Tag Archives: Alcoholism

Straight, No Chaser: Alcoholism and Alcohol-Related Deaths Are on the Rise

January 27, 2017General Health and Wellness, Public Health, Toxicology/Drugs844-SMA-TALK, Alcohol related deaths, Alcoholism, Behind the Curtain, CDC, Centers for Disease Control and Prevention, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Does it seem that alcoholism isn’t discussed much anymore, or is it that the public health community has focused more on overdose deaths from heroin and prescription painkillers of late? In the news is reason that should change. According to the Centers for Disease Control and Prevention, alcoholism and the deaths related to it are on the rise. Consider the sum total of the following statistics:

Alcohol is killing Americans at a rate higher than at any time in the last 35 years. In 2014, there were 9.6 deaths from alcohol-induced causes per 100,000 people, representing an increase of 37% since 2002.
Last year, more than 30,700 Americans died from causes directly related to alcohol (e.g. alcohol poisoning and cirrhosis).
In 2014, more people died from alcohol-induced causes (30,722) than from overdoses of prescription painkillers and heroin combined (28,647).

In reality, the annual number of deaths directly or indirectly caused by alcohol is closer to 90,000, as the official count of alcohol-induced fatalities excludes deaths from drunk driving, other accidents, and homicides committed under the influence of alcohol.
Where do you fit in this equation? Here’s the deal: 30% of American adults don’t drink at all. Another 30% consume less than one drink per week (on average). On the other hand, the top 10% of American adults (approximately 24 million people) consume an average of 74 drinks per week, or a little more than 10 drinks per day. The heaviest drinkers are at the greatest risk for the alcohol-induced causes of death.

An easy way to minimize your risk, assuming you’re going to drink, is to restrict your alcohol intake at any one time to 2 drinks per day. The especially good news is that level – defined as moderate alcohol consumption – is actually associated with a decreased risk of mortality.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Self Assessment of Alcohol Dependency

April 6, 2016Toxicology/Drugs844-SMA-TALK, Alcohol abuse, Alcohol dependency, Alcohol intoxication, Alcoholism, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight, Straight No ChaserJeffrey Sterling, MD

The number one response to the post on acute alcohol poisoning was pretty simple: “How can I tell if I’m drinking too much over the long haul?” And so it’s back to back the Straight, No Chaser (literally) days. The problems with most intoxicating substances involve the same consideration. You had the most incredible time and got the most incredible high the first time, and you spend the rest of your life chasing the joy of that first buzz, which for most drugs you’ll never get again. The difference with alcohol abuse is that alcohol is legal and comparatively inexpensive, so you get to keep trying without much fuss (at least initially).
Let’s set the stage by standardizing some terms:

Alcohol intoxication: You’re drunk and under the influence of alcohol.
Alcohol abuse: Your drinking habits are unhealthy, resulting in bad consequences (e.g., at work, in your relationships, with the law).
Alcohol dependency: You’re physically and/or mentally addicted to alcohol. You crave liquor and seemingly can’t do without it. Dependency involves withdrawal symptoms when alcohol is not in your system. These symptoms may include anxiety, nausea, sweating, jitteriness, shakes and even withdrawal seizures.

Alcoholism is a chronic disease. Unfortunately, some of us start with a predisposition based on genes and strong influences based on family and cultural considerations. It is so much more than either a lack of willpower or an inability to quit. This disease has a predictable course and defined effects on various parts of the body, leading to specific means of death if unaddressed. Because I’m Straight, No Chaser, I’m not going to deal with the subjective “I can handle my liquor” or “I can stop anytime I want.” I’m going to give you some medical data that defines when you’re doing damage to your body. It’s actually pretty simple.
Are you this guy or gal? (Keep in mind a standard drink is defined as one 12 ounce can of beer, one glass of wine or one mixed drink.)

Women having more than three drinks at one time or more than seven drinks a week
Men having more than four drinks at one time or more than 14 drinks a week

If so, you’re causing damage. We’ve discussed the damage in these additional Straight, No Chaser posts.

Now let’s discuss dependency. Consider the possibility that you may be dependent on alcohol if you have any of these problems over the course of a year:

While you’re drinking, you can’t quit or control how much you drink.
You have tried to quit drinking or to cut back the amount you drink, but can’t.
You need to drink more to get a previous effect. (This is called “tolerance.”)
You have withdrawal symptoms (discussed earlier) when you stop.
You spend a lot of your time either drinking, recovering from drinking or giving up other activities so you can drink.
You continue to drink even though it harms your relationships and causes physical problems.

