Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

18 Sivan 5760 - June 21, 2000 | Mordecai Plaut, director Published Weekly








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Home and Family
Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

One of the problems in writing a medical column is that the discussion of some conditions is irrelevant to many readers. Sometimes what I write about it is relevant to people who don't read my articles; sort of like the rav whose sermon to his congregation is more relevant to those who aren't there. But at some point you may meet a neighbor or a chavrusa with this problem and your intervention may save a life.

Today's subject is a difficult one and not often discussed in our circles. As it is embarrassing to admit to this problem, and often those who suffer from it deny it is a problem, it is impossible to know it's incidence. I'm speaking about alcoholism.

The use of alcohol is different than cigarettes. With cigarettes, the research has shown that even a small amount is dangerous. Occasional alcohol use may even be beneficial. However, like many things overuse can cause many problems.

An acute overdose of alcohol can cause vomiting and stomach distress. What is most concerning is that an acute overdose can cause enough sleepiness to stop breathing. We see this most with higher proof alcohol in those not used to drinking and in those who drink and use medications that may compound the effects.

Probably the most dangerous thing in acute alcohol use is the impaired judgment. Drunken drivers kill thousands yearly in the U.S.A., and even small amounts of alcohol can impair enough judgment to cause a major accident. Before Purim and before going to a chasunah one should give his car keys to his wife or consider taking a taxi home.

Chronic overuse of alcohol can cause liver failure (commonly known as cirrhosis) and other diseases such as pancreatitis, esophageal cancer, stomach ulcer, and heart failure. Alcohol easily becomes fat, another problem we commonly see (the so called "beer belly"). Fetal alcohol syndrome is a condition where a child develops poorly due to the mother's drinking while pregnant. Often alcoholics are malnutritioned.

This will not happen to those who have a small cup of wine with dinner. So how can one tell who needs help?

There are many scales and tests, but one I find particularly helpful is the CAGE questionnaire. This identifies alcoholics who should seek help.

The four questions are as follows: Have you ever tried to cut down on your drinking? Do you get annoyed when people complain about your drinking? Do you feel guilty about your drinking? Do you ever need an "eye opener"?

People who answer yes to these questions should get help through substance abuse programs that are available to the frum community. Unfortunately the results are mediocre, especially in view of the fact that alcoholism may be hereditary. Also, unlike stopping to smoke, stopping to drink often requires hospitalization as these people go through terrible withdrawal reactions, including shaking episodes, delirious episodes, and hallucinations. This is a terrible disease and if you know someone who may have this problem, do your best to help and daven for them will all your heart. Write me in care of the Yated.

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