1. Copyright Alcohol Medical Scholars Program1 Medical Consequences of Alcohol and Drug Use Disorders Eric B. Raimo, M.D.

2. Copyright Alcohol Medical Scholars Program2 www.alcoholmedicalscholars.org

3. Copyright Alcohol Medical Scholars Program3 Overview Acute effects Chronic heavy use Withdrawal

4. Copyright Alcohol Medical Scholars Program4 Epidemiology 20-40% hospital admissions Outpatient setting 100,000 deaths per year Alcoholics who continue drinking have a shortened life-span of 15 years

5. Copyright Alcohol Medical Scholars Program5 Acute Effects CNS –accidents Gastrointestinal Respiratory –overdose

6. Copyright Alcohol Medical Scholars Program6 Overview Acute effects Chronic heavy use Withdrawal

7. Copyright Alcohol Medical Scholars Program7 Effects of Chronic Heavy Drinking CNS –Neuropathies –Cerebellar degeneration –Dementia –Wernicke-Korsakoff’s syndrome

8. Copyright Alcohol Medical Scholars Program8 Effects of Chronic Heavy Drinking Gastrointestinal –Alimentary/stomach –Liver –Pancreas Cardiovascular –Hypertension –Cardiomyopathy –Stroke

9. Copyright Alcohol Medical Scholars Program9 Effects of Chronic Heavy Drinking Reproductive

10. Copyright Alcohol Medical Scholars Program10 Effects of Chronic Heavy Drinking Hematologic Musculoskeletal Endocrine Dermatologic

11. Copyright Alcohol Medical Scholars Program11 Biological Markers of Chronic Heavy Drinking GGT (>30) CDT (>20) MCV (>90) AST/ALT

12. Copyright Alcohol Medical Scholars Program12 Overview Acute effects Chronic heavy use Withdrawal

13. Copyright Alcohol Medical Scholars Program13 Withdrawal Effects Rule of thumb: –Withdrawal effects are opposite of intoxication sx/signs Alcohol withdrawal

14. Copyright Alcohol Medical Scholars Program14 Alcohol-Drug Interactions Illicit drugs (e.g., cocaine, heroin) Prescription drugs (e.g., benzodiazepines, metronidazole) Over-the-counter drugs (e.g., acetaminophen) Rx

15. Copyright Alcohol Medical Scholars Program15 Fetal Alcohol Syndrome Growth retardation Facial dysmorphism Severe CNS dysfunction

16. Copyright Alcohol Medical Scholars Program16 Moderate Alcohol Use Cardiovascular Gallstones Other potential beneficial effects

17. Copyright Alcohol Medical Scholars Program17 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

18. Copyright Alcohol Medical Scholars Program18 Marijuana Motor vehicle accidents Learning Respiratory Immune system

19. Copyright Alcohol Medical Scholars Program19 Stimulants (Cocaine and Amphetamine) Cardiovascular Neurological Injection risks

20. Copyright Alcohol Medical Scholars Program20 Opioids Overdose Injection risks Gastrointestinal Musculoskeletal

21. Copyright Alcohol Medical Scholars Program21 Other Drugs PCP Inhalants

22. Copyright Alcohol Medical Scholars Program22 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