So What?
Unfortunately, I’m pretty sure no one is giving up alcohol by reading this. Alcohol is part of the American social fabric. We live, celebrate and commemorate milestones with it. It’s glamorized throughout society. It’s constitutionally approved. I appreciate that. In moderation, it’s a good time. Just understand that it’s not a free ride. The danger is in the insidious nature of this disease, meaning issues may creep up on you before you ever know what’s hit you. Then we’re having a completely different conversation.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Medical Complications and Medication Treatment of Alcoholism

April 4, 2016Gastrointestinal, Toxicology/DrugsAcamprosate, Alcoholic beverage, Alcoholism, Behind the Curtain, Delirium tremens, health, Naltrexone, Neurological disorder, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

There are interesting commonalities of certain drugs like alcohol and cigarettes. One is users that really enjoy them are able to do so for a long time while being oblivious to the growing danger those activities pose. Another commonality is even more so than mentally, when things go wrong physiologically, they really go very wrong.
Possible Complications
Alcoholism and alcohol abuse pose threats to many aspects of your health, including the following.

Birth defects (fetal alcohol syndrome)
Bleeding throughout your digestive tract, including the esophagus (up to and including rupture), gastritis (inflammation of the stomach) and ulcer disease.
Brain cell damage
Brain disorder called Wernicke-Korsakoff syndrome (includes dementia, mental status changes)
Cancer of the esophagus, liver, colon, and other areas
Changes in the menstrual cycle (period)
Delirium tremens (DT’s)
Dementia and memory loss
Depression and suicide

Erectile dysfunction
Heart damage
High blood pressure
Increased risks for behavioral disorders including depression and suicide
Increased risks for sexually transmitted infections (STIs)
Increased risks for trauma, including motor vehicle collisions, violence and head injuries with intracranial bleeding
Inflammation of the pancreas (pancreatitis)
Insomnia
Liver disease, including alcoholic hepatitis, cirrhosis and cancer
Nerve damage
Nutritional deficiencies

Treatment

Medical goals and patient goals are often different and seem to depend on the extent of perceptible injury that has occurred at the time of the decision to quit drinking. Often, patients will want to reduce drinking instead of stopping completely. Continued drinking in moderation is only as viable an option as the patient’s level of alcohol-related level of disease and the patient’s ability to stay limited in consumption and focused toward that goal.
Ideally, abstinence (the complete stopping of alcohol intake) is the goal, and it needs to be the goal if and when the desire to stop drinking is coupled with the presence of significant alcohol-related disease.
As everyone knows, the management of alcoholism requires multiple simultaneous approaches, including family and social networks. It is often the family network that helps the alcoholic come to the understanding that alcohol intake has disrupted his or her ability to function normally. It is a most unfortunate occurrence when this has not occurred prior to the development of significant medical disease. Individuals with alcohol problems are more likely to take the steps necessary to successfully withdraw from alcohol use.
Regarding the medical aspects of alcohol cessation, withdrawal is a very important consideration and is best done in a controlled manner. Components of effective withdrawal address the various medical and mental health considerations reviewed earlier and medical avoidance treatment.
Medical avoidance treatment includes medicine that prevent relapse via various methods, and they include the following:

Antabuse (generic name: disulfiram) is a well-known and commonly used medicine that works by producing very unpleasant side effects with virtually any alcohol intake within two weeks of taking the medicine.
Naltrexone (brand name: Vivitrol) is an injectable medicine that works to decrease alcohol cravings.
Acamprosate is a drug that has been shown to lower relapse rates in those who are dependent on alcohol.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Alcohol Abuse and Alcoholism

April 3, 2016Toxicology/DrugsAlcohol, Alcohol abuse, Alcoholism, Behind the Curtain, Drink, Facebook, National Institutes of Health, Physical dependence, Self-esteem, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Substance abuse, WithdrawalJeffrey Sterling, MD

With all the focus of late on other forms of drug use and abuse (e.g., methamphetamine, marijuana), alcohol abuse seems to be lacking the attention it deserves. Fully one in six people in the United States has a drinking problem. In this segment of the Straight, No Chaser series on alcohol, we will explore problem drinking.
“Problem drinking” is a way of describing alcohol intake that causes problems with your functioning. Alcohol abuse is an episode or continued excessive alcohol consumption that causes problems with your daily living activities, such as family or job responsibilities. Of course, a single episode of alcohol abuse can cost you your life if you’re an impaired driver who runs into a tree or some other calamity befalls you.

