This paper is part of a larger project on the consumption of a locally made alcohol, akpeteshie, and its impact on the health and well-being of the people in the Upper West Region of Ghana. The paper reports the findings of a qualitative study using focus group discussions about community perceptions and impacts of akpeteshie. Focus groups were undertaken differently for men (n=25) and women (n=20), and the contents were analysed using grounded theory and from a social learning perspective. Participants indicated that both the elderly and the young were engaged in the use and abuse of akpeteshie. Men drink mainly for coping responses, such as, increased self-confidence, adult status, and to cope with the various social demands. Women seem to drink for socialising with peers. Akpeteshie drinking by both men and women is on the rise, and is increasingly used for sexual abuse and rape. The findings reveal strong perceptions of the health and economic damage that alcohol is having on the people of the area; and the need for policy intervention that not only target health promotion, but an improvement of the socioeconomic conditions of the people and the akpeteshie vendors in the region.