Open Journal of Psychiatry, 2012, 2, 301-304 OJPsych
http://dx.doi.org/10.4236/ojpsych.2012.24042 Published Online October 2012 (http://www.SciRP.org/journal/ojpsych/)
Alcohol dependence: Does the composition of the available
beverages promote it?
Mary W. Kuria, Yvonne Olando
Department of Psychiatry, University of Nairobi, Nairobi, Kenya
Received 8 September 2012; revised 7 October 2012; accepted 15 October 2012
ABSTRACT
Affordability and availability of alcohol are factors
that have been associated with alcohol dependence.
Ethanol content in the alcoholic beverages is an im-
portant determinant in alcohol dependence. Quality
control of alcoholic beverages available in the market
is important in safeguarding the health of alcohol
consumers. Few studies in Kenya have determined
the chemical composition of alcohol used by the study
participants. Objective: To determine the chemical
composition of alcoholic beverages used by a group of
alcohol dependent study participants. Design: The
study was a clinical trial with pre and post measure-
ments. Method: The CIDI and WHO-ASSIST were
administered to 188 alcohol-dependent persons at
intake and after six months. A researcher-designed
socio demographic questionnaire was also adminis-
tered at intake. Alcohol beverages were randomly
collected from the location of the study area and their
chemical composition analyzed using gas chromatog-
raphy. Results: The mean AUDIT score of the par-
ticipant was 28.6 for male and 26.6 for females. Three
of the alcohol samples collected was illicit brews col-
lected while 11 were licit. Four out of the eleven licit
brews had ethanol levels that did not complied with
the set government standards. Conclusion: Illicit
brews with high ethanol content are available in the
Kenyan market, while some of the manufacturers of
the licit brew do not comply with government set
content recommendations.
Keywords: Alcoholic Beverages; Ethanol; Composition;
Illicit; Licit
1. INTRODUCTION
The control of composition of alcohol standard is done
by the Kenya bureau of standards (KEBS). The Kenya
Bureau of Standards recommends spirits, gin whisky and
brandy to contain a minimum 37.5% of alcohol by vo-
lume, while beer should have 4% - 8%, fruit win 8% -
14% fortified wine 1 3% - 34 % alcohol by v olume.
There is an overwhelming proliferation of illicit alco-
holic brews both in the urban and rural parts of Kenya.
This prompted the law makers to enact the new Alcohol
Control Law. According to the newly passed law better
control of alcohol quality and enforcement of the laws
has been proposed. National Agency for the Campaign
Against Drug Abuse (the government body responsible
for dealing with substance abuse) acknowledges that
abuse and misuse of alcohol and other drugs in Kenya
has now reached magnitudes that may lead to a national
disaster if timely measures are not put in place [1].
The Kenya Alcoholic Drinks Control Act, (2010) de-
fines alcohol as “the product known as ethyl alcohol ob-
tained by fermentation and distillation of any fermented
alcoholic product”. “Alcoholic drink includes spirits,
wine, beer, traditional alcoholic drink and any one or
more such varieties containing one-half of one percent or
more of alcohol by volume” [2]. Worldwide three types
of alcoholic beverages namely, beer, wine and spirits.
Beer and wine have lower alcohol content as compared
to spirits.
Ideally the definition of alcohol should be at an etha-
nol content level low enough to include most of the al-
coholic beverages consumed in the country. Such defini-
tion takes into consideration the alcohol by volume con-
tent of the drink [3]. Amounts of alcohol consumed by a
person depend partly on the ethanol content. Estimates of
both mean volume of alcohol consumption and heavy
drinking amounts are influenced by variation in alcohol
concentration and quantity [4]. People from poor com-
munities prefer cheap and potent alcohol.
The use and abuse of alcohol in Africa involves both
local and industrialized typ es of alco hol [5 ] with as much
as half of the consumption being unrecorded alcohol [6].
Traditional drinks including homemade brews and dis-
tilled beverages accounts for 74% of the total alcohol
consumption in Kenya [7]. The use of the local tradi-
tional brews poses a danger to the society for a number

M. W. Kuria, Y. Olando / Open Journal of Psychiatry 2 (2012) 301-304 302
of reasons. Firstly, the manufacture of the traditional
brews is usually unhygienic and at times the brews have
been laced with methanol resulting to deaths blindness
and disabilities [8]. Secondly, most of the brews are
manufactured illegally without control on the ethanol
content. Thirdly, the cost of the brews is relatively lower
than that of the legal brews and therefore the majority of
the alcohol users can afford it. Kenya has currently
passed a law to legalize traditional and illicit brews so as
to regulate production, sale and consumption of alcoholic
drinks [1].
Kenyans have a hazardous drinking pattern of alcohol
which can cause social and medical harm [7,9] with an
increasingly use by underage and young persons [10].
