Korean Journal of Substance Abuse Treatment

South Korea
A Destructive Drinking Culture
Pamela Weeks
Creator of Pam and Buffy Children’s Edutainment Television and founder of U-R Special,
a philanthropic organization promoting drug abuse education awareness and positive character building skills
B.A. CAC
Graduate Studies, South Korea

Abstract
Due to destructive drinking habits, the problem of alcoholism is growing serious in South Korea. The number of alcoholics in the country has reached three million. According to the Ministry of Health and Welfare, one in ten adults suffer from health problems related to heavy drinking. This paper addresses the issue of alcohol abuse in South Korea. It will explore challenges and boundaries as part of the culture, historical data, showing government support and proposed treatment for alcoholics and education to change the destructive drinking culture.
Destructive Drinking Culture
. Koreans drink too much alcohol. People binge drink at bars and restaurants. Walking on the street in late hours of the evening, you can see the suffering effects from excessive consumption of alcohol. It is common to witness vomiting, fighting, and watch as some people are carried away by police for committing more serious offences.
Excessive Consumption
According to the Ministry of Health and Welfare Korea is the world's fourth-largest consumer of strong liquor, and its per capita consumption of alcohol, 9.3 liters a year, is 19th among the 30 member states of the Organization for Economic Cooperation and Development. Each average Korean gulps down 72 bottles of Soju and 108 bottles of beer each year.
Traditional drinking habits
Many blame traditional drinking habits as a contributor to alcoholism in South Korea. Some traditional drinking habits are gulping down shots of liquor at short intervals, exchanging glasses, persuading cohorts to drink the same number of shots, and making late night rounds to restaurants and bars.


The Protocol
Korea is known as the country of good manners. It is considered to have good manners to accept the first round of alcohol, even if you do not like to drink. Declining the offer is seen as having bad manners. When an older person presents you with a drink, you are to stand up, bow and take the drink with both hands. You are not to drink however, until the older person has raised their glass. The older person at the table is always offered alcohol first.
Historical Influence
Soju was first used by the King. Drinking was introduced to Korea from China. There is a myth of how a King first used soju, a potent rice wine to seduce and impregnate a young female aristocrat. Alcohol began to be produced in Buddhist monasteries and was widely used for medicinal purposes. Soju was first distilled around 1300 A.D. Because of its availability and low price, it became a favorite among Koreans and found easily in restaurants and bars. These habits encourage self-destructive bingeing, causing death, illness, lost productivity, damage to human relations, and family problems.
A classic South Korean working day
After work employers and employees usually end up in huesiks, Korean for binge
drinking. Binge drinking at one time meant drinking heavily over several days. Now, the
term refers to heavy consumption of alcohol over a short period of time (just as binge eating
means a specific period of uncontrolled overeating). Today the generally accepted definition of
binge drinking in the United States is the consumption of five or more drinks in a row by men
and four or more drinks in a row by women. Heavy binge drinking can include three or more
episodes within a 2 week period.


Binge drinking increases strokes
A study from the Institute for Health Promotions finds that Korean men who frequently
binge drink--consume six or more alcoholic drinks at one occasion, at least once a
week—increase their risk of hemorrhagic stroke by more than 300%. Risk of total stroke
was 86% higher among binge drinkers than non-drinkers. Most of the alcohol consumed
was soju, which is 25% alcohol by volume and similar to vodka.
Approximately 46% of Korean men are considered heavy drinkers. "Binge drinking and
mortality from all causes and cerebrovascular diseases in Korean men and women: A Kangwha
Cohort Study." (July 2009) From the Institute for Health Promotion (J.W.S.,H.O.)
Consequence
As a consequence, about 2.21 million Koreans, 6.8 percent of the population aged 18-64, are alcoholics. More alarming is that one out of every three adults 20 years or older is in the category of "high-hazard" group, who drink in excess of their capacity. Police figures show that in 2001, alcohol played a part in 63.2 percent of murders where a conviction was made, 62.9 percent of the cases of violent behavior, and 64.5 percent of those convicted of serious traffic violations, including drunk driving that resulted in human casualties.
Alcohol-related problems cost society large amounts of money.
The socio-economic cost of alcohol is around 14.9 billion US dollars each year and it will be 2.86% of GDP; 22,000 alcohol related deaths each year (8.7 of all deaths); alcohol related traffic deaths have risen from 379 in 1990 to 1,217 in 2000; and almost two thirds of homicides and violent behaviour are alcohol related. The consequences of alcohol misuse are serious, in many cases life threatening.

