Alcohol and SCI

[Shawn]

As we already know, alcohol is not good for the human body but, what about an SCI person abusing alcohol? How does alcohol effect a SCI person? If a person is incomplete, will it reduce return? http://sci.rutgers.edu/forum/images/smilies/confused.gif

[stephen212]

A friend of mine who is an SCI and an alcoholic has been a text book case of everything that can go wrong post injury. I can't speak to the physiological consequences of alcohol abuse and SCI, but I can tell you that he's had countless episodes of falling out of his chair and hurting himself -- badly. He's broken so many bones that I've lost count. Surgeries, extended hospitalizations. . . it's been one calamity after another.

And as if the physical consequences weren't sad enough, the mental deficits are even more depressing. You can only pickle your brain so many times and expect to recover. Slurred speech, desultory conversation, etc.

Heard enough?

[Shawn]

Thank you for your response Stephen. By the sound of it, you have alot to say about this topic so please, if you (and others) have more to say about just how bad alcohol is for SCI, go-ahead and make us all aware thereof. Some people tend to drown their sorrows and problems in the bottle without realising that, it only makes matters worse so, the more educated we are on this subject, the better. http://sci.rutgers.edu/forum/images/smilies/smile.gif

[SCI-Nurse]

There is a significant problem with alcohol abuse in people with SCI. Some studies indicate as many as 60% of people with SCI use alcohol to excess. Of course many of these people had a problem prior to their injury...which often contributed to their injury.

Excessive use of alcohol can cause one or more of the following physical problems: interfere with or cause side effects when combined with common SCI drugs (Valium, baclofen, Ditropan, etc. etc.), interfere with the absorption of antibiotics, decrease the function of the liver (which is also vulnerable to damage from chronic NSAIDS taken by people with SCI for pain). Long term use can cause liver damage resulting in poor blood clotting and decreased blood protein levels needed for wound healing.

Psychological effects can include decreased self esteem, loss of support systems (burning out family/friends from chronic abuse), and problems with coping. In my experience, the person with substance abuse problems (not just alcohol) tends to have more falls, more pressure ulcers, more UTIs and more other complications such as contractures. Part of being a person with a SCI is needing to constantly be attentive to possible safety problems and avoiding these and tending to your health . The person who is abusing often does not do weight shifts or turns, does not inspect their skin or take correct action when early problems are found, often over-distends their bladder, falls asleep in their chair overnight, falls, and often lacks the capacity to problem solve and make good judgements.

Unfortunately it is extra difficult to get treatment for substance abuse with a SCI. Health care professionals significantly underdiagnose the problem, or excuse it (the syndrome of "if I had a SCI I would probably drink too" is well known in health professionals). Once diagnosed, finding a treatment program, either inpatient or outpatient that can accomodate the person's disability and care assistance needs is often nearly impossible. In our area a consortium of substance abuse agencies and disability organizations surveyed all treatment programs for accessibility, and found most to be sorely wanting, and not in compliance with the ADA. This is improving only due to the actions and follow up of the consortium.

Alcohol in small amounts, carefully coordinated with medications, and discussed with your physician whenever new medications are started is generally OK. Of course a person who has an abuse problem cannot stop at a small amount, so they need to get into a program that will help them learn to stop completely.

I do have a pretty good brochure from a Canadian organization on alcohol and SCI that I could share for anyone who is really interested. (KLD)

[Ulsio]

SCI Nurse wrote:
The person who is abusing often does not do weight shifts or turns, does not inspect their skin or take correct action when early problems are found, often over-distends their bladder, falls asleep in their chair overnight, falls, and often lacks the capacity to problem solve and make good judgements.

A c5 quad that was a neighbor of mine was a big time abuser. His judgement & knowledge of his meds was terrible. He had his PCA give him his meds (she gave him the bottle). The conjunction of too many spasm meds & the alcohol killed him.

