Alcohol Abuse

Incidence in USA: 10% of Americans, incl physicians, will abuse alcohol at some point in their lives.

1:5 surgical pts has some form of alcohol use disorder.

Third leading cause of death and disability, incl 30% of traffic fatalities.

Male gender and family Hx major are risk factors.

Severe malnutrition as significant as ETOH-induced end-organ injury.

Risk of Htn, CVA, diabetes, GI disease.

Liver is the most severely affected organ.

Dilated cardiomyopathy.

Withdrawal symptoms can be life threatening.

Concomitant use of other drugs: Amphetamines, cocaine, benzodiazepines.

Affects of chronic smoking, such as COPD and emphysema.

Vasopressor effect of ETOH may cause Htn.

Acute withdrawal and delirium tremens are life-threatening complications. Symptoms caused by sympathetic stimulation can range from mild tremors to electrolyte disturbances, seizures, and death.

Disease characterized by addiction (compulsion and craving despite consequences) to alcohol.

Clinical syndromes related to direct effect of ETOH and secondary adaptive response to excess ETOH exposure.

ETOH rapidly absorbed and metabolized.

Hepatic dysfunction usually takes 10 to 15 y to develop.

Cirrhosis may develop after 1 or more acute episodes.

Unknown: Likely mutifactorial with environmental, genetic, and psychosocial components