• Gerald M. Cross
  • Kenneth J. Hoffman


Alcohol is America’s foremost drug of abuse. More people drink alcohol than smoke cigarettes. Like tobacco, alcohol has a dramatic impact on America’s health. An estimated 105,000 deaths annually are alcohol-related. Even though per capita alcohol consumption declined during the decade of the 1980s, by 1995 it is estimated 11.2 million Americans will show evidence of alcohol dependence (Table 60.1) and another 7.2 million will show evidence of alcohol abuse.1 These problem drinkers will experience more injuries and illness than the rest of the population. Their medical care will cost up to three times more than that of the general population.2


Alcohol Withdrawal Blood Alcohol Concentration Alcoholic Hepatitis Thiamine Deficiency Fetal Alcohol Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    U.S. Department of Health and Human Services. The seventh special report to the U.S. Congress on alcohol and health. Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, Rockville, MD, 1990; IX, XV, XXII, XXIV; 26, 27, 33, 34–36,46,119,123,141.Google Scholar
  2. 2.
    Blose J, Holder H. Injury-related medical care utilization in a problem drinking population. Am J Public Health 1991 ;81:1571–5.PubMedCrossRefGoogle Scholar
  3. 3.
    Diagnostic and Statistical Manual of Mental Disorders. 3rd rev. ed. Washington, DC: American Psychiatric Association, 1987:173.Google Scholar
  4. 4.
    Healthy people 2000: national health promotion and disease prevention objectives. DHHS Publication No. (PHS) 91–50213.Google Scholar
  5. 5.
    Baer J, Stacy A, Larimer M. Biases in the perception of drinking norms among college students. J Stud Alcohol 1991;52:580–6.PubMedGoogle Scholar
  6. 6.
    Dielman T, Butchart A, Shope J, Miller M. Environmental correlates of adolescent substance use and misuse: implications for prevention programs. Int J Addict 1990;25:855–80.PubMedGoogle Scholar
  7. 7.
    Parker DA, Harford TC. Gender-role attitudes, job competition and alcohol consumption among women and men. Alcohol Clin Exp Res 1992;16:159–65.PubMedCrossRefGoogle Scholar
  8. 8.
    Brower K, Blow F, Beresford T. Treatment implications of chemical dependency models: an integrative approach. J Subst Abuse Treat 1989;6:147–57.PubMedCrossRefGoogle Scholar
  9. 9.
    Morse RM, Flavin DK. The definition of alcoholism. JAMA 1992; 268:1012–14.PubMedCrossRefGoogle Scholar
  10. 10.
    Kaprio J, Viken R, Koskenvuo M, Romanov K, Rose R. Consistency and change in patterns of social drinking: a 6-year follow-up of the Finnish twin cohort. Alcohol Clin Exp Res 1992;16:234–40.PubMedCrossRefGoogle Scholar
  11. 11.
    Cen C, Hwu H, Yeh E, Morimoto K, Otsuki S. Aldehyde dehydrogenase deficiency, flush patterns, and prevalence of alcoholism: an inter-ethnic comparison. Acta Med Okayama 1991;45:409–16.Google Scholar
  12. 12.
    DiPadova C, Worner T, Julkunen R, Lieber C. Effects of fasting and chronic alcohol consumption on the first-pass metabolism of ethanol. Gastroenterology 1987;92:1169–73.PubMedGoogle Scholar
  13. 13.
    Goldstein DB. Pharmacology of alcohol. New York: Oxford University Press, 1983:80.Google Scholar
  14. 14.
    Maddrey W. Alcoholic hepatitis: clinico-pathologic features and therapy. Semin Liver Dis 1988;8:91–102.PubMedCrossRefGoogle Scholar
  15. 15.
    Rimm EB, Giovannucci EL, Willet WC, et al. Prospective study of alcohol consumption and risk of coronary disease in men. Lancet 1991:338:464–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Geokas M. Ethanol and the pancreas. Med Clin North Am 1984;68(l):60–67.Google Scholar