Barry

Fish#3 - Hey, look. Howard's being eaten

[dax]

My personal experience with the consumption of alcohol with a SCI is this. First off, I'm still in the stage of my life where I go out with friends and have some drinks. I usually have only 1 or 2 now since my injury, but there have been nights where I've had a few too many. The only problems that I've had, have been with my bladder and bowels, which aren't small problems. As far as my bladder is concerned, my capacity ranges from 350 cc to 425 cc on a normal day. But, when I drink alcohol, it causes my body to relax. So when I go and cath after drinking sometimes it has been as high as 750cc. And when I go to bed and don't cath all night (thanks to a condom cath and leg bag) my bladder will expand to an excessive amount. This results in my bladder being overstretched and will only hold about 50cc for abuout a week. This has only happened twice and I've learned my lesson with that. Also, after 4 or so beers I'm almost guaranteed to have a bowel movement within the next few hours. Again, this is a problem if you are at a bar, or sleeping. So now I don't drink or only have one, it just isn't woth the consequences.

[SCI-Nurse]

Actually alcohol is a fairly potent diuretic, so it makes you produce more urine that the amount of fluid that you take in. If you are having a couple beers or a few cocktails, then you will need to plan to cath sooner and more frequently. Coffee and drinks containing caffeine such as sodas also act as a diuretic.

You are correct that even one episode of overdistention of the bladder can damage the bladder walls, and repeated overdistention can cause the bladder to develop diverticuli (out-pouchings) which can collect pus, germs and urine and increase the risk of UTI.

Since your body perceives alcohol as a poison, one of the ways that your gut responds to it is by increasing its motility (to get rid of the poison faster), which can cause bowel accidents and loose stools. Planning for more frequent bowel care, or moving it up a day may help some if you have been to a party, etc. (KLD)

[monkeygirl]

Well I totally, agree with everything that's been said that's bad about drinking and being in our position. I am a t6 para, for 18yrs now and have been sober for 11 yrs, the day I put the plug in the jug, was when I finally started taking care of my body. I could not believe what abuse I put my body through, I'm bloody lucky to be alive. The reason I'm a para to begin with is because I was loaded and rolled my truck. I even got in more accidents loaded since then, including impaired charges, Anyway, I used to fall out of my chair all the time, broke my leg, had cast on for 6mths. Gee lots of fun trying to function with that thing on. Got pressure sores on a regular basis. Stretched my bladder to ridiculous limits, buggered up my kidney for life, because of it. Had bladder infections all the time. I've burned my legs from smoking,(to loaded to notice, can't feel it right) And that's just the beginning!!. I won't even get into what dope does to our bod's, that's a whole other subject. I just know that for me I don't ever want to touch another drink or drug as long as I live, seeings how now that I'm clean and sober I really am living, and I plan to for a long long time!!! I guess what I'm saying is drinking is one thing, but drinking with a sci or is a whole other ballgame, especially if you drink to excess, Be Careful OK. http://sci.rutgers.edu/forum/images/smilies/wink.gif

[Chris Chappell]

However I only drink on days that end in "y" and only alone or with somebody.

Just a little quad humor. http://sci.rutgers.edu/forum/images/smilies/tongue.gif

[Shaun]

HEY CAREFUL NOW!! Im a displaced Van Islander and I wont have you talkin bad about Miss Mary J....

........\/PEACE
~Shaun~

[monkeygirl]

Hey don't worry Shaun, I'm not taking about pot! I wouldn't knock our #1 export, just cause I don't smoke it. Besides it's legal to have it here now for medicinal purposes. To each their own.

[This message was edited by monkeygirl on August 13, 2001 at 11:16 PM.]

[Shawn]

When i used to go out to hang with friends, i usually had bladder and bowel accidents because of, either the food i ate or, the alcohol i consumed. Thus, to prevent/control this, i take one Ditropan tablet (for my bladder) and two Immodium's (for my bowel). Is this a bad combination of med's or more so, how bad is it to mix with alcohol? The only thing i've noticed thus far is that, i'm thirsty all the time so, i consume more alcohol than i should. I know this is bad but, hanging with my friends is something i really enjoy and it's about the only social life i have at the moment. Please advise. http://sci.rutgers.edu/forum/images/smilies/frown.gif

[Curt Leatherbee]

Is simply to lay off the booze. Alcohol is Poison, don't make it a part of you're life.

[Scorpion]

Actually, studies have shown, in moderate amounts, alcohol may have a beneficial effect on the body. Everything in moderation, I say. I mean, we all need sodium in or diets, but too much is bad--same with sugar, fat, etc.

