“Having worked in the emergency department for over 30 years I certainly agree with Dr. Green’s comments [regarding alcohol related problems seen in the ER]. I would also go as far to say that more than 50% of the problems we see in the emergency department are substance use disorder related (alcohol, opiates, tobacco, stimulants, etc).
While the office practice of medicine is less dramatic, alcohol use disorder has a heavy footprint here as well. While most medical conditions are made worse by unsafe alcohol use the following is a partial list of conditions that quickly come to mind: neurological disorders (seizures, neuropathies); sleep apnea; diabetes; obesity; heart disease (especially arrhythmias such as atrial fibrillation), diabetes; obesity, psychiatric disorders (depression, anxiety); GI disorders (GERD, gastritis, stomach ulcers) and liver conditions.
It is hard to overstate the effect of alcohol on the practice of medicine. Any treatment that is effective will have tremendous personal and public health benefits. Medication assisted treatment with naltrexone, The Sinclair Method, appears to be the most effective treatment for alcohol use disorder at this time.”
Dr. Clifford Fields, October 2020