By Henrietta N. Barnes, Mark D. Aronson, Thomas L. Delbanco, Julius B. Richmond, A. Abrams, M.D. Aronson, H.N. Barnes, R.D. Bayog, M. Bean-Bayog, J. Bigby, B. Bush, M.G. Cyr, J. Daley, T.L. Delbanco, J. Ende, A.W. Fox, P.A. Friedman, M.E. Griner, P.F. Griner
Based at the Commonwealth Harvard Alcohol learn and educating application, this clinically orientated paintings is designed to offer internists and first care practitioners the information and talents essential to realize and deal with sufferers with alcoholism.
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Additional info for Alcoholism: A Guide for the Primary Care Physician
FRIEDMAN and 1. GUZMAN, There is a vast amount of literature about the pharmacology of alcohol. However, there are limitations to the clinical applicability of much of the information, since many of the studies reported are in animals, and extrapolation from animal models to humans can be misleading. Further, most of the literature refers to the properties of ethanol and does not describe adequately the pharmacology of the beverages consumed. Both metabolites of alcohol and other components of alcoholic beverages possess pharmacologic properties of their own.
16 This psychodynamic model of the development of alcoholism and denial is drawn from the observation of experienced clinicians. It describes a common 3. 18 although the course and progression of the disease may vary enormously. What Is the Course of the Disease? Classic teaching about alcoholism describes the disease as an inexorable downward progression leading either to abstinence or death. More recent long-term studies indicate that the course of alcoholism in a cohort of alcoholics is, in fact, quite variedl,19 and that the course for a particular person may be even more variable.
It is clear that they differ significantly from their counterparts who have continued to experience problems with alcohol. Men who returned to asymptomatic drinking were less likely to be physically dependent on alcohol, had experienced fewer alcohol-related problems (job loss, medical problems), described a shorter duration of loss of control drinking, and were less likely to have received any treatment for alcoholism. I Stable, Nonprogressive Drinking The "atypical alcoholic," to use Vaillant's phrase, who abuses alcohol without any apparent progression of disease, represents only a small fraction of patients with alcoholism.
Alcoholism: A Guide for the Primary Care Physician by Henrietta N. Barnes, Mark D. Aronson, Thomas L. Delbanco, Julius B. Richmond, A. Abrams, M.D. Aronson, H.N. Barnes, R.D. Bayog, M. Bean-Bayog, J. Bigby, B. Bush, M.G. Cyr, J. Daley, T.L. Delbanco, J. Ende, A.W. Fox, P.A. Friedman, M.E. Griner, P.F. Griner