Shawn, I hang with friends a lot who drink a LOT. It's simply a matter of deciding, before you start drinking, how much you'll drink. I usually have a couple drinks then switch to soda. If you're really thirsty, the alcohol or soda will actually suck water out of your system. If you're really thirsty, drink water or something. My friends often give me shit for not drinking much, but I tell them to 'fuck off, I've gotta drive home later.' My masculinity or my coolness isn't attached to what I drink. If you can't go out without drinking a lot of booze, and you actually don't want to drink much, you have a drinking problem, bro. You don't have to get drunk to hang out with your friends if you don't want to.

[This message was edited by Scorpion on August 29, 2001 at 04:11 PM.]

[Shawn]

Thanx for the advise Scorpion and Curtis. Although i only drink on weekends, i should really cut down or not drink at all.

Dr. Young or SCI-Nurse: can one of you please answer my question with regard to the combination of Ditropan and Immodium as well as Ditropan, Immodium and Alcohol. Thank you in advance. http://sci.rutgers.edu/forum/images/smilies/smile.gif

[monkeygirl]

Hey Shawn, I couldn't help but notice you first asked about someone abusing alcohol. Then the next post you said you know you drink too much and know it's bad. Then the post where in order to drink you take imodium and ditropan. Geez Bud this don't sound to good . The other thing why do you feel you have to drink to hang with with your friends? Hey if telling them to screw off dosen't work find new friends, they can't be too great a bud's if ya ask me.
Anyway Shawn, If I were you I'd take a real good look-see about your drinking, It's a real scary monster once unleashed. Just caring about ya Shawn, I'm not preaching, it's just that "been there done that" and I can relate. Oh Yeah I forgot the only drink on week-ends (yeah ok point being)and yeah may-be I should cut down or quit, geez you sound just like I did. Definately time to shut er down hey. It'll be the best move you ever made, trust me, besides what have you got to loose? Just everything to gain!

[Shawn]

Thanks for caring Monkeygirl, it's highly appreciated. To truth is, i do have a drinking problem and it's having serious negative implications on my life as well as my familie's. I know i have to seek professional help but, i also know that i can overcome this if i put my mind to it. Do you mind telling me how you overcame your problem with alcohol abuse? Other's with similar experience's are also welcome to share their's. Thank you and GOD Bless! http://sci.rutgers.edu/forum/images/smilies/smile.gif

[Wise Young]

shawn, I was waiting for our spinal nurses to post an opinion. You probably know the answer to your question already. Don't mix alcohol with drugs. The reason is not just because alcohol is habit-forming and addictive.

Alcohol has complicated effects on the brain. At low levels, it inhibits some of the inhibitory neurons which accounts for the "buzz" and the loss of inhibition. At high levels, it suppresses excitability of many parts of the nervous system, including those that coordinate movements and pain.

The liver breaks down alcohol. The metabolic product of alcohol is aldehyde which causes vasodilation (hence the flushing of the face and skin) and headaches (the hangover). Chronic alcohol causes liver damage. Alcohol is also a diuretic. It causes dehydration.

When you mix alcohol with drugs, the effects are often unpredictable. You are in essence causing your brain and spinal cord to adjust its neurotransmitter levels to the drugs and alcohol... Your nervous system (central and peripheral) is constantly adjusting its neurotransmitter levels to accomodate to drugs. Because people take alcohol intermittently and push the level of drinking to the point where they can feel the effects of alcohol, the situation is analogous to constantly ramping up and down drug effects in your body.

Yes, there is some evidence that high levels of alcohol impair axonal growth (see abstract below). There is, however, an older study that suggests that lower doses of ethanol do not inhibit axonal sprouting i n the brain. The effect of alcohol on regeneration is likely to be related to dose.

Wise.


&bull; Zimnoch L, Szynaka B, Cylwik B and Kozielec Z (2000). Morphometric and ultrastructural studies of the sciatic nerve regeneration in rats intoxicated with ethanol. Exp Toxicol Pathol. 52 (5): 455-63. Summary: The aim of the study was to examine the process of sciatic nerve regeneration and changes in the dorsal root ganglia (from which sensory fibres of the sciatic nerve extend) in animals intoxicated with ethanol. The experiment used 20 rats, divided into two groups: control and treated. The treated animals were intragastrically given 2g/kg b.w. of ethanol in 25% aqueous solution. In both groups the right sciatic nerve was transected and then sutured. Aft er 5 months the animals were anaesthetized. The left and the right spinal dorsal ganglia-L5 and sections from the non-operated and operated sciatic nerves were collected for analysis. Ultrastructural examinations and morphometric measurements were conduct ed. It was found that ethanol administrated to rats inhibited regeneration of the transected and then sutured sciatic nerve, impairing the growth of axons in the transected nerve and destroying the regenerating sensory ganglion cells. The mechanism of the changes described may be associated with axonal transport disorders or with the suppressed production of biologically active substances, which affect nerve regeneration. <http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11089897 > Department of Pathological Anatomy, University School of Medicine, Bialystok, Poland.


