks—being generously served. In Sikkimese culture, alcohol is not merely a drink but a symbol of hospitality and cultural identity, tying together generations through shared experiences. However, today, this cultural cornerstone has become an increasing burden on the health, economy, and social fabric of the community.
From Traditional Drinks to a Growing Crisis
The preparation of chang was once a communal and sacred practice, consumed occasionally during festivals or rituals. However, the introduction and widespread availability of commercial alcohol have drastically shifted drinking habits. Bottled alcohol, inexpensive and easily accessible, has replaced traditional brews, leading to frequent and excessive consumption. What once symbolized unity and celebration now fuels habitual drinking and contributes to a rising public health crisis. The situation worsens as many individuals, particularly youth, transition from alcohol abuse to narcotics and pharmaceutical drugs, exacerbating the already dire health and social consequences.
Doma Bhutia from Rezay, Bhusuk, East Sikkim, laments, “In the past, Mong Chee (millet brew) was sacred and shared only on special occasions. Now, young people drink beer and wine every day.”
Alcohol, Drug Abuse, and Suicide: A Deadly Link
Sikkim’s struggle with alcohol and drug abuse is compounded by its alarming suicide rates. According to the National Crime Records Bureau (NCRB), Sikkim has the highest suicide rate in India, earning it the title of the “suicide capital.” In 2015, the state reported a suicide rate of 37.5 per 100,000 people, more than double the national average.
Experts attribute many suicides to the devastating effects of alcohol and drug abuse, combined with mental health struggles like depression and anxiety. The vicious cycle begins when individuals, facing personal or economic pressures, turn to substances as an escape, only to find their problems deepened, leading to suicidal ideation. Rapid modernization, lack of opportunities, and youth disillusionment further exacerbate this crisis.
The Social Stigma
Alcohol and drug abuse in Sikkim are heavily stigmatized. Addiction is often seen not as a medical issue but as a moral failing or lack of self-control, leading to judgment and discrimination. This stigma discourages individuals from seeking help, fearing ostracization or being labeled as weak. The stigma extends to rehabilitation, with many avoiding treatment due to fear of social marginalization. The shame associated with addiction perpetuates feelings of isolation, making it harder for individuals to break free from the cycle of substance abuse.
Substance abuse is also linked to domestic violence, child neglect, and criminal behavior, further reinforcing negative stereotypes. Families, especially in rural areas, are reluctant to speak out about the issue, which only allows addiction to continue unchecked.
Public Health Implications
The consequences of this shift in drinking habits are profound. Alcohol consumption in rural Sikkim stands at 36.6%, with 51.2% of men and 23% of women consuming alcohol regularly. Alcohol-related illnesses, such as liver diseases, cardiovascular conditions, and mental health disorders, have risen dramatically. Healthcare providers in rural clinics have reported a 20% increase in alcohol-related liver diseases in the past decade.
The situation is made worse by pharmaceutical drug abuse, with 70% of teenagers estimated to be involved in illicit drug use. This rise in substance abuse, particularly among the youth, has compounded the mental health crisis and suicide epidemic, where addiction becomes both a trigger and consequence of deteriorating mental health.
The Ripple Effect on Families and Communities
The impact of alcohol and drug abuse extends beyond individual health, having severe social and economic consequences. Families already struggling with limited resources often divert household income toward alcohol and drugs, neglecting essential needs like education, healthcare, and nutrition.
For women and children, the effects are particularly harsh. Alcohol abuse is a leading cause of domestic violence, with many women forced to care for children and manage households alone, often while dealing with intoxicated or absent partners. In agrarian families, addiction reduces productivity, threatening food security and economic stability. A labor force entrenched in addiction cannot contribute meaningfully to the community, worsening cycles of poverty.
The government of Sikkim has recognized the gravity of the crisis and taken steps to address it. The ‘Nasha Mukt Sikkim’ campaign, launched in 2024, focuses on education, prevention, and rehabilitation. This initiative aims to engage the community, particularly youth, in tackling addiction through awareness programs and structured interventions.
The Excise Department has also implemented measures to regulate alcohol consumption, including relocating liquor shops away from educational institutions and freezing new licenses in rural areas. The department is working to educate both vendors and consumers on responsible alcohol use while ensuring compliance with Excise rules.
A New Path Forward
The public health challenges in Sikkim—alcohol abuse, drug addiction, and rising suicide rates—demand a comprehensive approach. This includes policy changes, community involvement, and support for vulnerable groups to break the cycle of addiction and promote long-term recovery.
An example of such efforts is the study titled “Effect of Group Activity on Psychological, Cognitive, and Psychomotor Abilities of Individuals Undergoing Treatment in Rehabilitation Centers of Sikkim“ by Dr. Tenzing Norzom Bhutia (2023). The study demonstrates how structured group activities can improve mental well-being, self-control, working memory, selective attention, reaction time, and hand dexterity among individuals in rehabilitation.
This story has been published as part of the AIPP-EastMojo Fellowship 2024
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