Heavy drinking can increase the risk for
 Cancers
 Liver cirrhosis
 Immune system problems
 Brain damage
 Harm to the fetus during pregnancy
 In addition, drinking increases the risk of death from automobile crashes as well as recreational and on-the-job injuries.
 Both homicides and suicides are more likely to be committed by persons who have been drinking.
A Disease
Alcoholism, known as “alcohol dependence,” is a disease needing medical treatment.
However, we have long been tolerant about heavy drinking. There is still a tendency, though much diminished now, to regard heavy drinking as manly and those who drink a lot are believed to have good personal relationships. Such misconceptions make it difficult to identify those who are suffering due to heavy drinking.
The rampant habit of coercing people into drinking without regard to their capacity has also helped to create many alcoholics. This atmosphere has made it possible for many of those in need of medical treatment due to heavy drinking to be passed off as mere heavy drinkers, not alcoholics. It is fortunate that the government is recognizing the seriousness of the situation.
Treatment
The government plans to run specialized alcoholic medical care units in Seoul and provincial cities beginning next year. It will also improve medical checkups to detect potential alcoholics early. Non-drinking areas in national parks and amusement parks will be designated to reduce the opportunities of drinking. The efforts aimed at getting rid of bad drinking habits should be continued consistently. The goal is to increase people’s awareness about the seriousness of alcoholism.
A call to action
Change the drinking culture in South Korea and get rid of deep-rooted habits of forcing people to drink at parties or other gatherings.
The first step to change is awareness
The nation is beginning to address the growing problem. Policymakers are becoming aware of the importance of sobering up the nation with “The Bluebird 2010 Plan” to reduce Koreans' heavy dependence on alcohol.
The "Blue Bird 2010 Plan," is outlined by the Health Ministry.
The plan includes programs for a nationwide public campaign, a designation of "non-drinking zones" in such public facilities as parks and stadiums, and an expansion of counseling and rehabilitation centers for alcoholics The participation of public offices and private companies are valuable in limiting excessive drinking by many Koreans that share booze with their colleagues and business partners. Herald Media Inc., a newspaper publisher supports a campaign, including the designation of Monday as "non-drinking day," to encourage its employees to be responsible drinkers.
Changing the destructive drinking culture by:
 Toughening laws on liquor sales, especially to underage youths.
 Banning of drinking scenes on television,
 Alcohol education at schools.
Health officials are aware that the traditional drinking culture and social acceptance of alcohol abuse are barriers to alcohol policy and that “society is not ready to take a firm attitude to the alcohol industry due to a lack of awareness on alcohol related harm”. 6.8% of the total population have a drinking problem or are dependent.
Goals of the Campaign
The goals of the campaign are to: “Improve the quality of life and enhance national competitiveness through alcohol free healthy citizens and happy families by creating a social drinking culture, protecting the public from alcohol related harm and supporting medical treatment and rehabilitation. Create a social and cultural environment open to alcohol control policy and improve awareness on alcohol harm.
Another goal is to reduce risk factors with early detection of high-risk groups, vulnerable groups and alcohol dependent people. Strengthen the nation’s treatment and rehabilitation nurturing human resources - alcohol experts and volunteers; and create a social and cultural environment open to alcohol control policy.”
Success Measure
To measure the success of the campaign, targets have been set, which it is hoped will be reached by 2010. A decrease in per capita consumption from 9.3 to 8.4%; decrease in high risk drinking among males from 14.9 to 13%; and decrease in youth drinking from 29.6 to 25.0%.





Attitudes
Korean has a positive attitude for the drinking. 61.5% recognize the alcoholic beverage is

necessary for social life 19.1% recognize moderate drinking in pregnant situation is no

problem. 20.1% agree ‘no problem for the students drinking under the 19 years. Cho ( 2009).


Evolution of time

People act on previous decisions, experience, information, new skills and motivations for

making a change. Change begins with one person and the burning desire to create a new

environment. Identifying desires, actions and motivation of behavior brings clarity and

healing. When the desire to change becomes greater than our fear of failing, we can

begin to disseminate information to begin the process. We have many causes that may require

policy and legislation. Putting into action our beliefs, knowledge and passion through strong

visionary leadership, it can illuminate a spark to freedom from self- destructive drinking






















References

The Globe Issues No 1 & 2 (2007)
Retrieved December 21, 2009 from The Globe Issue http://www.ias.org.uk/resources/publications/theglobe/globe200712/gl200712_index.htl
Korea.Net News (2006, August 30) Steps taken to tackle heavy drinking culture
Retrieved December 21, 2009, http://www.korea.net/News/News/NewsView.asp?serial_no=20060829028&part=109&SearchDay=
Tourret N.& Royer A. (2008, November 24). Huesik: Korean for binge drinking
Retrieved December 07, 2009 from France 24 International News Website:
http://www.france24.com/en/20081124-south-korea-binge-drinking-social-event-huesik

Stroke 2009; 40: 2953-2958 (3 July 2009) A Kangwha Cohort Study J W S, PhD; Sang-Wook Yi, MD, PhD; Chung Mo Nam, PhD Heechoul Ohrr, MD, PhD

