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National Collegiate Alcohol Awareness WeekAlcohol Awareness Week Oct. 21 - 25Monday, Oct. 21“Alcohol’s Effects on the Fetus: Evidence from History and Current Research” Suzanne Thomas, Ph.D. *Noon, room 100, Basic Science Building Auditorium College of Dental Medicine Tuesday, Oct. 22
Wednesday, Oct. 23
Thursday. Oct. 24
Friday, Oct. 25
Food Booths
Alcohol, drugs disrupt lives of professionalsby Robert Mallin, M.D.Department of Family Medicine “I was in my sixth treatment center and was still sneaking out and going to the liquor store down the block, buying the little airplane bottles, drinking them on the way back to treatment and trying to pretend to be sober. My best friends there turned me in and I was subsequently kicked out of that treatment center. Something happened the day I had to leave there-I’ve always considered it a gift from God. I was able to see that I was not hurting anyone but me with my sneaking and “getting away” with drinking. That I was responsible for doing the things needed to get sober...not the treatment center or my therapist. That I was no different from any other alcoholic—I needed to follow all the directions that I was given from Alcoholics Anonymous, or treatment. That day was the first day of my sobriety. “I had already lost my medical license for the second time. I wasn’t even thinking about whether I would get my license back or not—I was worrying about whether I would be able to get sober when I got kicked out of treatment that time. I had realized that I had no place to go, nothing to do but being miserable, drinking, stealing, using if I didn’t get sober.” These are the words of a young, woman physician, describing her struggle with alcoholism. It describes the desperation many health care professionals experience as they struggle with this disease. Alcoholism and other drug addictions are as prevalent among health care professionals as other segments of the population. The shame associated with the disease, as well as the level of intellectual defense (often described as denial) can make recovery difficult. Often, significant consequences, associated with intervention by licensing boards, or health care workers support groups are necessary to break through this denial and get help for these healers. An anesthesiologist describes his experiences prior to getting intervened upon. “My last days before my intervention were a complete hell on earth. I had come to the realization that I could not stop using drugs. My multiple efforts at self-detox and weaning had inevitably failed. I was gripped with the horror that my life had spun out of control and I was unable to do a thing about it. I felt hopeless. There was no solution. It was utter despair. I began planning my suicide, which was the best solution I could come up with. I remember thinking that at least my family would get the insurance money. “During those last days, I was hanging on by a thread. I was walking around the OR in a state of intermittent amnesia. I would start a case in which I was supervising a nurse anesthetist, leave the room after induction, come back in to start the case and ask the nurse anesthetist who helped her start the case. I got many puzzled looks. But no one said anything. When I was doing my own cases, I made frequent careless mistakes, some very dangerous. Luckily I didn’t kill anyone.” “I knew I had alcohol on my breath when I would come to work”, says an emergency room nurse. “I guess I really believed that since it was vodka, and I used mouthwash that no one would notice. That changed the day I fell asleep while watching a critically ill patient, and was put on administrative leave.” “My alcohol blood level came back high enough to be illegal while driving. I spent the next four months in a treatment center, working on my alcoholism.” A pharmacist describes his last days of drinking. “During my last days of drinking I was in a phase I called intermittent abstinence. I would be abstinent during the week and binge drink at night on the weekends. Fine motor tremors would be present on Monday and gone by Thursday. Monday was hell day. A day of shame, remorse, humiliation, and guilt combined with the physical effects of withdrawal. By Thursday I was feeling a hint of decency about myself. I would think, there is still hope that one day I could become a social drinker again. On Saturday, of my fourth or fifth week of intermittent abstinence, my supply ran dry. The liquor stores would be closing shortly. Half lit, I got in my vehicle, hit two liquor stores in 20 minutes and immediately started treating my addiction. Approximately 15 minutes later and cruising around 45-55 miles per hour, I found myself upside down, bleeding profusely, totally confused and not giving a damn. My vehicle was totaled, my soul diced open, my body in shambles. This alcoholic just hit bottom after 10 years of hell.” Generally speaking, the signs and symptoms of alcohol or other drug addiction do not become evident in the professional lives of health care workers until the illness is late in its course. Because health care professionals often view their self-worth through their work, they guard their careers carefully. Consequently, by the time someone shows up at work intoxicated or is impaired in their