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Is the Patient an Alcoholic?

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Is the Patient an Alcoholic?

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99 bottles of whiskey on the wall...

99 bottles of whiskey on the wall…

You are an attorney handling a case in which the question of alcoholism is raised. Alcoholism may be a factor in litigation in a number of ways:

  • A woman with a markedly elevated blood alcohol level appears to be sober when she drives through a red light and broadsides a car.
  • The caretaker of an alcoholic man supplies him with his liquor of choice and then puts a pen in his hand so he can sign over his fortune to her.
  • The primary care doctor fails to recognize signs of alcoholism and does not order the medications needed to prevent delirium tremens (alcohol withdrawal) when the patient is in the hospital. The patient climbs out of bed and fractures his hip.

What Are the Signs of Alcoholism?
Many of the physical signs of alcoholism affect the gastrointestinal system, although every part of the body may be affected. The alcoholic may consume calories in the form of alcohol and skip eating meals. Since the liver detoxifies alcohol, it is a prime target for the toxic effects of alcohol. Fat accumulates in the liver, replacing normal tissue with less functional cells. The patient may develop alcoholic hepatitis because liver cells become inflamed and die. One in four alcoholics develops cirrhosis – a form of scarring associated with nodules. The enlarged liver presses on blood vessels, resulting in an accumulation of fluid in the abdomen, known as ascites.

In addition to liver problems, the alcoholic may have chronic diarrhea, nausea, vomiting, abdominal pain, gastritis (inflammation of the stomach), pancreatitis, and gastrointestinal bleeding.

The alcoholic’s skin may be affected also. The patient may turn yellow from bile, which is made by the liver. It accumulates in the blood, causing the patient’s skin and eyes to become yellow. A deficiency of B vitamin can lead to dry, red, itching skin. The alcoholic’s fingertips and nose may become swollen.

The cardiovascular system may also be affected by alcoholism. Alcoholics may develop irregular heartbeats, an enlarged heart, anemia, and dilated blood vessels.

Alcohol has a direct toxic effect on the lungs. It kills air sacs, and may result in chronic obstructive airway disease. Alcoholics are more susceptible to infection, leading to pneumonia.

The toxic effects of alcohol also affect the brain. Brain cells affected by alcohol cannot be replaced. Alcoholics may have memory impairments, blackouts, seizures, insomnia, nightmares, and hallucinations. I remember taking care of a hospitalized alcoholic man who developed severe gout when he stopped taking his gout medication. He became so crippled by gout that he could not walk, and instead scooted over the wooden floor. He came to the hospital with pieces of wood embedded in his severely damaged buttocks.

Vitamin B deficiency may result in numbness and tingling in hands and feet and muscle weakness. Loss of balance is a late sign. Alcoholics may develop muscle wasting from improper or inadequate nutrition.

Alcohol may also affect the reproductive system. Women may stop menstruating and men may become impotent. The kidney may become inflamed and fail to efficiently function, resulting in red urine and urinary tract infections.

Hospital staff dread seeing the signs of delirium tremens. A patient may begin to show hand tremors within hours after her last drink. She may become excitable, irritable and nervous. Without adequate medication, she may progress to having hallucinations and seizures. There is a high risk of injury – the patient may become combative and try to hurt the staff, or hurt herself.

Many of these harmful effects of alcohol can be reversed if the patient stops drinking.

Med League provides well-qualified expert witness to assist with alcohol related cases.

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