Alcohol Abuse and Related Medical Illnesses 

Alcohol abuse is often associated with medical illness, which frequently becomes a common consequence of heavy drinking and also may occur in the absence of alcohol dependence.  Early in the course of drinking, some individual’s alcohol abuse problems may show no physical or laboratory abnormalities, but as drinking continues problems begin to manifest themselves in many of the body’s organ systems.  Obviously, a physical examination is necessary if there is any indication whatsoever of any medical problems.  This physical examination will include important information about the presence and also the extent of any organ damage, and should be geared toward examining the organ systems most vulnerable to alcohol abuse including: the cardiovascular system, the gastrointestinal system, and the central and peripheral nervous systems.  The physician will also be alert to other possible concerns related to alcohol such as alcohol withdrawal or delirium, intoxication or withdrawal from other drugs, and the acute presentation of psychological problems.  Other nonspecific or systemic health problems associated with alcohol abuse include malnutrition, muscle wasting, specific vitamin deficiencies, infectious diseases (such as tuberculosis, dermatitis, pediculosis, and hepatitis), and trauma secondary to fights and accidents. 

Alcohol abuse and related laboratory tests: 

There are a variety of laboratory tests which may be helpful in assessing the effects of alcohol abuse and consumption.  Most alcoholics or individuals experiencing alcohol-related disorders are usually reluctant to seek help, and usually underreport the frequency and intensity of their drinking.  There are diagnostic laboratory markers that can help detect individuals who minimize their consumption.  Laboratory testing can help resolve diagnostic dilemmas among individuals who do not report drinking-related activities accurately, or who have physical findings which are inconclusive. 

Laboratory tests are also sensitive to detecting when heavy drinking has occurred and may be helpful in detecting relapsing drinking behavior.  Early detection of continued alcohol abuse can sometimes prevent the reinstatement of alcohol dependence and may diminish the adverse consequences of heavy drinking by promoting modifications to the original treatment plans, or prompting more aggressive therapeutic interventions.  Also, laboratory markers of heavy drinking are also helpful for evaluating the effectiveness of specific therapeutic interventions and also provide funding agencies with objective data related to treatment outcomes. 

Several laboratory tests, particularly those related to hepatic function (e.g. serum transaminases, bilirubin, prothrombin time, and partial thromboplastin time) have been used by clinicians fairly commonly.  Other laboratory tests (e.g. gamma-glutamyl transpeptidase (GGTP) mean corpuscular volume (NCV) of erythrocytes can be used as objective indicators of heavy drinking.  Another laboratory evaluation that is often indicated in alcohol abuse individuals is a urine toxicology screen.  This screen is used to identify drugs that the alcohol abuser denies or does not recognize as being problematic, and includes a screen for opiates, cocaine, benzodiazepines, and cannabis, also, routine urinalysis, blood chemistries, hepatitis profile, complete blood count, and serological test for syphilis and (for women) serum tested for pregnancy should also be conducted.

From DSM-IV-TR Mental Disorders: Diagnosis, Etiology and Treatment by Michael B. First and Allan Tasman

Additional Information and webpage by Paul Susic  MA Licensed Psychologist   Ph.D. Candidate  (Health and Geriatric Psychologist)

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