Alcoholism is alcohol dependence, which is composed of two separate considerations:

Physical addiction to a drug is defined by tolerance and withdrawal symptoms. Tolerance is when you become acclimated to the same dose of drug, meaning, in this case, the same amount of liquor no longer gives you the same buzz. Withdrawal symptoms occur when you experience effects from no longer having the drug in your system.
Mental addiction to alcohol is illustrated by its increasingly prominent role in your life. Your life becomes centered around the pursuit and consumption of alcohol. It creates problems with your physical, mental and social health, controlling your life and relationships.

Regarding environment, there’s no fixed equation to if and when you’ll become dependent, but there is a correlation with certain activity and an increased risk. Consider the following activities as suggestive of a significant risk for development alcoholism:

Men who have 15 or more drinks a week (One drink is either a 12-ounce bottle of beer, a 5-ounce glass of wine or a 1.5 ounce shot of liquor.)
Women who have 12 or more drinks a week
Anyone who has five or more drinks at a time at least once a week
Anyone who has a parent with alcoholism

Here are some less hard signs, but these situations also have been shown to increase risk, according to the National Institutes of Health:

You are a young adult under peer pressure
You have a behavioral health disorder such as depression, bipolar disorder, anxiety disorders, or schizophrenia
You have easy access to alcohol
You have low self-esteem
You have problems with relationships
You live a stressful lifestyle
You live in a culture in which alcohol use is more common and accepted

Straight, No Chaser: Alcoholism and Alcohol-Related Deaths Are on the Rise

January 30, 2016General Health and Wellness, Public Health, Toxicology/Drugs844-SMA-TALK, Alcohol related deaths, Alcoholism, Behind the Curtain, CDC, Centers for Disease Control and Prevention, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Alcohol is killing Americans at a rate higher than at any time in the last 35 years. In 2014, there were 9.6 deaths from alcohol-induced causes per 100,000 people, representing an increase of 37% since 2002.
Last year, more than 30,700 Americans died from causes directly related to alcohol (e.g. alcohol poisoning and cirrhosis).
In 2014, more people died from alcohol-induced causes (30,722) than from overdoses of prescription painkillers and heroin combined (28,647).

An easy way to minimize your risk, assuming you’re going to drink, is to restrict your alcohol intake at any one time to 2 drinks per day. The especially good news is that level – defined as moderate alcohol consumption – is actually associated with a decreased risk of mortality.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Self Assessment of Alcohol Dependency

April 10, 2015Toxicology/Drugs844-SMA-TALK, Alcohol abuse, Alcohol dependency, Alcohol intoxication, Alcoholism, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight, Straight No ChaserJeffrey Sterling, MD

Alcohol intoxication: You’re drunk and under the influence of alcohol.
Alcohol abuse: Your drinking habits are unhealthy, resulting in bad consequences (e.g., at work, in your relationships, with the law).
Alcohol dependency: You’re physically and/or mentally addicted to alcohol. You crave liquor and seemingly can’t do without it. Dependency involves withdrawal symptoms when alcohol is not in your system. These symptoms may include anxiety, nausea, sweating, jitteriness, shakes and even withdrawal seizures.

Women having more than three drinks at one time or more than seven drinks a week
Men having more than four drinks at one time or more than 14 drinks a week

If so, you’re causing damage. We’ve discussed the damage in these additional Straight, No Chaser posts.

Now let’s discuss dependency. Consider the possibility that you may be dependent on alcohol if you have any of these problems over the course of a year:

While you’re drinking, you can’t quit or control how much you drink.
You have tried to quit drinking or to cut back the amount you drink, but can’t.
You need to drink more to get a previous effect. (This is called “tolerance.”)
You have withdrawal symptoms (discussed earlier) when you stop.
You spend a lot of your time either drinking, recovering from drinking or giving up other activities so you can drink.
You continue to drink even though it harms your relationships and causes physical problems.

