Alcohol and SCI

Shawn · 08-07-2001, 06:17 AM

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?

stephen212 · 08-07-2001, 06:36 AM

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 · 08-07-2001, 06:57 AM

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.

SCI-Nurse · 08-07-2001, 07:54 AM

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 · 08-08-2001, 03:12 PM

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 · 08-10-2001, 08:08 AM

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 · 08-10-2001, 10:30 AM

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 · 08-13-2001, 02:22 PM

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.

Chris Chappell · 08-13-2001, 02:58 PM

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

Just a little quad humor.

Shaun · 08-13-2001, 04:09 PM

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

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

08-07-2001, 06:17 AM	#1
Shawn Senior Member Join Date: Jul 2001 Location: South Africa Posts: 284	Alcohol and SCI 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?

08-07-2001, 07:54 AM	#4
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,327	Alcohol 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)

08-08-2001, 03:12 PM	#5
Ulsio Junior Member Join Date: Aug 2001 Location: Champlin, MN, USA Posts: 11	SCI & Alcohol 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

08-10-2001, 08:08 AM	#6
dax Member Join Date: Aug 2001 Posts: 89	Alcohol and the bladder 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.

08-10-2001, 10:30 AM	#7
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,327	B & B effects 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)

08-07-2001, 06:36 AM	#2
stephen212 Senior Member Join Date: Jul 2001 Location: New York City Posts: 5,289	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?

08-07-2001, 06:57 AM	#3
Shawn Senior Member Join Date: Jul 2001 Location: South Africa Posts: 284	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.

08-13-2001, 02:22 PM	#8
monkeygirl Senior Member Join Date: Jul 2001 Location: BC, Canada Posts: 1,972	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.

08-13-2001, 02:58 PM	#9
Chris Chappell Senior Member Join Date: Jul 2001 Location: Denver, CO Posts: 7,035	Good points everyone! However I only drink on days that end in "y" and only alone or with somebody. Just a little quad humor.

08-13-2001, 04:09 PM	#10
Shaun Moderator Join Date: Jul 2001 Location: Canada Posts: 7,790	Monkeygirl HEY CAREFUL NOW!! Im a displaced Van Islander and I wont have you talkin bad about Miss Mary J.... ........\/PEACE ~Shaun~

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