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

Copyright Alcohol Medical Scholars Program 4

Epidemiology

• 20-40% hospital admissions

• Outpatient setting

• 100,000 deaths per year

• Alcoholics who continue drinking have a shortened life-span of 15 years

Copyright Alcohol Medical Scholars Program 5

Acute Effects

• CNS– accidents

• Gastrointestinal

• Respiratory– overdose

Copyright Alcohol Medical Scholars Program 6

Overview

• Acute effects

• Chronic heavy use

• Withdrawal

Copyright Alcohol Medical Scholars Program 7

Effects of Chronic Heavy Drinking

• CNS– Neuropathies– Cerebellar

degeneration– Dementia– Wernicke-Korsakoff’s

syndrome

Copyright Alcohol Medical Scholars Program 8

Effects of Chronic Heavy Drinking

• Gastrointestinal– Alimentary/stomach– Liver– Pancreas

• Cardiovascular– Hypertension– Cardiomyopathy– Stroke

Copyright Alcohol Medical Scholars Program 9

Effects of Chronic Heavy Drinking

• Reproductive

Copyright Alcohol Medical Scholars Program 10

Effects of Chronic Heavy Drinking

• Hematologic

• Musculoskeletal

• Endocrine

• Dermatologic

Copyright Alcohol Medical Scholars Program 11

Biological Markers of Chronic Heavy Drinking

• GGT (>30)

• CDT (>20)

• MCV (>90)

• AST/ALT

Copyright Alcohol Medical Scholars Program 12

Overview

• Acute effects

• Chronic heavy use

• Withdrawal

Copyright Alcohol Medical Scholars Program 13

Withdrawal Effects

• Rule of thumb:–Withdrawal effects are opposite

of intoxication sx/signs

• Alcohol withdrawal

Copyright Alcohol Medical Scholars Program 14

Alcohol-Drug Interactions

• Illicit drugs (e.g., cocaine, heroin)

• Prescription drugs(e.g., benzodiazepines, metronidazole)

• Over-the-counter drugs (e.g., acetaminophen) Rx

Copyright Alcohol Medical Scholars Program 15

Fetal Alcohol Syndrome

• Growth retardation

• Facial dysmorphism

• Severe CNS dysfunction

Copyright Alcohol Medical Scholars Program 16

Moderate Alcohol Use

• Cardiovascular

• Gallstones

• Other potential beneficial effects

Copyright Alcohol Medical Scholars Program 17

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

Copyright Alcohol Medical Scholars Program 18

Marijuana

• Motor vehicle accidents

• Learning

• Respiratory

• Immune system

Copyright Alcohol Medical Scholars Program 19

Stimulants (Cocaine and Amphetamine)

• Cardiovascular

• Neurological

• Injection risks

Copyright Alcohol Medical Scholars Program 20

Opioids

• Overdose

• Injection risks

• Gastrointestinal

• Musculoskeletal

Copyright Alcohol Medical Scholars Program 21

Other Drugs

• PCP

• Inhalants

Copyright Alcohol Medical Scholars Program 22

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