So What?
Unfortuantely, I’m pretty sure no one is giving up alcohol by reading this. Alcohol is part of the American social fabric. We live, celebrate and commemorate milestones with it. It’s glamorized throughout society. It’s constitutionally approved. I appreciate that. In moderation, it’s a good time. Just understand that it’s not a free ride. The danger is in the insidious nature of this disease, meaning issues may creep up on you before you ever know what’s hit you. Then we’re having a completely different conversation.
I look forward to any questions or thoughts on the topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: The Medical Complications and Medication Treatment of Alcoholism

April 8, 2015Gastrointestinal, Toxicology/DrugsAcamprosate, Alcoholic beverage, Alcoholism, Delirium tremens, health, Naltrexone, Neurological disorder, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Birth defects (fetal alcohol syndrome)
Bleeding throughout your digestive tract, including the esophagus (up to and including rupture), gastritis (inflammation of the stomach) and ulcer disease.
Brain cell damage
Brain disorder called Wernicke-Korsakoff syndrome (includes dementia, mental status changes)
Cancer of the esophagus, liver, colon, and other areas
Changes in the menstrual cycle (period)
Delirium tremens (DT’s)
Dementia and memory loss
Depression and suicide

Erectile dysfunction
Heart damage
High blood pressure
Increased risks for behavioral disorders including depression and suicide
Increased risks for sexually transmitted infections (STIs)
Increased risks for trauma, including motor vehicle collisions, violence and head injuries with intracranial bleeding
Inflammation of the pancreas (pancreatitis)
Insomnia
Liver disease, including alcoholic hepatitis, cirrhosis and cancer
Nerve damage
Nutritional deficiencies

Antabuse (generic name: disulfiram) is a well known and commonly used medicine that works by producing very unpleasant side effects with virtually any alcohol intake within two weeks of taking the medicine.
Naltrexone (brand name: Vivitrol) is an injectable medicine that works to decrease alcohol cravings.
Acamprosate is a drug that has been shown to lower relapse rates in those who are dependent on alcohol.

Feel free to contact your SMA expert consultant if you have any questions on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Alcohol Abuse and Alcoholism

April 7, 2015Toxicology/DrugsAlcohol, Alcohol abuse, Alcoholism, Drink, Facebook, National Institutes of Health, Physical dependence, Self-esteem, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Substance abuse, United States, Withdrawal, WordPressJeffrey Sterling, MD

Alcoholism is alcohol dependence, which is comprised of two separate considerations:

Physical addiction to a drug is defined by tolerance and withdrawal symptoms. Tolerance is when you become acclimated to the same dose of drug, meaning, in this case, the same amount of liquor no longer gives you the same buzz. Withdrawal symptoms occur when you experience effects from no longer having the drug in your system.
Mental addiction to alcohol is illustrated by its increasingly prominent role in your life. Your life becomes centered around the pursuit and consumption of alcohol. It creates problems with your physical, mental and social health, controlling your life and relationships.

Men who have 15 or more drinks a week (One drink is either a 12-ounce bottle of beer, a 5-ounce glass of wine or a 1.5 ounce shot of liquor.)
Women who have 12 or more drinks a week
Anyone who has five or more drinks at a time at least once a week
Anyone who has a parent with alcoholism

Here are some less hard signs, but these situations also have been shown to increase risk, according to the National Institutes of Health:

You are a young adult under peer pressure
You have a behavioral health disorder such as depression, bipolar disorder, anxiety disorders, or schizophrenia
You have easy access to alcohol
You have low self-esteem
You have problems with relationships
You live a stressful lifestyle
You live in a culture in which alcohol use is more common and accepted

Straight, No Chaser: Questions About Memory Loss and Forgetfulness

June 1, 2014Diet and Nutrition, General Health and Wellness, Neurology844-SMA-TALK, Alcoholism, amnesia, forgetfulness, korsakoff's psychosis, memory loss, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, wernicke's encephalopathyJeffrey Sterling, MD

Are you the type that has a bad memory? Is your memory good when you “want it to be?” Do you just have problems paying attention? Are you concerned about elderly family members suffering from dementia or Alzheimer’s disease? This Straight, No Chaser may have some answers to your common questions. Feel free to ask any others you may have.
Am I forgetful, absent-minded or do I have a serious memory problem?
You tell me. It’s not memory loss if you never paid attention to begin with (there’s a joke about husbands and sporting events in here somewhere). It’s certainly the case that the more you focus on remembering whatever it is, the more likely it is that you will.
Ok then, what’s the difference between normal forgetfulness and serious memory loss?
To understand this distinction, think about functionality. We all forget things. It is a clear concern when the things being forgotten involve items needed for activities of daily living (your name, your address, your birthday, etc.).
Why do we forget?
This is a very complicated question and the cause is often multifactorial, include one or several of aging, medical and emotional considerations.

