45% of adults are current drinkers, 22% former drinkers and 35% life-time abstainers
Hazardous drinking in males ranges from 14-18% and 4-5% in females
Alcohol abuse or dependence has an overall prevalence of about 7-16%
Abuse more common in males, lower income, lower education, lower age groups
Women account for about 1/3 of alcohol disorders
Mortality follows a J or U shaped curve in developed countries since moderate drinking improves coronary mortality, but 3 or more drinks/day leads to increased mortality-lowest risk is at 20 grams/day of alcohol (about 1 drink)
Excess mortality has been noted in large male studies when more than 2 or 3 drinks were consumed daily
Similar studies have noted excess mortality in women who have more than two drinks a day
Binge drinking of more than 4 drinks (compared to abstainer) has a relative risk of accidental death of almost 2X
Binge drinking of more than 8 drinks has a relative risk of accidental death 3.3 X
Increased rates of cancer death include mouth, esophagus, pharynx, larynx, liver, breast in females
Co-morbid conditions include depression, anxiety, substance abuse, anti-social personality
Alcohol metabolism is a two stage process: ethanol is converted to acetaldehyde by alcohol dehydrogenase and acetaldehyde is converted to acetate by aldehyde dehydrogenase
After drinking, women have higher blood alcohol levels than men because of smaller build, higher fat%, and lower gastric alcohol dehydrogenase levels
On average, ethanol accounts for half an alcoholic's caloric intake thereby displacing normal nutrients leading to deficiencies of folate, thiamine, iron, etc. This can be magnified by gastrointestinal malabsorption and pancreatic insufficiency
Liver injury is more frequent and progresses faster in women than men
Elderly tolerate alcohol less well
Mortality of alcoholic cirrhosis in elderly (>60 yr.) was 50% at one year vs 7% in younger patients
Serious drinking often starts in adolescence (40% of alcoholics develop first symptoms between 15-19 yr.)
Patients with late onset alcoholism (i.e. due to retirement, bereavement, etc.) generally have better prognosis than those with early onset alcoholism
alcohol has a genetic component estimated to be 40-60%
45% of adults are current drinkers, 22% former drinkers and 35% life-time abstainers Hazardous drinking in males ranges from 14-18% and 4-5% in females Alcohol abuse or dependence has an overall prevalence of about 7-16% Abuse more common in males, lower income, lower education, lower age groups Women account for about 1/3 of alcohol disorders Mortality follows a J or U shaped curve in developed countries since moderate drinking improves coronary mortality, but 3 or more drinks/day leads to increased mortality-lowest risk is at 20 grams/day of alcohol (about 1 drink) Excess mortality has been noted in large male studies when more than 2 or 3 drinks were consumed daily Similar studies have noted excess mortality in women who have more than two drinks a day Binge drinking of more than 4 drinks (compared to abstainer) has a relative risk of accidental death of almost 2X Binge drinking of more than 8 drinks has a relative risk of accidental death 3.3 X Increased rates of cancer death include mouth, esophagus, pharynx, larynx, liver, breast in females Co-morbid conditions include depression, anxiety, substance abuse, anti-social personality Alcohol metabolism is a two stage process: ethanol is converted to acetaldehyde by alcohol dehydrogenase and acetaldehyde is converted to acetate by aldehyde dehydrogenase After drinking, women have higher blood alcohol levels than men because of smaller build, higher fat%, and lower gastric alcohol dehydrogenase levels On average, ethanol accounts for half an alcoholic's caloric intake thereby displacing normal nutrients leading to deficiencies of folate, thiamine, iron, etc. This can be magnified by gastrointestinal malabsorption and pancreatic insufficiency Liver injury is more frequent and progresses faster in women than men Elderly tolerate alcohol less well Mortality of alcoholic cirrhosis in elderly (>60 yr.) was 50% at one year vs 7% in younger patients Serious drinking often starts in adolescence (40% of alcoholics develop first symptoms between 15-19 yr.) Patients with late onset alcoholism (i.e. due to retirement, bereavement, etc.) generally have better prognosis than those with early onset alcoholism alcohol has a genetic component estimated to be 40-60%
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