These coupled with a repo rted increase in lifetime drink-
ing among young, black African; and use of drugs by
females as a way to cope with current or past life stress-
ors [11,12] demands that quality control of alcoholic
brews be instituted and enforced.
Anecdotal reports indicate that consuming killer sub-
stances bottled in filthy backyards and cleverly labeled
as fortified wine, gin, opaque beer, vodka, brandy or rum
are currently sold in the Kenyan market. According to
anecdotal reports the suspect drinks, said to control 80
per cent of the wines and spirits market, contravene all
the mandatory requirements for manufacture as well as
trade in alcoholic beverag es—tax obligation, quality cer-
tification, wholesomeness and packaging. Cheap alcohol
package in small quantities (250 milliliter) which have in
the past being available in the Kenyan market has cur-
rently being prohibited by the new Alcoholic Drinks
Control Act, 2010.
In Kenya, alcohol consumption is highest in poor
communities where potent home brewed alcoho l is cheap
and readily available. Quality control is weak; meaning
ethanol content can at times be dangerously high. Ex am-
ples of such home made brews include, “muratina”,
“mnazi”, “changaa”, “mbangari”, “busaa”, and “kumi-
kumi”. These are the illicit brews that the newly passed
law (Alcohol Drinks Control Act) intends to make licit
and industrialize the production in attempt to protect the
alcohol users from harmful effects of contaminated il-
licit brews (Kenya Gazette supplement, 2010). Since
cost and availability of alcohol are factors that influ-
ence alcohol use an increase in available licit types of
alcohol in market may result to more people drinking
alcohol.
Illicit drug use has spread from urban and advantaged
groups to rural and disadvantaged (poor) communities
where youth associate alcohol use with enjoyment, fun
and survival [13]. This is true for Kenya where use of
illicit alcohol has become common among rural and in-
formal settlement communities where dealing with the
alcohol dependence problem is further complicated by
the scarce resources in such communities.
In spite of the high health and social economic costs
associated with alcohol use disorders most African go-
vernments depend heavily on alcohol industries for reve-
nue received through taxation. These coupled with em-
ployment opportunities for people gives the alcohol in-
dustries a bargaining power when it comes to introduce-
tion, implementation and enforcement of alcohol po licies
in Africa.
2. METHOD
Ethical approval for the study was obtained from the
Kenyatta National Hospital/University of Nairobi ethi-
cal review board. Permission to collect the illicit alco-
hol brew samples was obtained from the Ministry of
Public Health and all ethical considerations were ad-
hered to. One hundred and eighty eight participants of a
community based detoxification and rehabilitation pro-
gramme were asked to indicate the types of alcohol
beverages they were using in order of prevalence irre-
spective of whether the brews were licit or illicit. Four-
teen most commonly used brews were randomly pur-
chased fro m the twelv e vi llage s lo cat ed wi thin the s tud y
area.
The purchased alcohol beverages were given a serial
number and taken to the Government Chemist for che-
mical, analysis principal investigator and a public health
officer.
The chemical composition of the alcohol samples was
determined through gas chromatography.
3. RESULTS
A total of 188 participants underwent community-based
detoxification but only 156 were followed up for the six
months. Majority (91.5%) was male and 8.5% were fe-
male. Majority (60.5%) of the participants had begun
drinking alcohol before the age of 18 years, with the
mean AUDIT score being 28.6 for males and 26.6 for
females. The mean age of the group was 31.9 years, with
majority (84%) of the participants aged below 40 years.
The majority (53.3%) of the participants earned an in-
come of less than 143 United States dollars per month.
The majority (51.1%) were married, while 38.9% were
single. The remaining participants were either separated
or divorced.
Fourteen samples of alcoholic b everage were collected
from the study area and labeled F517 - F527 for the licit
brews and F480 - F482 for the illicit brews. Two of the
illicit brews were within the beer range of alcoholic
brews while the third one was within the spirit range.
The results are shown in Table 1.
Four out of the eleven licit brews had not complied
with the recommended Kenya Bureau of Standards

M. W. Kuria, Y. Olando / Open Journal of Psychiatry 2 (2012) 301-304 303
Table 1. Ethanol content of illicit alcohol beverages.
Sample No. Sample description Ethanol content % (v/v)
F480/07-08 Chang’aa 33.54
F481/07-08 Muratina 4.84
F482/07-08 Busaa 6.03
ethanol levels. Samples in report F523 and F525 had
lower than recommended ethanol levels. Sample F518
was labelled as an herbal brew but was found to have a
high content of ethanol (8.9% v/v), qualifying it to be a
stronger than beer and in the range of fruit wines (8% -
14% v/v ethanol content). The manufacturer labeled sam-
ple F519 as a traditional brew but the ethanol content
(31.5% v/v) which qualified it to be a spirit. The results
are shown in Table 2.
