Alcohol Abuse & SCI

Reprinted from PN January 2010

Alcohol plus SCI can be a risky combination; aging only adds to the problem.

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What do the following have in common?

  • Increased muscle spasticity
  • Fractures
  • Heart, liver, kidney, and brain damage
  • Pressure ulcers
  • Malnutrition
  • Urinary-tract infections

 These problems are associated with mixing spinal-cord injury (SCI) and alcohol.

A recent study indicates that as people age, their ability to handle alcohol decreases. Many of the same issues that caused stress at the time of SCI show up again with aging. Alcohol plus SCI can be a risky combination; aging only increases the odds.

How Am I at Risk?

Drinking alcohol in moderate amounts—two drinks a day for men, one for women—is rarely a problem. But approximately 14 million Americans—one in every 13—abuse alcohol enough to be classified as alcoholics. Several million more allow drinking to at least occasionally interfere with their lives. Over half of all adults in the country say a close relative has problems with alcohol.

Most people drink to be sociable or to relax. But drinking can quickly become a problem when people begin using it for stress relief, especially when trying to deal with major life problems such as:

  • Retirement, underemployment, or unemployment
  • Marital stress or loss of a loved one
  • Lower income or financial problems
  • Health problems or decline in function or mobility
  • Decrease in or loss of independence
  • Isolation or increased leisure time

If any of these stressors sound familiar, it’s because many of them describe life with SCI. Maybe that’s why people with SCI overuse and abuse alcohol at about twice the rate of the general population.

People with SCI overuse and abuse alcohol at about twice the rate of the general population.

“But I’m Different!”

A variety of things can help us identify drinking problems; numerous behaviors indicate drinking is more than just social. The challenge is that many of those behaviors are often attributed to disability or “just getting older.”

The following behaviors often serve as red flags for drinking problems. Any of them sound familiar?

  • Drinking to calm nerves, forget worries or reduce depression
  • Loss of interest in food, or poor nutritional habits
  • Drinking alone or in secret
  • Making a ritual of drinking such as before, during, or after dinner
  • Medical, social, or financial problems due to drinking
  • Acting irritable, resentful, or unreasonable when sober
  • Isolation or losing interest in hobbies or activities
  • Falls or accidents, inadequate self-care
  • Lack of exercise
  • Housing problems

 Is It Use—or Abuse?

Ask yourself these questions:

  1. Have you ever thought you should cut down on your drinking?
  2. Have people annoyed you by criticizing your drinking?
  3. Have you ever felt bad or guilty about your drinking?
  4. Have you ever taken a drink first thing in the morning as an eye opener to steady your nerves or get rid of a hangover?

These four questions are what the professionals use for diagnosing drinking problems. Answering yes to one of them should serve as a warning. Answering yes to two is a “red alert,” as 81–97% of those giving two yeses really are alcohol abusers.

The Problems

Alcohol can cause serious health and safety problems for all people. SCI systems are already compromised, and because people with SCI tend to take more medications, they’re even more at risk. Other potential problems include:

  • Negative interactions with more than 150 prescription drugs, impaired judgment and coordination, increased or decreased speed of the drugs’ effects, and increased drowsiness.
  • Combination of alcohol and antibiotics resulting in alcohol intolerance, along with headache, rapid pulse, vomiting, palpitations, and rapid respiration.
  • Water loss, increased urination, and a disrupted catheterization program, which can lead to a bladder or kidney infection or cause involuntary urination.
  • Compromised safety due to impaired judgment; increased risk of falls and car accidents, along with more problematic weight shifts and transfers.
  • Increased incidences of insomnia and depression, as well as impaired sex drive and performance.
  • Decreased ability to handle alcohol with aging, making even moderate consumption a potential problem.

Cutting back on drinking can often effectively decrease or even eliminate many of the so-called symptoms of “old age.”

The Age Factor

Use and abuse do not decrease with age—at least one third of older people with drinking problems developed them later in life, usually in response to specific situations, crises, or events. As you age, drinking can get out of hand much more quickly, sometimes in a matter of a few months. At least 10–15% of Americans 55 and older abuse alcohol, the same rate as everyone else. And just as many people over 55 are hospitalized for alcohol-related problems as for heart attacks.

Excessive drinking in the older population is often in response to negative situations such as loss, grief, loneliness, retirement, or illness. Strategies for dealing with these losses could include cutting down isolation, addressing depression, and reducing the stressors of aging.

The Good News

But there’s good news here: Older adults have the highest success rate and best one-year sobriety rate after treatment. And many of the factors people say cause them to drink—health problems, loss of self-esteem, too much free time, isolation, depression, financial worries, family changes—are issues you’ve successfully dealt with before. Your job now is to fall back on those coping skills and remember: You know how to do this!

Getting help can begin with a family doctor or member of the clergy, through a local health department or social service agency, or with one of the following agencies:

Alcoholics Anonymous (AA), a voluntary fellowship of peers whose purpose is to help themselves and each other stay sober. Check your phone book for local chapters.

National Clearinghouse for Alcohol Information, a federal information service. Write: P.O. Box 2345, Rockville, MD 20852.

National Council on Alcohol distributes literature and can refer you to treatment services in your area. Check your phone book for the nearest office.

RRTC for Substance Abuse and Disability does research and distributes information on the combination of alcohol and disability. Write to the RRTC c/o Wright State University, School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH 45435. 

Preparation of this article was funded by the U.S. Department of Education’s National Institute on Disability and Rehabilitation Research (NIDRR). The opinions here are those of the grantee and do not necessarily reflect those of the U.S. Department of Education. For more information about this and other research projects at Craig Hospital, contact Susan Charlifue, PhD, 303-789-8306.


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