Medical Consequences

of Alcohol and Drug Use

Disorders
Eric B. Raimo, M.D.

Copyright Alcohol Medical Scholars Program 1

 www.alcoholmedicalscholars.org

Copyright Alcohol Medical Scholars Program 2

 Overview
• Acute effects

• Chronic heavy use

• Withdrawal

Copyright Alcohol Medical Scholars Program 3

 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 4

 Acute Effects
• CNS
– accidents

• Gastrointestinal

• Respiratory
– overdose

Copyright Alcohol Medical Scholars Program 5

 Overview
• Acute effects

• Chronic heavy use

• Withdrawal

Copyright Alcohol Medical Scholars Program 6

 Effects of Chronic Heavy
Drinking
• CNS
– Neuropathies
– Cerebellar
degeneration
– Dementia
– Wernicke-Korsakoff’s
syndrome

Copyright Alcohol Medical Scholars Program 7

 Effects of Chronic Heavy
Drinking
• Gastrointestinal
– Alimentary/stomach
– Liver
– Pancreas

• Cardiovascular
– Hypertension
– Cardiomyopathy
– Stroke
Copyright Alcohol Medical Scholars Program 8
 Effects of Chronic Heavy
Drinking
• Reproductive

Copyright Alcohol Medical Scholars Program 9

 Effects of Chronic Heavy
Drinking

• Hematologic

• Musculoskeletal

• Endocrine

• Dermatologic

Copyright Alcohol Medical Scholars Program 10

Biological Markers of Chronic
Heavy Drinking
• GGT (>30)

• CDT (>20)

• MCV (>90)

• AST/ALT

Copyright Alcohol Medical Scholars Program 11

 Overview
• Acute effects

• Chronic heavy use

• Withdrawal

Copyright Alcohol Medical Scholars Program 12

 Withdrawal Effects

• Rule of thumb:
– Withdrawal effects are opposite
of intoxication sx/signs

• Alcohol withdrawal
Copyright Alcohol Medical Scholars Program 13
 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 14
 Fetal Alcohol Syndrome

• Growth retardation

• Facial dysmorphism

• Severe CNS dysfunction

Copyright Alcohol Medical Scholars Program 15

 Moderate Alcohol Use

• Cardiovascular

• Gallstones

• Other potential beneficial effects

Copyright Alcohol Medical Scholars Program 16

 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 17

 Marijuana

• Motor vehicle accidents

• Learning

• Respiratory

• Immune system

Copyright Alcohol Medical Scholars Program 18

 Stimulants
(Cocaine and Amphetamine)

• Cardiovascular

• Neurological

• Injection risks

Copyright Alcohol Medical Scholars Program 19

 Opioids
• Overdose

• Injection risks

• Gastrointestinal

• Musculoskeletal

Copyright Alcohol Medical Scholars Program 20

 Other Drugs

• PCP

• Inhalants

Copyright Alcohol Medical Scholars Program 21

 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

Copyright Alcohol Medical Scholars Program 22