  17. 17.
    Day N, Richardson G. Prenatal alcohol exposure: a continuum of effects. Semin Perinatol 1991;15:271–9.PubMedGoogle Scholar
  18. 18.
    Ewing JA. Detecting alcoholism, the CAGE questionnaire. JAMA 1984;252:1905–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Selzer M. The Michigan Alcoholism Screening Test: the quest for a new diagnostic instrument. Am J Psychiatry 1971;127:1653–8.PubMedGoogle Scholar
  20. 20.
    Pokorny AD, Miller BA, Kaplan HB. The brief MAST: a shortened version of the Michigan Alcoholism Screening Test. Am J Psychiatry 1972;129:342–5.PubMedGoogle Scholar
  21. 21.
    King A, Errico A, Parsons O, et al. Blood pressure dysregulation associated with alcohol withdrawal. Alcohol Clin Exp Res 1991; 15:478–82.PubMedCrossRefGoogle Scholar
  22. 22.
    Mander A, Young A, Merrick M, et al. Fluid balance, vasopressin and withdrawal symptoms during detoxification from alcohol. Drug Alcohol Depend 1987;24:233–7.CrossRefGoogle Scholar
  23. 23.
    Foy A, March S, Drinkwater V. Use of an objective clinical scale in the assessment and management of alcohol withdrawal in a large general hospital. Alcoholism Clin Exp Res 1988;12:360–4.CrossRefGoogle Scholar
  24. 24.
    American Society of Addiction Medicine. Patient placement criteria for the treatment of psychoactive substance use disorders. Washington, DC: American Society of Addiction Medicine, 1991: 1–15.Google Scholar
  25. 25.
    Nutt D, Glue P. Neuropharmacological and clinical aspects of alcohol withdrawal. Ann Med 1990;22:275–81.PubMedCrossRefGoogle Scholar
  26. 26.
    Kramp P, Rafaelsen O. Delirium tremens: a double blind comparison of diazepam and barbital treatment. Acta Psychiatr Scand 1978;58:174–90.PubMedCrossRefGoogle Scholar
  27. 27.
    Koranyi E, Ravindran A, Seguin J. Alcohol withdrawal concealing symptoms of subdural hematoma—a caveat. Psychiatr J Univ Ottowa 1990;15:15–17.Google Scholar
  28. 28.
    Vaillant G. A summing up: the natural history of alcoholism. Cambridge, MA: Harvard University Press, 1983:307–16.Google Scholar
  29. 29.
    Cross G, Morgan C, Mooney A, Martin C, Rafter J. Alcoholism treatment: a ten-year follow-up study. Alcohol Clin Exp Res 1990;14:169–73.PubMedCrossRefGoogle Scholar
  30. 30.
    Negrete J. The role of medical schools in the prevention of alcohol related problems. Can Med Assoc J 1991;143:1048–53.Google Scholar
  31. 31.
    Hoadley J, Fuch B, Holder H. The effect of alcohol beverage restrictions on consumption: a 25 year longitudinal analysis. Am J Drug Alcohol Abuse 1984;10:375–401.PubMedCrossRefGoogle Scholar
  32. 32.
    O’Malley P, Wagenaar A. Effects of minimum drinking age laws on alcohol use, related behaviors and traffic crash involvement among American youth: 1976–1987. J Stud Alcohol 1991;52:478–91.PubMedGoogle Scholar
  33. 33.
    Jones N, Pieper C, Robertson L. The effect of legal drinking age on fatal injuries of adolescents and young adults. Am J Public Health 1992;82:112–15.PubMedCrossRefGoogle Scholar
  34. 34.
    Mann R, Vingilis E, Gavin D, Adlaf E, Anglin L. Sentence severity and the drinking driver: relationships with traffic safety outcome. Accid Anal Prev 1991;23:483–91.PubMedCrossRefGoogle Scholar
  35. 35.
    Green R, French J, Haberman P, Holland P. The effects of combining sanction and rehabilitation for driving under the influence: an evaluation of the New Jersey Countermeasures Program. Accid Anal Prev 1991;23:543–55.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Gerald M. Cross
  • Kenneth J. Hoffman

There are no affiliations available

Personalised recommendations