&bull; Cassel JC, Pacteau C and Will BE (1987). Ethanol intoxication fails to affect sprouting induced by entorhinal cortex lesions. Alcohol. 4 (5): 367-72. Summary: After unilateral entorhinal cortex lesions, acute ethanol exposure (mean daily intake = 16.3 +/- 0.3 g/kg for 15 days) of juvenile rats failed to alter lesion-induced axonal sprouting in the dentate gyrus. The distribution of acetylcholinesterase in the dentate gyrus was identified histochemically as an indicator of axonal sprouting. Comparisons between operated and intact sides were based on qualitative observations and quantitative morphometry techniques using a computerized image analyser to evaluate the widths of the bands of the molecular layer. Whether ethanol-exposed or not, rats with unilateral entorhinal cortex lesions exhibited substantial qualitative and quantitative evidence of axonal sprouting. These results indicate that a 15-day post-oper ative ethanol exposure had no effect on axonal sprouting in juvenile rats and thus qualify previous findings about ethanol-mediated effects on axonal sprouting. <http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=3675857> Laboratoire de Neurobiologie des Comportements, Universite Louis Pasteur, Strasbourg, France.h

[This message was edited by Wise Young on August 31, 2001 at 01:16 AM.]

[Curt Leatherbee]

I never realized what a real sickness Alcoholism was till she was in my life. I mean I could have wheeled off the side of the Grand Canyon and as long as she had her bottle, she would have been happy. We were trying to do a long range Sailing trip, but with her Drinking problem, she would have ended up falling overboard. I really found her Alcoholism to be even more of a disability than my Paraplegia. I have been afraid to even date much for the last year because if freaked me out so much. Best off to not drink at all is what I say. It screws up too many lives. Was just reading an article about Russia the other day, they are dropping like flies over there at a very young age because of all their boozing, definately, not worth it.

[monkeygirl]

Hi Shawn! I knew you had a problem, I just didn't want to seem like a jerk and tell you that,just in-case you got pissed at me. You see not to many people can handle being told they got a problem, without freaking on the person who says it. But cool, you've done the best thing you could do so far and admitted that you do!
Like in an earlier post it was said many people with a sci do drink to much and are alcoholics, Well I am too, I am a recovering alcoholic who has been clean and sober for 11yrs, and I know exactly what you are going through. It sure sucks doesn't it! It's like ok where did I cross that line from party'n and having a blast to this shit?
My biggest reason for not wanting to quit drinkin, was oh yeah right what am I going to do, cause everything I did involved drinkin one way or another. I loved party'n, I had a blast it was all the consequenses after the fact, it literally dragged me down, almost destroyed my life. Well I finally just got sick and tired of being sick and tired, I reached out and phoned that dreaded AA place. Gee to my surprise it wasn't no religious cult, bible thumping weirdo's. It was a bunch of people just like me or you,doctors lawyers,mom's dad's brother's and sister's. It was just a bunch of people with one common purpose, to help eachother stay sober, It's pretty cool, the support you recieve is awesome, and you sure need it, it's the hardest thing you'll probably ever do, I won't lie to ya. But hey we're worth it, Life is pretty awesome today, thing is though,all it would take is one drink, and it will all come tumbling down again, because I can never have just one and roll away, ya know I mean. Pick up the phone bud! For us it's a life and death deal, and I've seen to many people die! Hang in their Bud you are not alone their are millions of people just like us everywhere you look. http://sci.rutgers.edu/forum/images/smilies/wink.gif

[mikep]

Monkeygirl Rocks!!!Currently in just my 15th month of sobriety, three years post-injury, and I can assure you those simple steps are very doable in a chair. "Simple" is not easy, but life on life's terms has changed what many consider a curse (SCI) into another chance (recovery, to sobriety).

