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Copyright Alcohol Medical Scholars Program 1
Medical Consequences of Alcohol and Drug Use
Disorders
Eric B. Raimo, M.D.
Copyright Alcohol Medical Scholars Program 2
www.alcoholmedicalscholars.org
Copyright Alcohol Medical Scholars Program 3
Overview
• Acute effects
• Chronic heavy use
• Withdrawal
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Epidemiology
• 20-40% hospital admissions
• Outpatient setting
• 100,000 deaths per year
• Alcoholics who continue drinking have a shortened life-span of 15 years
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Acute Effects
• CNS– accidents
• Gastrointestinal
• Respiratory– overdose
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Overview
• Acute effects
• Chronic heavy use
• Withdrawal
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Effects of Chronic Heavy Drinking
• CNS– Neuropathies– Cerebellar
degeneration– Dementia– Wernicke-Korsakoff’s
syndrome
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Effects of Chronic Heavy Drinking
• Gastrointestinal– Alimentary/stomach– Liver– Pancreas
• Cardiovascular– Hypertension– Cardiomyopathy– Stroke
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Effects of Chronic Heavy Drinking
• Reproductive
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Effects of Chronic Heavy Drinking
• Hematologic
• Musculoskeletal
• Endocrine
• Dermatologic
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Biological Markers of Chronic Heavy Drinking
• GGT (>30)
• CDT (>20)
• MCV (>90)
• AST/ALT
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Overview
• Acute effects
• Chronic heavy use
• Withdrawal
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Withdrawal Effects
• Rule of thumb:–Withdrawal effects are opposite
of intoxication sx/signs
• Alcohol withdrawal
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Alcohol-Drug Interactions
• Illicit drugs (e.g., cocaine, heroin)
• Prescription drugs(e.g., benzodiazepines, metronidazole)
• Over-the-counter drugs (e.g., acetaminophen) Rx
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Fetal Alcohol Syndrome
• Growth retardation
• Facial dysmorphism
• Severe CNS dysfunction
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Moderate Alcohol Use
• Cardiovascular
• Gallstones
• Other potential beneficial effects
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Summary
• Alcohol can be medically hazardous acutely, with chronic high levels of use, and in withdrawal
• Every major organ system is affected
• Morbidity and mortality
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Marijuana
• Motor vehicle accidents
• Learning
• Respiratory
• Immune system
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Stimulants (Cocaine and Amphetamine)
• Cardiovascular
• Neurological
• Injection risks
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Opioids
• Overdose
• Injection risks
• Gastrointestinal
• Musculoskeletal
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Other Drugs
• PCP
• Inhalants
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Summary
• Alcohol and drugs of abuse are physically hazardous
• Medical consequences are associated intoxication, chronic heavy use, and withdrawal
• Specific drugs affect major organ systems differently
• Morbidity and mortality
