THE TWO-MARTINI LUNCH

The drinking of alcoholic beverages is a social custom for the great majority of adults in the United States. In moderation this custom may improve circulation, reduce blood pressure, and act as a relatively mild and safe tranquilizer. However, 10 percent of our population have serious drinking problems. These people constitute over 20 percent of all hospitalized patients. They typically suffer from one or more of a set of related serious problems; cirrhosis of the liver, ulcer disease, bleeding from the bowel, premature senility, and vitamin deficiencies are among the most frequent. Sometimes they show signs of severe mental psychosis, and they may exhibit the spectacular “delirium tremens” – the “DT’s” or “the shakes.” They drive automobiles into immovable objects or innocent folks with a frequency that is truly alarming; deaths related to alcohol represent nearly one-half of all deaths in young adult life. Suicide and homicide are frequently related to alcohol use.

Alcohol is high in calories. It may increase obesity, as in a “beer belly,” and it thereby increases other health problems related to obesity. People who drink heavily tend to eat less nutritional food. This can result in a variety of nutritional problems as well as cirrhosis of the liver.

Treatment of the alcoholic continues to be a frustrating, often unsuccessful venture. Within the medical community, enthusiasm for a wide variety of treatment methods waxes and wanes. Non-medical organizations, especially alcoholics Anonymous, enjoy a success rate that is at least equal to that of any “medical” treatment. Associated organizations, such as Al Anon, which work with the families of alcoholics, also show considerable promise. The key elements of these treatments are that they deal with motivated people who truly wish to change, and the treatments continually reinforce the subject’s desire to remain free of alcoholic influence.

When should you seek help? Everyone has a different definition of how much alcohol is too much, and the amount probably is different for different people. You should seek help if you have problems with alcohol, and you should not make excuses for the problems. Face up to them. Here are some of the frequent signals that you need help: a drunken driving citation, an automobile accident after two or more drinks, missing work because of feeling poorly from drinking the night before, a pattern of work absences on Monday mornings, a hospitalization for an alcohol-related problem such as gastritis or upper bowel hemorrhage, inability to function at top efficiency in the afternoon because of a two-martini lunch or its equivalent. If you develop the insight that you have these serious problems and that your situation must be changed, you are a good candidate for successful treatment.

COFFIN NAILS

Cigarette smoking, it says on the pack, may be hazardous to your health. This is the most harmful of the personal vices, and is fortunately becoming less socially acceptable. Physicians rate smokers by their number of “pack-years,” which is the number of packs per day multiplied by the number of years that you have smoked. For example, if you have smoked two packs per day for five years, you are a ten pack-year smoker. For each pack-year that you smoke, you decrease your life expectancy by about one month. You greatly increase your chance of sudden death. A heavy smoker, smoking two packs daily for thirty years, or sixty pack-years, has decreased his or her life expectancy by five years.

THE CIGARETTE SMOKER

More Heart Attacks (x2)
More strokes (x4)
More Lung Cancer (x300)
More Emphysema (x300)
More skin Wrinkles (x4)
More High Blood Pressure (x2)

Other bad things happen too. The physical reserve of the cigarette smoker is decreases. Smokers are less healthy, less vigorous, have less active sex lives, and appear to develop skin wrinkles at earlier ages. They spend twice as much time in the hospital as nonsmokers.

Just as important, the last years of a cigarette smoker are not a period of grace and beauty. Tortured wheezing, swollen purple lips, and the feeling of suffocation mark these years. In medical slang, the late-stage cigarette smoker is termed a “blue bloater.” Fortunately, present evidence suggests that the ex-cigarette smoker can regain much lost function and improve life expectancy, although not back to that of the nonsmoker. Pipe and cigar smoke, when not inhaled, is less hazardous and accounts for only a fraction of the problems created by inhaled cigarette smoke, but smoking a pipe or cigar can also certainly decrease your social acceptability. The militant nonsmoker (“Would you mind putting out that cigarette?”) is a constructive new social phenomenon, and the smokers are being packed into smaller and smaller spaces in the back of the airplane. The hazards of “second-hand smoke” are real, although relatively small, and many people feel that forced exposure to the smoke of others is deeply offensive. Five up your cigarettes and avoid the hassles.