[Patty]

5 years sober here and 10 years post injury. :-)

Shawn, make that call, find a meeting and givr it a try.
You will find a whole new life out there and I guarentee it is better then the one you are living now.

Patty

[SKYCO]

I got married,that was the end of my party.
Good luck,control the bottle,don't let the bottle control you.
Steve

[monkeygirl]

Hi KLD! You mentioned in an earlier post about a pamphlet on alcohol and SCI, from a Canadian Orginization. I am very interested in it, could you please tell me where I could get it. Thank-you very much.

[Shawn]

I would like to thank you all for your advice and words of encouragment to overcome my alcohol addiction. At first, i want to use my own willpower to overcome it and if that doesn't work then, i'll seek professional assistance.

Mike or anyone else

Would you mind telling me what those 12 steps are?
Thank you in advance. http://sci.rutgers.edu/forum/images/smilies/wink.gif

[SCI-Nurse]

Here is a valuable link to lots of information about Alcoholics Anonymous (AA):

http://www.alcoholics-anonymous.org/index.html

Here is a direct link to the 12 steps:

http://www.alcoholics-anonymous.org/english/E_FactFile/M-24_d6.html

Shawn, I would urge you to try AA. There is no associated cost, and the peer support for "doing this with will power" cannot be underestimated in importance. Although there is a spiritual component, it does not require a belief in any specific religion. A good AA sponsor can make all the difference in the world. Please explore this. (KLD)

[Scorpion]

Shawn, good luck, bro. If you can conquer an addiction on your own, that's cool, and I think I can understand you wanting to give it a go. There's no shame in asking for help if you need it though. Only you can determine if you need it.

~Rus

"Because you're not promised tomorrow." ~ Stuck Mojo

[Shawn]

Once again, thank you all for your kind support, advise and encouragement. The weekend is close by so, here come's my first test to pull through without the use of alcohol. I'll keep you all updated on the outcome on Tuesday as i will not be available on Monday (17/09/01). I have my first appointment at a newly found SCI Rehab Centre. I'm curious and excited to know what they have to offer and what they can do to assist me. http://sci.rutgers.edu/forum/images/smilies/smile.gif

[Sue Pendleton]

Hey Shawn,

Take the money you figure you would spend this weekend on partying and put it in a big jar. Then label the jar with something you really want--vacation to a topless beach, adapted van, new TV, or to give to cure research or save for a piece of exercise equipment. Sometimes seeing how much we waste on stupid vices helps to motivate too.

And do what people stopping smoking do...hang out where drinking is not allowed or available. So good time to visit museums, family members who don't drink , go window shopping, sit int the sun and really pay attention to the late spring weather. Maybe go buy a few pots of flowers. How about something that really makes you look cool like new sun glasses instead of drooling beer down your shirt? Whatever hits your fancy. And remember, your liver loves you. http://sci.rutgers.edu/forum/images/smilies/biggrin.gif

[Shawn]

Sue - that's a great idea. Believe me, i've wasted alot of money on alcohol and if i save what i usually spend on it, there's so much more i can do with it so, i'm gonna take your advise and start saving immediately.

[monkeygirl]

Hey Shawn, where ya been? I was kinda worried about ya! I was afraid I or some of us might have scared ya off talking about gettin help to put the plug in the jug. KLD put the links of AA in for you which is a good plan, I just can't stress enough though, when you see god all the time don't freak. It was seeing all the god stuff that turned me off and I didn't go back, consequently it wasn't long after I rolled my 4x4, hence the sci. Oh well I'm not here to preach aa but just keep an open mind. Also all the power to ya trying on your own, I tried that too, about 150 times. As for this weekend, keep real busy, reach out to people, phone people, and most importantly don't take that 1st drink, or your screwed again. E-mail me if you need someone to talk to this weekend, cause I've been there done that, and I'm here to help, Hang in Bud! http://sci.rutgers.edu/forum/images/smilies/smile.gif

[Shawn]

Hi there monkeygirl. No need to worry, i'm still around posting on this message board. I'm so glad i started this topic and admitted that i have a drinking problem because, now i have the support and advise of all you wonderful people. This weekend is going to be tough because, all my drinking buddies are already calling to discuss the plan's for the weekend. I told each one that i'm not gonna drink but, they don't believe me. Thanx for the offer to e-mail you over the weekend if need be, it's highly appreciated. http://sci.rutgers.edu/forum/images/smilies/wink.gif