work performance, there are usually multiple signs of trouble in the other areas of their lives. Alcohol and other drug addiction is a brain disorder that is manifested by a loss of control over the use of these substances. This loss of control may be seen in the areas of family, social, legal, financial and professional consequences. Often the person affected cannot see the connection between their alcohol or other drug use and these consequences, and will go to extraordinary lengths to protect their careers. Fortunately, this disease is treatable and remission is not only possible but, common in the health professions. Intensive treatment followed by regular monitoring and a lifelong commitment to abstinence results in recovery for a large percentage of health care professionals. As a physician with almost three years of recovery states, “This is a new life of freedom, still with problems, with a whole new set of ‘tools’ that I can use throughout the day, with integrity honesty, that allow me to live a full life, with contentment, and look my family, my colleagues, my patients, and life-in-general in the eye. I am very grateful to have had to go through this experience because my life is better now than ever before.” A clear understanding of the natural history of this disease coupled with a willingness to confront it when we see it will help protect both our patients and colleagues from potentially life-threatening consequences. Although it is common for people with this illness to react with defensiveness and anger when confronted, most are grateful for the intervention once they get well. Often colleagues are reluctant to comment on another’s drinking. They feel that it is an issue of personal choice or privacy. Once recognized as an illness, it becomes a responsibility of health care professionals to speak up and offer help to our colleagues, in the interests of each other and our patients. Do you know a colleague that has a problem with alcohol or other drug use? If so, tell them about the South Carolina Recovering Professionals Program (SCRPP). This organization helps many health care professionals get help for their addiction and protects their professional license. Call (877) 349-2094. What is a safe amount of alcohol?by Larry Blumenthal, M.D.,Director, Student Health Services It is difficult to accurately assess an individual for drinking problems solely by the amount and frequency of alcohol consumption they report. A more accurate picture is obtained by including the social and physical consequences of their drinking. Some screening questionnaires (MAST, CAGE) accurately identify alcohol dependence, but fail to detect early problem drinking in a younger population. Heaviest alcohol consumption occurs during the late teens through the late twenties, which is also a high risk time for alcohol-related accidents. It is therefore important to identify hazardous drinking behaviors before the adverse consequences of alcohol occur and heavy drinking patterns develop. Some people can successfully reduce their risk by drinking less. If drinking significantly affects one’s medical, personal, or professional life, complete cessation of alcohol use is recommended. Definitions of drinking levels have been defined as: Low-risk alcohol consumption—one drink/day for non-pregnant women, 1-2 drinks/day in men, and no more than one drink/day in persons older than 65. Coronary heart disease incidence and mortality rates are 20 - 40 percent lower in persons who drink at this level. (Standard drink = one 12 oz bottle of beer; or 5 oz glass of wine; or one shot of 80-proof spirits.) At-risk alcohol use—In women: >7 drinks/week
or >3 drinks per occasion (“binge”); and for men as: >14 drinks/week or
>4 drinks per occasion. The beneficial cardiovascular effects of alcohol
are lost with >3 drinks/day, and the risk for stroke, hypertension, and
all-cause mortality are increased.
Take the test
2) How many drinks do you have on a typical day when you drink?
3) How often do you have 6 or more drinks on one occasion?
4) How often during the past year have you found that you were not able
to stop drinking once you started?
5) How often during the past year have you failed to do what was normally
expected from you because of drinking?
6) How often during the past year have you needed a first drink in the
morning to get yourself going after a heavy drinking session
7) How often during the past year have you had a feeling of guilt or
remorse after drinking?
8) How often during the past year have you been unable to remember what
happened the night before because you had been drinking?
9) Have you or someone else been injured as a result of your drinking?
10) Has a relative/friend/doctor/or other health worker been concerned
about your drinking or suggested you cut down?
Questions 1-8 are scored 0, 1, 2, 3, or 4. Questions 9 and 10 are
scored 0, 2, or 4. A score of 8 or more is suggestive of problem
drinking.
Catalyst Online is published weekly, updated as
needed and improved from time to time by the MUSC Office of Public Relations
for the faculty, employees and students of the Medical University of South
Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107
or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst
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