Mortality alcohol

Adverse consequences of drinking include a variety of social, legal, medical, and psychiatric problems (Babor et al. 1987, 2003). Alcohol is among the top four causes of mortality in 1988, 107,800 deaths, or about 5% of all deaths in the United States, were attributed to alcohol-related causes (Stinson and DeBakey 1992). Approximately 17% of alcohol-related deaths were directly attributable to alcohol, 38% resulted from diseases indirecdy attributable to alcohol, and 45% were attributable to alcohol-related traumatic injury (U.S. Department of Health and Human Services 1994). Alcohol-related mortality declined during the latter part of the twentieth century. For example, the age-adjusted mortality rate from liver cirrhosis in 1993 (7.9 deaths per 100,000 persons) was just over half the rate in 1970 (14.6 deaths per 100,000) (Saadat-mand et al. 1997), and the proportion of automobile fatalities that was related to the use of alcohol fell to a two-decade low of 33.6% in 1993 (Lane et al. 1997). 

Saadatmand F, Stinson FS, Grant FB, et al Liver cirrhosis mortality in the United States, 1970-94 (Surveillance Report No 45). Rockville, MD, National Institute on Alcohol Abuse and Alcoholism, 1997... 

Stinson FS, DeBakey SF Alcohol-related mortality in the United States, 1979-1988. BrJ Addict 87 777-783, 1992... 

Modification of classic risk factors, such as tobacco and alcohol consumption, is important to minimize the potential for further aggravation of heart function. Data from observational studies suggest that patients with HF who smoke have a mortality rate 40% higher than those who do not consume... 

Kearns, Weinman, and Decker determined the dosages of a number of the chlorinated compounds, dissolved in 95% ethyl alcohol, required to produce a 50% mortality of the housefly (7). The values obtained, expressed as micrograms of toxicant per gram of fly weight, are listed in Table V. 

Menon PA, Thach BT, Smith CH, et al. Benzyl alcohol toxicity in a neonatal intensive care unit. Incidence, symptomatology, and mortality. Am J Perinatal 1984 1(4) 288-292. 

Interest in the health effects of anthocyanins was piqued by the French paradox in which the mortality from cardiovascular disease was lower than that predicted from the intake of dietary saturated fatty acids. The beneficial effects were greater in association with alcohol taken in the form of wine suggesting that there may be a protective effect of other components of wine. Needless to say the wine industry was pleased with this research. 

Mortality data obtained from Office of Population and Statistics of England and Wales and Registrar-General of Scotland. Data for single drug or single drug+alcohol. 

In a later similar study, Cremieux et al. (2005) used Canadian data to examine the relationship between pharmaceutical spending and infant mortality. This study examined determinants of life expectancy as well. The explanatory variables included food intake, alcohol and tobacco... 

Alcohol abuse and dependence, widely known as alcoholism, is a major cause of morbidity and mortality. Its acute and chronic toxicity spreads across multiple systems and organs, from child abuse to domestic or public violence to traffic accidents and from cirrhosis to hypertension. Mean life expectancy of alcohol abusers is around 55 years. Alcohol seems involved in several hundred thousand deaths each year in Europe, with considerable added social and health care costs. This is in clear contrast with the little attention paid to the treatment of alcohol dependence and abuse. On the other hand, much is made of the French Paradox , the J curve and the demonstrated cardiovascular benefits of regular moderate wine intake. 

Intravenous silymarin has been demonstrated to lower mortality from Amanita mushroom poisonings, but this formulation is available only in Europe. Animal studies have demonstrated hepatic protection against alcohol, acetaminophen, and mushroom toxins and protection against hepatic fibrosis with bile duct occlusion. There is also evidence of silybin protecting against cis-platin-induced nephrotoxicity in rats. It is not yet clear whether milk thistle extract offers any renal protection to humans. 

Suicidal risk. Data from 36,689 adult men and women (25-64 years of age) who participated in a population survey between 1972 and 1992 indicated that clustering of the heavy use of alcohol, cigarettes, and coffee could serve as a new marker for increased risk of suicide. The mortality of the cohort was monitored for a mean of 14.4 years, which yielded 169 suicides. Criteria for heavy use of each psychoactive substance were defined as alcohol more than 120 g/ week, cigarettes more than 21/day, and coffee more than 7 cups/day. Approximately... 

Depressive disorders can lead to death in other ways (Table 6-9). For example, depressed individuals are more prone to accidents that result from their impaired concentration and attention. They also often attempt to self-medicate, particularly with alcohol or other sedative agents, which may lead to death as a result of organ toxicity, as well as accidents. Psychotic depressive patients may act irrationally, putting themselves at greater physical risk. Although rare today, patients have died of severe malnutrition secondary to catatonic symptoms that precluded the ability to care for their basic needs. Depression can also contribute to a higher morbidity and mortality rate in patients with co-morbid medical disorders. For example, a large database indicates that depression may predispose to the development of ischemic heart disease and increase the risk of cardiac-related death ( 51). 

In contrast, moderate alcohol consumption in the middle-aged and elderly slightly reduced overall mortality risk. 

Thun MJ, Peto R, Lopez AD, et al. Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engi J Med 1997 337 1705-1714. 

Dependence becomes apparent 6-12 hours after cessation of heavy drinking as a withdrawal syndrome that may include tremor (mainly of the hands), nausea and vomiting, excessive sweating, agitation, and anxiety. In some individuals, this is followed by visual, tactile, and auditory hallucinations 12-24 hours after cessation. Generalized seizures may manifest after 24-48 hours. Finally, 48-72 hours after cessation, an alcohol withdrawal delirium (delirium tremens) may become apparent in which the person hallucinates, is disoriented, and shows evidence of autonomic instability. Delirium tremens is associated with 5-15% mortality. 

Exposure to powerful drugs does have a serious impact on infant mortality, including low birth weight, developmental disabilities, and sudden infant death syndrome (SIDS). Use of crack cocaine has declined somewhat since the 1990s, but a 2001 study by the Journal of the American Medical Association concluded that much of the damage previously attributed to cocaine use may in fact be attributable to alcohol or tobacco that was also used by the mothers in question. Even moderate use of alcohol poses a risk to the fetus. 

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