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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