Alcohol

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Benefits: LOW LEVELS 1-2 drinks

CVD (atherosclerosis) “J” shaped curve

HDL ( less cardiac death, coronaries, angina)

Peripheral artery disease advantages

Diabetes-advantages

Ischemic- advantages

What is a J shaped mortality curve?

Note high drinkers

Note abstainers

How?

More HDL by 5-10%

Less clotting on cholesterol plaques

Some clot dissolving

Improved insulin sensitivity insulin levels

BPH

ED

Dose, an issue!

1) not binging

2) 7-14 US drinks/ week

3) some are susceptible to abuse and addiction

Risks:> 3 drinks/day or binging!

BPStrokeHeart irritationProstate cancerOral cancerPancreatic cancer

Trauma;Violence ED more Sperm quality GI irritation Pancreatitis Hepatic disease Fatty Liver

Definitions:

Alcohol abuse is:

APA definition: maladaptive pattern leading to 1) failure to fulfill work, school, home obligations 2) recurrent use in hazardous situations 3) legal problems 4) drinking despite social problems

Problem Drinking:

WHO ( world health organization) says

> 2 drinks / day (every day average) or > 4 in 1 day

Alcohol Dependence:

tolerance

Physical or emotional withdrawal

amounts over longer time periods

Desire to control use or inability to control

Involvement with alcohol

recreational activities

Drinking despite problems

Define Alcoholism:

See page 204 in Simon, MD

Cage Test:

Cut Down?

Annoyed by criticism?

Guilty about drinking

An a.m. “eye opener”?