Retrieved December 20, 2009 from The Institute for Health Promotion (J.W.S.,H.O.)

http://stroke.ahajournals.org/cgi/content/abstract/40/9/2953
SG Cho DH Kim (2006), SG Cho et al. (2009) Drinking Patterns and Alcohol Policy in Korea Korea Alcohol Research Center,
Retrieved December 22, 2009 http://www.ihra.net/Assets/1947/1/Presentation_23rd_M10_Cho.pdf



Figure Captions
Figure 1. Caption of figure Drinking alcohol is taken very seriously in Korea. The highest per capital alcohol consumption in the world is in Korea. There is a protocol to be followed. http://www.nationmaster.com/graph/foo_alc_con-food-alcohol-consumption-current source
Rank Countries
Amount

# 1 Luxembourg:
15.5 litres per capita
# 2 France:
14.8 litres per capita
# 3 Ireland:
13.5 litres per capita
# 4 Hungary:
13.4 litres per capita
# 5 Czech Republic:
12.1 litres per capita
# 6 Spain:
11.7 litres per capita
# 7 Denmark:
11.5 litres per capita
# 8 Portugal:
11.4 litres per capita
# 9 United Kingdom:
11.2 litres per capita
# 10 Austria:
11.1 litres per capita
# 11 Switzerland:
10.8 litres per capita
# 12 Belgium:
10.7 litres per capita
# 13 Germany:
10.2 litres per capita
# 14 Australia:
9.8 litres per capita
# 15 Netherlands:
9.7 litres per capita
= 16 Finland:
9.3 litres per capita
= 16 Korea, South:
9.3 litres per capita
# 18 Greece:
9.2 litres per capita
# 19 New Zealand:
8.9 litres per capita
# 20 United States:
8.3 litres per capita
# 21 Poland:
8.1 litres per capita
# 22 Italy:
8 litres per capita
# 23 Canada:
7.8 litres per capita
= 24 Japan:
7.6 litres per capita
= 24 Slovakia:
7.6 litres per capita
# 26 Sweden:
7 litres per capita
# 27 Iceland:
6.5 litres per capita
# 28 Norway:
6 litres per capita
# 29 Mexico:
4.6 litres per capita
# 30 Turkey:
1.5 litres per capita
Weighted average: 9.6 litres per capita


Figure 2.

Soju, first distilled around 1300 A.D.


Figure 3.

International Blood Alcohol Limits
as a percentage ‘Blood Alcohol Concentration’ (BAC)
http://www.driveandstayalive.com/articles%20and%20topics/drunk%20driving/artcl--drunk-driving-0005--global-BAC-limits.htm
South Korea 0.05 / 0.053 8 / 49
USA 0.08 (now all 50 states) 2, 3, 5, 8





Figure 4.
Stroke 2009; 40: 2953-2958
http://stroke.ahajournals.org/cgi/content/abstract/40/9/2953
Date Posted: 3 July 2009
A Kangwha Cohort Study
Jae Woong Sull, PhD; Sang-Wook Yi, MD, PhD; Chung Mo Nam, PhD Heechoul Ohrr, MD, PhD
From the Institute for Health Promotion (J.W.S., H.O.), Graduate School of Public Health, Yonsei University, Seoul, Korea; the Department of Preventive Medicine and Public Health (S.-W.Y.), Kwandong University College of Medicine, Gangneung, Korea; and the Department of Preventive Medicine (C.M.N., H.O.), Yonsei University College of Medicine, Seoul, Korea.
Correspondence to Heechoul Ohrr, MD, PhD, Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea. E-mail ohrr@yuhs.ac
Background and Purpose— The purpose of this study was to examine the association between binge drinking and risks of mortality due to all causes of death with a focus on cerebrovascular disease in Korean men and women.
Methods— This study followed a cohort of 6291 residents in Kangwha County, aged 55 years in March 1985, for their cause-specific mortality for 20.8 years up to December 31, 2005. We calculated hazard ratio of mortality by experience or frequency of binge drinking using the Cox proportional hazard model. Binge drinking was defined as having 6 drinks on one occasion.
Results— In men, binge drinkers who drink daily had an increased risk of mortality from all causes (hazard ratio, 1.33; 95% CI, 1.11 to 1.60) as compared with nondrinkers. They showed much increased risks of mortality from total stroke (hazard ratio, 1.86; 95% CI, 1.16 to 2.99) and hemorrhagic stroke (hazard ratio, 3.39; 95% CI, 1.38 to 8.35). Female binge drinkers also showed an increased risk of mortality from cardiovascular disease as compared with female nondrinkers, but the outcome was not statistically significant.
Conclusions— The results of this study suggest that frequent binge drinking has a harmful effect on hemorrhagic stroke in Korean men. These findings need to be confirmed in further studies.

Key Words: alcohol consumption • binge drinking • hemorrhagic stroke mortality





Figure 5.