Kerala has the highest per capita consumption of alcohol in the country. (Image for representation: PTI)

Special passes will be issued for tipplers in Kerala to buy liquor but on doctor's prescription that they are showing withdrawal symptoms due to non-availability of alcohol in view of lockdown over novel coronavirus spread.

A decision allowing the purchase of liquor from the Excise department in a "controlled manner" was taken by the state government to "resolve" what it called many social issues including suicidal tendencies and frustration among people who consumed alcohol regularly.

However, the medical fraternity was up in arms on Tuesday against the government order.

The Kerala Government Medical Officer's Association (KGMOA) has decided to observe April 1 as 'black day' in protest against the order issued late on Monday night.

Dr Vijayakrishnan G S, General Secretary of the KGMOA, called the decision a medical blunder.

The Indian Medical Association(IMA) also flayed the Left government's plan to supply liquor to addicts based on prescription, saying it was not "scientific".

Three men in Kerala have committed suicide after allegedly showing alcohol withdrawal symptoms within days after liquor stores shut the doors following the 21-day national lockdown that came into force last Wednesday to try halt the spread of COVID-19. Similar incidents have been reported in other parts of the country including in neighbouring Telangana and Karnataka.

Kerala has the highest per capita consumption of alcohol in the country. The sale of liquor in the state has continued on an upward spiral despite the prohibitive tax on legal alcohol and the many dry days.

The state had a record Rs 14,508 crore liquor sales in 2018-19 sold through the Kerala State Beverages Corporation (Bevco), the state-owned liquor retail monopoly, compared to around Rs 11,000 crore in the previous year, according to official data.

The amount of liquor sold in bars and hotels remained unquantified. Bootleg liquor, hooch and moonshine also appropriated a sizeable segment of the market for cheap and hard spirits on holidays.

"Following the lockdown and the closure of liquor outlets in the state, there were many instances of social issues including the frustration and suicide tendencies shown by those who used to consume liquor regularly and the state government has decided to initiate steps to resolve the matter," the order said.

The order said that those who have physical and mental issues due to withdrawal symptoms could be given liquor in a "controlled" and "prescribed" manner.

It also said that such persons with withdrawal symptoms should approach the Public Health Centres, Taluk hospitals, district hospitals, general hospitals or the medical college hospitals and get themselves examined by the doctor.

"If such a person gets a prescription from the doctors saying he has withdrawal symptoms, he could be provided with liquor in a controlled manner," the order read.

It said the prescription could be produced at the nearby Excise office along with a government issued identity card of the person carrying the prescription and receive a liquor pass.

The pass can be produced before the office of the Beverages Cooperation Managing Director, who will take necessary steps to distribute liquor, the order said.

The order also said that the liquor outlets need not be kept opened for this purpose.

"Those showing withdrawal symptoms should be provided scientific treatment which can be given at homes or by giving medicines after admitting them at hospitals," said IMA's Abraham Varghese.

Dr Vijayakrishnan said that at a time when the doctors are fighting the pandemic the move by the government will affect the morale of medical practitioners.

"The duty of the doctor is to treat the patient who approaches him with withdrawal symptoms. The medicines given to during treatment do have side-effects and it's not possible to provide liquor with that," he told reporters.

In neighbouring Telangana, cases of people suffering from alcohol withdrawal have also shown a rise.

Nearly 250 cases have been reported so far at the Institute of Mental Health in Erragadda in Hyderabad.

"Due to non-availability of toddy or liquor in local markets in view of ongoing coronavirus lockdown for the past one week, tipplers are experiencing mild, moderate and severe withdrawal symptoms such as sleeplessness and restlessness. Those complaining of moderate and severe symptoms are admitted to hospitals," doctors at the institute said.

According to the doctors, severe withdrawal symptoms include seizure, epilepsy, behaving in an anti-social manner, injuring themselves or harming others also.

Doctors also warned that sometimes the withdrawal symptoms would be so severe that such patients would develop suicidal symptoms.

On Friday last, a 50-year-old daily wage worker in Hyderabad allegedly committed suicide by jumping off a building as he was upset at not being able to get liquor.

One person died and several others were in a critical condition in Assam's Jorhat district on Monday after consuming raw spirit as a substitute for liquor, police said.

In Karnataka, a man apparently frustrated at not being able to get liquor due to the lockdown attempted to end his life on Sunday, police said.