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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12630
Experience:  Emergency Medicine and Family Practice for over 26 years
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I am a functional alcoholic. I crave alcohol and "need" it.

Resolved Question:

I am a functional alcoholic. I crave alcohol and "need" it. In AA parlance, I am somewhat powerless over alcohol. However, I cannot follow the second part of the first step. My life is far from unmanageable. I am more successful in my career than I could have imagined at my age. I am in a loving relationship with my wife and about to have a first child. I am generally an anxious/depressed/anti-social person. Drinking makes me happier/calmer/social. I would say most people I know prefer me with a few drinks. I don't drink to the point of being sick or hungover. I exercise regularly, eat healthily, have low blood pressure and cholesterol and have a resting pulse of about 50.

I decided to categorize this recently. In June, I had 80 drinks. In July it will be about 120. I imagine my average is somewhat in between.

I see no reason to alter my habits for their own sake but am worried about the longterm effects. I have seen the guidance from HHS about 2 drinks on average per day.

My questions is two parts.

A. How likely is 90-100 drinks per month, indefinitely, to cause long term damage?
B. What tests procedures should I do that could be an early warning system for long term health damage?

Will only pay for answers that give me more than HHS recommendations and encouragements to stop drinking. Take the drinking as a given and please give me advice on how to monitor its effects on my body so that I don't develop liver cancer at 60.

Thanks!
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Natasha replied 1 year ago.

Doctor Cameron : Hello
Doctor Cameron :

I understand what you are saying

Doctor Cameron :

how likely is 90-100 drinks per month to cause long term damage? well, that is considered to be HEAVY binge drinking

Doctor Cameron :

If you are online I am more than happy to talk to you about it

Customer:

I am online now.

Doctor Cameron :

I keep missing you- i am going to refer you to one of the most competent drug/alcohol experts on the site.

Doctor Cameron :

His name is XXXXX XXXXX

Doctor Cameron :

Please do not reply or rate me. Wait for him.

Doctor Cameron :

thanks

Expert:  Family Physician replied 1 year ago.
Thank you for your question:

There are a number of potential health risks associated with intake of more than 2 standard drinks (14 grams of alcohol=1 drink). You specifically asked about the risk of cancer. This review article looked at the relative risk (compared to non-drinkers) of various cancers.
http://pubs.niaaa.nih.gov/publications/arh25-4/263-270.htm
Using the 50 gram/day (approximately 3 drinks per day), your risk of various cancers increases depending on the particular cancer. Oral cancer is 2.7 times as likely, esophageal cancer is 2.2 times as likely and liver cancer is 1.5 times as likely for males and 3.5 times as likely for women).
(These various risks would be further increased if you also smoke).

The most important thing you can do is to have a good working relationship with your primary care physician. You should be seen at least 1-2 times per year for BP checks, cholesterol, liver function tests (at least once per year) including GGT.

There is no known "antidote" or method to prevent the long-term effects of alcohol.
Customer: replied 1 year ago.

The overall risk factor numbers have a wide variance in my understanding from person to person and clearly there are a lot of conflating factors.


 


Cancer is not by any means my only concern, just one concern about the potential health risks of my current habits.


 


I'm not looking for an antidote but an effective monitoring and evaluation tool of my condition. I mentioned before regular screening for BP ad cholesterol. Liver function test I haven't done. WOuld those three test suffice to give an early indication of excess?


 

Customer: replied 1 year ago.

Also, on occasion I take 5mg of zolpidem and have 3 beers. I understand potential risks in drowsiness etc with such a combination but does the combination taken at the same time cause damage to the liver or any other organs?


 


Again, putting aside the pyschotropic /narcoleptic effects.


 


 

Expert:  Family Physician replied 1 year ago.
I'm sorry for the delay.

The testing that I suggested may or may not be adequate. The most important suggestion from my perspective, is a strong working relationship with your personal physician who should be seeing your at least 1-2 times per year. Based on your complete medical history and these physical examinations, your physician would likely adjust the screening based on these findings. There is not a "one size fits all" solution to screening. There are no formal national or international recommendations on screening individuals who consume more than recommended alcohol.

I do not know of any specific additional risk for liver or other organ damage with the combination of Zolpidem and alcohol. There is the risk of additional respiratory depression, falls etc.
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12630
Experience: Emergency Medicine and Family Practice for over 26 years
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