Deaths from Cirrhosis rose in all but one state between 1999-2016

Liver disease deaths jumped by 65 percent in the United States, from 1999-2016, disproportionately affecting adults ages 25-34. The increase in deaths among young adults was driven entirely by alcohol-related liver disease, according to a new study.

Liver specialist Elliot B. Tapper, M.D., says he’s witnessed the disturbing shift in demographics among the patients with liver failure he treats at Michigan Medicine. National data collected by Tapper and study co-author Neehar Parikh, M.D., M.S., confirms that in communities across the country more young people are drinking themselves to death.

Read the source article here.

 

 

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People with family history of alcoholism release more dopamine in expectation of alcohol

People with a family history of alcohol use disorder (AUD) release more dopamine in the brain’s main reward center in response to the expectation of alcohol than people diagnosed with the disorder, or healthy people without any family history of AUD, reports a new study in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

This explains a lot.

Read about this small interesting study here.

Washington’s heavy-drinking ways in spotlight

Today, Washingtonians purchase more alcohol on a per capita basis than any state except New Hampshire, according to statistics from the Centers for Disease Control and Prevention (CDC).

Nearly a quarter of District residents are binge drinkers, defined as consuming more than five drinks in an evening; that is the second-highest rate in the nation, behind North Dakota. And Washington bears higher economic costs of problem drinking than any other state, according to the CDC calculations.

A part of the higher rates comes from the high-stakes nature of government jobs, and from professions with a large presence in Washington, said Aaron White, the senior scientific adviser to the director of the National Institute on Alcohol Abuse and Alcoholism. Lawyers, plentiful in Washington, tend to drink more than those in other professions.

“We know that high-powered jobs, high income, that is a risk factor for excessive drinking,” White said. “You have a lot of people in powerful, high-paying jobs downtown. People with money and stressful jobs tend to drink more.”

Read the entire article here.

Anyone surprised?

Heavy Drinking ‘Strongest’ Modifiable Risk Factor for Dementia

The retrospective analysis involving 30 million people in France shows that those with a history of alcohol use disorders had a threefold increased risk for dementia and that over half those with early-onset dementia had a history of alcohol problems. “This study used a phenomenally large database, and the result showing that half the cases of early-onset dementia were associated with alcohol use disorders is truly staggering,” Ballard told Medscape Medical News.

The researchers used diagnostic codes on hospital records to identify patients with dementia and those who had a history of alcohol use disorders. They found over a million cases of dementia, after excluding people with diseases that can lead to rare types of dementia and those with early-life mental disorders that can increase or confound dementia diagnosis. There were also 945,000 people with alcohol use disorders.

Results showed a strong association between a history of alcohol problems and dementia. This was especially noticeable in early-onset dementia, with 57% of the 57,000 patients who had developed dementia under the age of 65 years having a history of alcohol use disorders (66% of men and 37% of women).

In an analysis of just those patients in whom the first record of dementia occurred in 2011-2013 and adjusted for other risk factors found in the medical records, the risk for dementia was three times greater if the patient had a history of alcohol use disorders. The hazard ratio was 3.36 for men and 3.34 for women.

Read the Medscape article here.  Or get down and dirty with the full study here.

Be careful with interpreting these results.

France.  I’m not joking.  Here’s  a Global Consumption Map.

 

 

PulmCrit- Phenobarbital monotherapy for alcohol withdrawal: Reloaded

It has been said that alcoholics exist to teach physicians humility. These patients are quite complicated, often suffering from several problems simultaneously (e.g., withdrawal, nutritional deficiencies, trauma, infection, psychiatric problems). Arguably the most important task when treating alcohol withdrawal is exclusion of alternative or superimposed problems. Phenobarbital obviously cannot be expected to solve every problem that may exist in an alcoholic patient.

Phenobarbital does, however, appear to be a uniquely effective and safe treatment for alcohol withdrawal (including withdrawal seizures and delirium tremens). Several reasons for the superiority of phenobarbital are listed above. Preliminary evidence suggests that these do indeed translate into meaningful clinical benefit (e.g. faster recovery, fewer complications).

Read the entire post here.