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Dangers of Drinking Stretch Into Sobriety

After treatment, alcoholics more injury prone than drug users

FRIDAY, Feb. 15, 2002 (HealthDayNews) -- Drinking can continue to harm you long after you stop.

A new study found that alcoholics who have gone through detoxification are more prone to injury than drug users who have been through the same program to kick their addiction.

Although there's no data to prove it, one reason for the higher injury rate may be the damage long-term alcohol use inflicts on nerve endings, the researchers suggest. Not surprisingly, that can translate into balance and mobility problems.

Dr. Jeffrey H. Samet, an associate professor of medicine and public health at Boston University, and his colleagues recruited 470 patients -- 360 males and 110 females -- from a Boston detoxification unit.

The patients were divided into three groups -- alcohol-dependent (99 patients), drug-dependent (172 patients) and those who were both alcohol- and drug-dependent (199 patients). The patients were interviewed while at the detoxification center and again at six months, 12 months, 18 months and 24 months after they'd been through treatment.

They were asked if they'd suffered any of the following kinds of injuries: gunshot wound, stab wound, accidents or falls requiring medical attention, fractures or dislocation of bones or joints, head injury, or an injury from an accident involving a car or motorcycle.

The study found 29 percent of those who were alcohol-dependent suffered an injury after detoxification, compared to 28 percent of the patients who were alcohol- and drug-dependent and 16 percent of those who were drug-dependent.

The study appears in the current issue of the journal Alcoholism: Clinical & Experimental Research.

Samet says he was surprised by the high injury rate for alcoholics after they'd been through detoxification. He and his colleagues first thought the higher injury rate could be explained by alcoholics who had started drinking again. However, the researchers couldn't find any strong evidence of that.

"It made us sit back and take a broader view of these individuals," Samet says.

He offers some ideas on the causes of these high injury rates, but stresses there is no data to support these hypotheses.

Damage to nerve endings in hands and feet, called peripheral neuropathy, is a known complication of chronic alcohol use. This may result in decreased sensation in a person's hands and feet, and an impaired ability to walk.

"These people have had their bodies exposed to alcohol for a long time, and there are neurotoxic effects. These neurotoxic effects, one can make the case, may put one at risk of injury," Samet says.

Another possible explanation for the higher injury rates among alcoholics may be found in their character.

"It could be risk-taking personality traits, which may not only put them at risk for alcohol and drugs, but for injuries as well," Samet says.

All these hypotheses require further study, he says.

Samet says the study suggests that detoxification centers may be an ideal place to do injury-prevention education.

Dr. Gail D'Onofrio, an emergency medicine expert, thinks that's the most significant point of this study.

"[These patients] are there, they're a captive audience, and this is another opportunity to think about how to prevent future injuries," says D'Onofrio, an associate professor at Yale University School of Medicine's Section of Emergency Medicine.

"It's a great way of offering them some information about injury prevention that we've never thought of before," she says.

That may include educating patients about their increased risk of injury or doing assessments of their living conditions to prevent falls and other accidents, D'Onofrio says.

What To Do

The National Institute on Alcohol Abuse and Alcoholism says about 14 million Americans are alcoholic or abuse alcohol. The institute also says 53 percent of adult Americans say they have a close relative with a drinking problem.

Between 20 percent and 30 percent of patients who show up in emergency rooms have alcohol problems, according to the Centers for Disease Control and Prevention. Nearly half of alcohol-related deaths are the result of motor-vehicle crashes, falls, fires, drowning, homicides and suicides.

For more information about alcoholism, go to the National Institute on Alcohol Abuse and Alcoholism. For more about drug dangers, visit the National Institute on Drug Abuse.

SOURCES: Interviews with Jeffrey H. Samet, M.D., M.A., M.P.H., associate professor, medicine and public health, Boston University, Boston; Gail D'Onofrio, M.D., M.S., associate professor, Section of Emergency Medicine, Yale University School of Medicine, New Haven, Conn.; February 2002 Alcoholism: Clinical & Experimental Research
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