Dr. Price’s Medical Note of the Month ll- March 2009

Have you ever heard of the CAGE question list? This is a mnemonic that doctors use to screen for overuse concerning levels of alcohol intake. Most of us have had some alcohol to drink, some more than others of course. But how many of us have stopped to think about how much we actually do drink.

u think about it. Medical literature defines one drink as 12 grams of pure alcohol, which is equal to one 12-oz can of beer, one 5-oz glass of wine or 1.5-oz (one jigger) of hard liquor (from Academy of American Family Physicians).

One thing that I find interesting to talk about with patients is the issue of how many alcoholic drinks in a sitting they think it takes to start affecting their liver. The liver, the largest organ in the human body outside of our skin, is the “factory” of the body. It metabolizes, it produces, and it cleans. It is the organ that both filters, so to speak, and can be damaged by alcohol.

Surprisingly, it doesn’t take much to damage the liver. In fact, after only four alcoholic drinks, a female’s liver can begin to show damage of hepatic cells and even become fatty. It takes a little more for a male’s liver but only by one or two more drinks in one sitting. This should tell us that even with those weekends where we’ve had a couple of drinks on Friday and Saturday night, we all need to be careful not to overindulge. The good news is, if caught early enough, the fatty changes can be reversed.

I refer back to the CAGE list I mentioned earlier. It was developed as an easy way to remember and quickly screen patients about their alcohol intake. If more than three of these questions are answered “yes,” patients should be advised to abstain from drinking alcohol.

C: Do you feel you should CUT down on how much you drink?A: Do you feel ANNOYED when people criticize your drinking?G: Do you ever feel GUILTY about your drinking?E: Have you ever had a drink first thing in the morning as an EYE OPENER to calm your nerves or to fix a hangover?

These questions have been studied and have been shown to be a great way to introduce the discussion of alcohol abuse and dependence. As a physician, one should feel comfortable discussing this with his patient. As a patient, one should always be honest about his drinking, because the effects can be devastating.

The Center for Disease Control and Prevention lists that alcohol causes about 79,000 deaths per year in the United States. The things that lead to these deaths include unintentional accidents and injuries, risky sexual behaviors, violence, miscarriage and stillbirths, and alcohol poisoning.

Please take a close look at your own habits and the habits of your loved ones, and talk honestly to your medical professionals about getting help.

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