So what about health-related causes of memory loss?
If this refers to non-aging causes, there are several. There a phenomenon called state-dependent learning that’s pretty fascinating. For example, if you learn something while intoxicated, you may not remember it while sober, and you may remember it again once intoxicated again. Alcoholism itself causes conditions (e.g. Wernicke’s encephalopathy and Korsakoff’s psychosis – these aren’t esoteric; these are out there) in which memory loss is a component. Chronic alcohol use and other conditions that involve vitamin deficiencies (e.g. Vit D, Vit B12) also produce memory loss and deficiencies.
Is it true that stress can cause memory loss?
Yes, both stress and depression can cause memory loss, both emotionally and physiologically.

Should I worry about Alzheimer’s?
No. Alzheimer’s happens whether you “worry” about it or not. What you should do is be concerned about memory loss and trying to prevent premature dementia. First, take steps to protect and build your memory. Second, if you are experiencing memory loss, discuss it with your physician. He or she will know what to do from there.
Ok, then how do I work on my memory?
An active brain is a healthy brain. Of course diet and exercise will keep all of you healthy, including your brain. There are untold numbers of memory games and problem-solving exercises you can perform to train and keep your brain sharp. Learn a new skill or dabble in a new language. In general, socializing and engaging your mind in activities is most of what you need. Alternatively, you can also protect against your bad memory (or inattentiveness). Make a habit of placing your keys, purse/wallet and other needed items in the same place, so when something’s lost, instead of remembering what you did, you can ask yourself “what was I supposed to do?” And yes, guys you can pay better attention to your wives.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Self Assessment of Alcohol Dependency

January 21, 2014Toxicology/Drugs844-SMA-TALK, Alcohol abuse, Alcohol dependency, Alcohol intoxication, Alcoholism, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight, Straight No ChaserJeffrey Sterling, MD

Alcohol intoxication: You’re drunk and under the influence of alcohol.
Alcohol abuse: Your drinking habits are unhealthy, resulting in bad consequences (e.g., at work, in your relationships, with the law).
Alcohol dependency: You’re physically and/or mentally addicted to alcohol. You crave liquor and seemingly can’t do without it. Dependency involves withdrawal symptoms when alcohol is not in your system. These symptoms may include anxiety, nausea, sweating, jitteriness, shakes and even withdrawal seizures.

Women having more than three drinks at one time or more than seven drinks a week
Men having more than four drinks at one time or more than 14 drinks a week

If so, you’re causing damage. We’ve discussed the damage in these additional Straight, No Chaser posts.

Now let’s discuss dependency. Consider the possibility that you may be dependent on alcohol if you have any of these problems over the course of a year:

While you’re drinking, you can’t quit or control how much you drink.
You have tried to quit drinking or to cut back the amount you drink, but can’t.
You need to drink more to get a previous effect. (This is called “tolerance.”)
You have withdrawal symptoms (discussed earlier) when you stop.
You spend a lot of your time either drinking, recovering from drinking or giving up other activities so you can drink.
You continue to drink even though it harms your relationships and causes physical problems.

So What?
Unfortuantely, I’m pretty sure no one is giving up alcohol by reading this. Alcohol is part of the American social fabric. We live, celebrate and commemorate milestones with it. It’s glamorized throughout society. It’s constitutionally approved. I appreciate that. In moderation, it’s a good time. Just understand that it’s not a free ride. The danger is in the insidious nature of this disease, meaning issues may creep up on you before you ever know what’s hit you. Then we’re having a completely different conversation.
I look forward to any questions or thoughts on the topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: The Medical Complications and Medication Treatment of Alcoholism

