Hidden hazards lurk for recovering alcoholics
(HealthDay News) – The first and most important action for alcoholics is to stop drinking. The second is to stay off the booze.
But after that, there are a number of unanticipated pitfalls, all depending on how a long a person has been drinking.
One study has found that alcoholics who have gone through detoxification are more prone to injury than drug users who have been through the same program to kick their addiction.
Although there's no data yet to prove it, one reason for the higher injury rate may be the damage long-term alcohol use inflicts on nerve endings, the researchers suggest. Not surprisingly, that can translate into balance and mobility problems.
Dr. Jeffrey H. Samet, a professor of medicine and chief of the section of general internal medicine at Boston University Medical Center , and his colleagues recruited 470 patients -- 360 males and 110 females -- from a Boston detoxification unit.
The patients were divided into three groups -- alcohol-dependent (99 patients), drug-dependent (172 patients) and those who were both alcohol- and drug-dependent (199 patients). The patients were interviewed while at the detoxification center and again at six months, 12 months, 18 months and 24 months after they'd been through treatment.
They were asked if they'd suffered any of the following kinds of injuries: gunshot wound, stab wound, accidents or falls requiring medical attention, fractures or dislocation of bones or joints, head injury, or an injury from an accident involving a car or motorcycle.
The study found 29 percent of those who were alcohol-dependent suffered an injury after detoxification, compared to 28 percent of the patients who were alcohol- and drug-dependent and 16 percent of those who were drug-dependent.
The study appears in the current issue of the journal Alcoholism: Clinical & Experimental Research .
Samet says he was surprised by the high injury rate for alcoholics after they'd been through detoxification. He and his colleagues first thought the higher injury rate could be explained by alcoholics who had started drinking again. However, the researchers couldn't find any strong evidence of that.
"It made us sit back and take a broader view of these individuals," Samet says.
Damage to nerve endings in hands and feet, called peripheral neuropathy, is a known complication of chronic alcohol use. This may result in decreased sensation in a person's hands and feet, and an impaired ability to walk.
"These people have had their bodies exposed to alcohol for a long time, and there are neurotoxic effects. These neurotoxic effects, one can make the case, may put one at risk of injury," Samet says.
Another possible explanation for the higher injury rates among alcoholics may be found in their character.
"It could be risk-taking personality traits, which may not only put them at risk for alcohol and drugs, but for injuries as well," Samet says.
All these hypotheses require further study, he says.
Samet says the study suggests that detoxification centers may be an ideal place to do injury-prevention education.
Dr. Gail D'Onofrio, a professor and emergency medicine chief at the Yale Medical Group, thinks that's the most significant point of this study.
"[These patients] are there, they're a captive audience, and this is another opportunity to think about how to prevent future injuries," says D'Onofrio.
"It's a great way of offering them some information about injury prevention that we've never thought of before," she says.
That may include educating patients about their increased risk of injury or doing assessments of their living conditions to prevent falls and other accidents, D'Onofrio says.
How widespread is alcohol abuse? Here's what the U.S. government's National Institute on Alcohol Abuse and Alcoholism (NIAAA) says:
Nearly 17.6 million adults in the United States are alcoholics or have alcohol problems. Alcoholism is a disease with four main features:
- Craving - a strong need to drink
- Loss of control - not being able to stop drinking once you've begun
- Physical dependence – withdrawal symptoms, such as nausea, sweating or shakiness after stopping drinking
- Tolerance - the need to drink greater amounts of alcohol in order to get “high”
On the Web
For more information about alcoholism, go to the U.S. government's National Institute on Alcohol Abuse and Alcoholism Web site.
SOURCES:
Interviews with Jeffrey H. Samet, M.D., M.A., M.P.H., Chief , Section of General Internal Medicine , Boston University Medical Center, Boston; Gail D'Onofrio, M.D., M.S. , Professor and Section Chief , Emergency Medicine/Adult, Yale Medical Group , New Haven, Conn.; February 2002 Alcoholism: Clinical & Experimental Research
Author:
Robert Preidt, HealthDay Reporter
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