Alcohol: Trauma Related Injuries

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Alcohol:  Trauma Related Injuries




Guest:  Dr. Keith Borg – Emergency Medicine

Host:  Dr. Linda Austin – Psychiatry


Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m talking with Dr. Keith Borg who is a physician in the emergency department here at MUSC.  Dr. Borg, what role does alcohol play in a typical kind of trauma from auto accidents that you take care of in the emergency department?


Dr. Keith Borg:  It’s a huge factor in a large percent of the traumas we see.  Most of the patients we see are either intoxicated themselves or were hit by somebody who was intoxicated.


Dr. Linda Austin:  Now, what is the legal blood alcohol limit?


Dr. Keith Borg:  Eighty milligrams per deciliter or .08.


Dr. Linda Austin:  In your opinion, can levels less than .08 still impair driving enough to be involved in an auto accident?


Dr. Keith Borg:  Sure.  Absolutely.  That’s a legal cut off and an arbitration, but people below that number can certainly be altered, and it can affect their driving.


Dr. Linda Austin:  How about the issue of people coming into the emergency department for alcohol-related issues other than traffic accidents, what kinds of problems come in?


Dr. Keith Borg:  We see a lot of complications from alcohol.  People have a variety of medical illnesses related to alcohol where that’s affecting any number of systems in their body.


Dr. Linda Austin:  Such as?


Dr. Keith Borg:  The heart, the liver, their GI system.  Many people have gastroesophageal problems, bleeding from a number of different sites related to alcohol, a lot of complications, along with the societal problems.  People lose their homes.  People lose their families.  People become homeless due to alcohol.  It’s a horrible disease.


Dr. Linda Austin:  Let’s go back to the issue of GI bleeding.  I think a lot of people don’t really understand how alcohol can cause bleeding in the stomach.  Can you explain that?


Dr. Keith Borg:  Sure.  It can cause bleeding in the stomach from a number of different of ways.  It irritates the stomach lining, and it’s called gastritis.  It can also cause significant liver problems, cirrhosis, that can affect the stomach and cause bleeding from what are called varices into the stomach as well.


Dr. Linda Austin:  I would imagine, though, that the two things can conspire or go on simultaneously to create a real medical catastrophe.

Dr. Keith Borg:  Absolutely.


Dr. Linda Austin:  So if you were to give advice to folks listening to this about their drinking behavior, what would you say?


Dr. Keith Borg:  I’d say, “Talk to your doctor about it.”  Talk to your doctor, talk to your family, about your drinking behavior and get some help.  If you think there’s a problem, that may be a sign that there is a problem, and getting help with that and getting into a treatment program may be a great first step.


Dr. Linda Austin:  But isn’t the problem that so many people don’t think it’s a problem, that they say, “Oh, you know, I’m not an alcoholic”?


Dr. Keith Borg:  Absolutely.


Dr. Linda Austin:  That there’s a sticking point around that word itself?


Dr. Keith Borg:  Absolutely.  But alcoholism is a disease, and if you start to have that thought that maybe this is affecting your life or it’s affecting your relationships with your family or your health, then it’s time to ask somebody about that and get some help in that kind of treatment.


Dr. Linda Austin:  I think it’s important to point out that the National Institutes of Health now has guidelines that are very specific.  I am of the opinion that people spend so much time quibbling over the word alcoholic that they miss the forest for the trees.  And the NIH guidelines now are 14 drinks a week for a male, 7 for a female, a drink being an ounce, not three ounces, and certainly not a tumbler full of whiskey, but an ounce of hard liquor, or a beer, or 5 ounces of wine. 


Dr. Keith Borg:  Sure.  One of the things we’re starting to do at MUSC is screen for alcohol abuse, hazardous drinking, in the ER, and we’re cooperating with Psychiatry here and looking at some research studies in that regard to try to put some resources together to help patients.


Dr. Linda Austin:  How often do you see kids coming in because of taking shot after shot, after shot, of alcohol?


Dr. Keith Borg:  We certainly see it.  Anytime you’re around a college campus or a young student population, you absolutely see it certain times of the year, when finals are over and college begins again.  When the fraternities and sororities are rushing, you absolutely see that.  And it’s horrible to see that kind of peer pressure drive people to drink, and the health complications are significant.


Dr. Linda Austin:  Such as what in a young person?


Dr. Keith Borg:  Well, certainly alcoholism can cause a number of complications acutely.  Certainly, in the extreme, it can kill people.  And you read about that every year.  In the press, there are usually a few very high profile-related deaths, certainly people are seen in the intensive care unit.  The cost in healthcare dollars is significant.


Dr. Linda Austin:  Dr. Borg, thanks so much.


Dr. Keith Borg:  Thank you.


If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection:  (843) 792-1414.

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