December 23, 2013Toxicology/DrugsAcamprosate, Alcoholic beverage, Alcoholism, Delirium tremens, health, Naltrexone, Neurological disorder, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Birth defects (fetal alcohol syndrome)
Bleeding throughout your digestive tract, including the esophagus (up to and including rupture), gastritis (inflammation of the stomach) and ulcer disease.
Brain cell damage
Brain disorder called Wernicke-Korsakoff syndrome (includes dementia, mental status changes)
Cancer of the esophagus, liver, colon, and other areas
Changes in the menstrual cycle (period)
Delirium tremens (DT’s)
Dementia and memory loss
Depression and suicide
Erectile dysfunction
Heart damage
High blood pressure
Increased risks for behavioral disorders including depression and suicide
Increased risks for sexually transmitted infections (STIs)
Increased risks for trauma, including motor vehicle collisions, violence and head injuries with intracranial bleeding
Inflammation of the pancreas (pancreatitis)
Insomnia
Liver disease, including alcoholic hepatitis, cirrhosis and cancer
Nerve damage
Nutritional deficiencies

Treatment
Medical goals and patient goals are often different and seem to depend on the extent of perceptible injury that has occurred at the time of the decision to quit drinking. Often, patients will want to reduce drinking instead of stopping completely. Continued drinking in moderation is only as viable an option as the patient’s level of alcohol-related level of disease and the patient’s ability to stay limited in consumption and focused toward that goal.
Ideally, abstinence (the complete stopping of alcohol intake) is the goal, and it needs to be the goal if and when the desire to stop drinking is coupled with the presence of significant alcohol-related disease.
As everyone knows, the management of alcoholism requires multiple simultaneous approaches, including family and social networks. It is often the family network that helps the alcoholic come to the understanding that alcohol intake has disrupted his or her ability to function normally. It is a most unfortunate occurrence when this has not occurred prior to the development of significant medical disease. Individuals with alcohol problems are more likely to take the steps necessary to successfully withdraw from alcohol use.
Regarding the medical aspects of alcohol cessation, withdrawal is a very important consideration and is best done in a controlled manner. Components of effective withdrawal address the various medical and mental health considerations reviewed earlier and medical avoidance treatment.
Medical avoidance treatment includes medicine that prevent relapse via various methods, and they include the following:

Antabuse (generic name: disulfiram) is a well known and commonly used medicine that works by producing very unpleasant side effects with virtually any alcohol intake within two weeks of taking the medicine.

Naltrexone (brand name: Vivitrol) is an injectable medicine that works to decrease alcohol cravings.
Acamprosate is a drug that has been shown to lower relapse rates in those who are dependent on alcohol.

This is part of an ongoing series on alcohol use and abuse.

Click here to review the symptoms suggestive of alcoholism.
Additional posts will review a severe form of alcohol withdrawal, delirium tremens (the DTs) and non-medical aspects of treatment.

Feel free to contact your SMA expert consultant if you have any questions on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Alcohol Abuse and Alcoholism

December 21, 2013Toxicology/DrugsAlcohol, Alcohol abuse, Alcoholism, Drink, Facebook, National Institutes of Health, Physical dependence, Self-esteem, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Substance abuse, United States, Withdrawal, WordPressJeffrey Sterling, MD

With all the focus of late on other forms of drug use and abuse (e.g., methamphetamine, marijuana), alcohol abuse seems to be lacking the attention it deserves. Fully one in six people in the United States has a drinking problem. In this segment of the Straight, No Chaser series on alcohol, we will explore problem drinking.
For an additional personal look at if you drink too much, click here.
“Problem drinking” is a way of describing alcohol intake that causes problems with your functioning. Alcohol abuse is an episode or continued excessive alcohol consumption that causes problems with your daily living activities, such as family or job responsibilities. Of course, a single episode of alcohol abuse can cost you your life if you’re an impaired driver who runs into a tree or some other calamity befalls you.
Alcoholism is alcohol dependence, which is comprised of two separate considerations:

Physical addiction to a drug is defined by tolerance and withdrawal symptoms. Tolerance is when you become acclimated to the same dose of drug, meaning, in this case, the same amount of liquor no longer gives you the same buzz. Withdrawal symptoms occur when you experience effects from no longer having the drug in your system.
Mental addiction to alcohol is illustrated by its increasingly prominent role in your life. Your life becomes centered around the pursuit and consumption of alcohol. It creates problems with your physical, mental and social health, controlling your life and relationships.

