alcohol

Binge Drinking Among Women and High School Girls — United States, 2011

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Results: Among adult women, the prevalence of binge drinking was 12.5%, and among those who binge drank, the frequency of binge drinking was 3.2 episodes per month and the intensity was 5.7 drinks on occasion. Binge drinking was most prevalent among women aged 18–24 years (24.2%) and 25–34 years (19.9%), and among those from households with annual incomes of ≥$75,000 (16.0%). Among those who binge drank, women aged 18–24 years had the highest frequency (3.6 episodes) and intensity (6.4 drinks) of binge drinking. Among high school girls, the prevalence of current alcohol use was 37.9%, the prevalence of binge drinking was 19.8%, and the prevalence of binge drinking among girls who reported current alcohol use was 54.6%.

Conclusions: Binge drinking is reported by one in eight U.S. adult women and one in five high school girls. Women who binge drink tend to do so frequently and with high intensity. Most high school girls who reported current alcohol use also reported binge drinking.

via Vital Signs: Binge Drinking Among Women and High School Girls — United States, 2011.

FDA Warns Against Combining Alcohol, Other CNS Depressants With Xyrem – AAFP News

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According to the Dec. 17 statement, the FDA recently evaluated reports of patients who died while taking Xyrem — which is used to reduce instances of cataplexy and to manage other symptoms of narcolepsy — along with alcohol or other central nervous system (CNS) depressants. Although the precise cause of the deaths remains uncertain — the reports contained incomplete information and did not adequately address confounding factors, such as pre-existing sleep apnea and/or chronic obstructive pulmonary disease — given some of the circumstances noted in the deaths, the FDA determined that the recommendations in the Xyrem drug label should be strengthened to highlight the risks of using the drug in conjunction with CNS depressant drugs or alcohol.

via FDA Warns Against Combining Alcohol, Other CNS Depressants With Xyrem — AAFP News Now — AAFP.

Oops.

Heavy Drinking May Lead to Early Stroke

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Drinking three or more alcoholic beverages a day may raise the risk for spontaneous intracerebral hemorrhage at a much younger age than typical, researchers found.

These strokes occurred at an average age of 60 with such high alcohol consumption, 14 years earlier than seen without heavy drinking (P<0.0001), Charlotte Cordonnier, MD, PhD, of the University of Lille Nord de France in Lille, France, and colleagues,

Heavy drinking also predicted a near doubling in 2-year mortality risk after a deep intracerebral hemorrhage before age 60, the group reported in the Sept. 11 issue of Neurology.

via Heavy Drinking May Lead to Early Stroke.

Weight Loss Surgery May Boost Problem Drinking

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Almost 10% of patients undergoing bariatric surgery to combat obesity had symptoms of an alcohol use disorder 2 years after surgery, a large prospective cohort study showed.

The prevalence of alcohol use disorders increased from 7.6% before surgery to 9.6% 2 years after the procedure, as reported online in the Journal of the American Medical Association.

via Medical News: Weight Loss Surgery May Boost Problem Drinking – in Primary Care, Obesity from MedPage Today.

Have surgery, lose weight, become alcoholic!

Binge Drinking in Adults United States 2010

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  • Binge drinking causes more than half of the 80,000 deaths and three quarters of the $223.5 billion in economic costs caused by excessive drinking.
  • Approximately one in six (38 million) U.S. adults binge drink, and do so approximately four times a month. On average, the largest number of drinks consumed by binge drinkers is eight drinks per occasion.
  • Prevalence and intensity of binge drinking was highest among persons aged 18–34 years, but the frequency of binge drinking was highest among binge drinkers aged ≥65 years. Binge drinkers with annual household incomes ≥$75,000 had the highest binge drinking prevalence, but binge drinkers with household incomes <$25,000 had the highest frequency and intensity of binge drinking.

via Medical News: Binge Drinking Common Among Adults, CDC Finds – in Public Health & Policy, Public Health from MedPage Today.

Vital Signs: Binge Drinking Prevalence, Frequency, and Intensity Among Adults — United States, 2010.

The first link takes you to the MedPage Today article.  The second link takes you to the source article which is also available in a downloadable PDF format.  This report is well worth sharing with your underwriting staff.

BBC News – Guns N’ Roses’ Duff McKagan’s ‘wake-up call’

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He began drinking heavily because he thought it would help to prevent his panic attacks – which he had suffered from since he was a teenager. At his worst, he says he was drinking “a gallon of vodka a day”, and then 10 bottles of wine a day “when I was trying to taper down”.

via BBC News – Hardtalk – Guns N’ Roses’ bassist Duff McKagan’s ‘wake-up call’.

For the next time someone asks you why entertainers are underwritten cautiously and carefully.

NEJM Resident e-Bulletin Teaching Topics 11.10.11

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Alcoholic Hepatitis

Original Article

Glucocorticoids plus N-Acetylcysteine in Severe Alcoholic Hepatitis

E. Nguyen-Khac and Others

Severe acute alcoholic hepatitis is a life-threatening liver disease. Although glucocorticoid treatment is recommended and improves survival, the mortality remains high, with 35% of patients dying within 6 months.

Clinical Pearls

Clinical Pearl  How does chronic alcohol consumption lead to hepatitis?

Chronic alcohol consumption increases intestinal permeability, worsens endotoxemia, stimulates Kupffer cells, and thus increases production of proinflammatory cytokines. High levels of tumor necrosis factor α (TNF-α) activate cell-death pathways and induce the production of reactive oxygen species, notably superoxide anions, by the hepatocyte mitochondria, leading to cell death.

Prescription Drug OD Deaths Up in Florida

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Medical News: Alprazolam Among Top Causes of Fatal Overdoses in Florida – in Public Health & Policy, Public Health from MedPage Today

Deaths in Florida involving prescription drugs in 2009 were four times as common as those related to illicit drugs, with alprazolam (Xanax) joining opioids among the top killers, the CDC reported.

From 2003 to 2009, the death rate in Florida from overdoses of prescription drugs increased 84.2%, from 7.3 to 13.4 per 100,000 population, according to data from the Florida Medical Examiners Commission analyzed by the CDC in the July 8 issue of Morbidity and Mortality Weekly Report.

Time to tighten up your anxiety/depression underwriting guidelines?  How about script checks at lower amounts?  Can you differentiate between the applicant who wants to off himself versus plain vanilla anxiety?