4. DISCUSSION
Published data on chemical composition of alcoholic
beverages used by alcohol dependent persons is scarce in
Africa. There is a wide range of alcoholic brews sold in
Kenya and although the majo rity of these brews are licit,
a good number of them are illicit and are prepared, sold
in secret and is therefore unrecorded. There is no re-
commended ethano l content in the illicit alcoholic brews
since they are manufactured illegally. This poses danger
of dependence to the consumers since some of the alco-
hol brews may be potent. The manufacture of illicit
brews is common in informal settlements like th e current
study area. The law enforcers are unable to penetrate the
densely populated settlements. The current study did not
find any methanol or impurities in the alcoholic brews.
In the past deaths and blindness has been reported after
use of illicit brews laced with methanol and toxic sub-
stances [8]. In spite of the reported dangers people con-
tinue to drink the brews because they are cheaper and
sometimes more potent than the licit brews. Maintain-
ing the recommended alcohol standards is difficult in
informal settlements where law and order is mostly not
observed and law enforcers may not be able to penetrate
the area due to unplanned and congested residential and
business premises. Furthermore, adequate social or
health facilities are unavailable to assist the dependent
persons, majority of whom cannot afford the cost of treat-
men t.
There was a discrepancy between the actual and the
recommended ethanol content in the licit brews. Since
taxation of alcoholic brews depends on the ethanol con-
tent such discrepancies are likely to benefit the alcohol
manufacturers. According to [4] variation in alcohol con-
centration is one of the factors that determine volume
consumed. The finding that some brews marketed as
herbal drinks had a high ethanol content indicates that
non suspecting Kenyans are using alcohol unknowingly.
Herbal beverages are used by many people as health
drinks. Such users of “herbal” drinks that have high
ethanol content are likely to become alcohol dependent
due to the regular and heavy use, and eventually damage
their health.
Though industrialized types of alcohol are used in
Kenya, there is currently a heavy use of traditional be-
verages which are cheaper and more potent with a high
unrecorded consu mption of 5 litres per capita [3,14]. The
Table 2. Analytic report of illicit alcohol beverages.
Sample
identity
Number Sample description Ethyl alcohol
content % v/v KEBS recommended levels of ethanol Methanol levels (PPM)Total diss olved solids (m/v)%Max. recomme nde d dissolved solids
KEBS
Compliant/
Non-compliant
F517 Tiger brandy 39.16 37.5 (min) Nil 0.045 2.0 Yes
F518* Miti ni dawa 8.90 Nil Nil Nil Not indicted No
F519 Kienyenji African
brew 32.21 Nil Nil 0.0029 0.0284 No
F520* Stega traditional brew 3.97
<4 Nil Nil Not indicated Yes
F521 Kenya king gin 41.92 37.5 (min) Nil 0.0047 1.5 (max) Yes
F522 Hardyman gin extra 38.8 4 37.5 (min) Nil 0.0168 0.5 (max) Yes
F523 Free gin 32.21 37.5 (min) Nil 0.0 029 No
F524 Raaz brandy 38.07 37.5 (min) Nil 0.0352 2.0 (max) Yes
F525 Lakers extra golden
spirits 33.58 37.5 (min) Nil 0.0029 1.5 (max) No
F526 Kana extra golden
label 39.29 37.5 (min) N il 0.0252 Not indicated Yes
F527 Safari ice berg liquor 11. 4 5 Nil Nil Not indicated Yes
*Traditional alcohol brew; KEBS: Kenya Bureau of Standard; PPM : Parts Per Million; m /v: Mi lligram Per Volume ; v/v: Volume by Volume.

M. W. Kuria, Y. Olando / Open Journal of Psychiatry 2 (2012) 301-304 304
current study confirms that some of the traditional be-
verages are highly po tent with the ethano l contents in the
range of spirits. This coupled with a hazardous drinking
pattern of Kenyans endangers the health of the users.
A new alcohol law has been instituted to regulate the
sale of alcohol to reduce the complications associated
with their use. The challenge is law enforcement espe-
cially in the informal settlements. Maintaining standard
control of composition of alcoholic brews may help re-
duce the prevalence and severity of alcohol dependence.
5. CONCLUSIONS
The findings of the current study indicates not only dis-
crepancies in the expected and real ethanol content in the
Kenyan alcoholic brews but also high ethanol containing
illicit brews alcohol beverages.
Curbing of manufacture of illicit alcohol beverages
and enforcing quality control on alcohol available in the
market is important. Law enforcers should ensure that all
alcoholic drinks in the market are licit and co mplies with
set standards.
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