Many of you ask if alcoholism is hereditary. Hereditary means a specific thing medically, so the answer is no. However, we believe genes play a role and increase the risk of alcoholism. It is most likely that genetics “load the gun,” but environment “pulls the trigger.”
Regarding environment, there’s no fixed equation to if and when you’ll become dependent, but there is a correlation with certain activity and an increased risk. Consider the following activities as suggestive of a significant risk for development alcoholism:

Men who have 15 or more drinks a week (One drink is either a 12-ounce bottle of beer, a 5-ounce glass of wine or a 1.5 ounce shot of liquor.)
Women who have 12 or more drinks a week
Anyone who has five or more drinks at a time at least once a week
Anyone who has a parent with alcoholism

Here are some less hard signs, but these situations also have been shown to increase risk, according to the National Institutes of Health:

You are a young adult under peer pressure
You have a behavioral health disorder such as depression, bipolar disorder, anxiety disorders, or schizophrenia
You have easy access to alcohol
You have low self-esteem
You have problems with relationships
You live a stressful lifestyle
You live in a culture in which alcohol use is more common and accepted

Feel free to contact your SMA expert consultant if you have any questions on this topic.
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Straight, No Chaser: Do You Drink Too Much?

August 6, 2013Health PreventionAlcohol, Alcohol intoxication, Alcoholism, Drink, health, Liquor, Standard drink, Straight No Chaser (composition), Substance abuse, United States, WithdrawalJeffrey Sterling, MD

It’s one of those Straight, No Chaser (literally) days. I haven’t addressed substance abuse much yet (and you know I will), but the problems with most intoxicating substances revolve around the same consideration. You had the most incredible time and got the most incredible high the first time, and you spend the rest of your life chasing the joy of that first buzz, which for most drugs you’ll never get. The difference with alcohol abuse is that alcohol is legal and comparatively inexpensive, so you get to keep trying without much fuss (or at least initially).
Let’s set the stage by standardizing some terms:

Alcohol intoxication: You’re drunk and under the influence of alcohol.
Alcohol abuse: Your drinking habits are unhealthy, resulting in bad consequences (e.g. at work, in your relationships, with the law).
Alcohol dependency: You’re physically and/or mentally addicted to alcohol. You crave liquor and seemingly can’t do without it. Dependency involves withdrawal symptoms when alcohol is not in your system. These symptoms may include anxiety, nausea, sweating, jitteriness, shakes and even withdrawal seizures.

Alcoholism is a chronic disease. Unfortunately, some of us start with a predisposition based on genes and strong influences based on family and cultural considerations. It is so much more than either a lack of willpower or an inability to quit. This disease has a predictable course and defined effects on various parts of the body, leading to specific means of death if unaddressed. Because I’m Straight, No Chaser, I’m not going to deal with the subjective thoughts you offer about whether or not you can ‘handle your liquor’ or whether you believe ‘you can stop anytime you want’. I’m going to give you some medical data that defines when you’re doing damage to your body. It’s actually pretty simple.
Are you this guy or gal (keep in mind a standard drink is defined as one 12 ounce can of beer, 1 glass of wine or 1 mixed drink)?

Women having more than 3 drinks at one time or more than 7 drinks a week.
Men having more than 4 drinks at one time or more than 14 drinks a week.

If so, you’re causing damage. We’ll get into the specifics at another time.
That’s damage. Let’s discuss dependency. Consider the possibility that you may be dependent on alcohol if you have any of these problems over the course of a year:

While you’re drinking, you can’t quit or control how much you drink.
You have tried to quit drinking or to cut back the amount you drink but can’t.
You need to drink more to get a previous effect (This is called ‘tolerance’.).
You have withdrawal symptoms (discussed earlier) when you stop.
You spend a lot of your time either drinking, recovering from drinking, or giving up other activities so you can drink.
You continue to drink even though it harms your relationships and causes physical problems.

So What?
No one is giving up alcohol by reading this, I’m sure. I haven’t even touched to the harsh realities of alcoholism (yet). Alcohol is part of the American social fabric. We live, celebrate and commemorate milestones with it. It’s glamorized throughout society. It’s constitutionally approved. I appreciate that. In moderation, it’s a good time. Just understand that it’s not a free ride. The danger is in the insidious nature of this disease, meaning issues may creep up on you before you ever know what’s about to hit you. Then we’re having a completely different conversation.
I look forward to any questions or thoughts on the topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.