Valuing Others

By Richard P. Holm MD

This week, in our little town in South Dakota, a young man in his twenties came into my office weeping and scratching his arms and legs. I was expecting a rash-type problem, when he blurted out that he was injecting methamphetamine two to four times a day. “It has destroyed my life,” he said. “I used to have a job, insurance, a house, and a life. Now I have nothing. Please help me,” he cried. I did my best for him.

By definition addiction is the state of physical or psychological dependence on a drug, which is liable to have a damaging effect. It’s a habit, a compulsion, or an obsession, which turns around and bites the user and everyone nearby. Alcoholism is the most pervasive and obvious addiction in our society. If it doesn’t directly affect you, most certainly it affects someone dear to you.

The potential for addiction is part of our collective human nature. I dare say that every one of us given just the right situation would be addicted to one drug or another, whether it be cigarettes, pain medicines, sleeping pills, marijuana, methamphetamine or a fine red wine.
What is it that separates the addict from normal happy people who are able to function in society? Some experts define addiction and, specifically, alcoholism with the four features of craving, loss of control, physical dependence, and tolerance. Others add that addiction means losing perspective about what has value in life. Vision of the surrounding world dims, and instead the addict obsesses on self and how to get another shot, pill, snort, drag, or drink. Addiction accelerates like a maelstrom into such selfness until nothing else exists.
It makes sense then that the opportunity for recovery comes with the sacred message of the Golden Rule: treating others with compassion and fairness. Valuing others is the key ingredient in order to sober- up the self-absorbed addicted individual. It is no wonder spiritual based programs for sobriety are the most successful.

No question, we are all at risk for the selfish cycle of addiction, and our best help comes by relearning how to care for others.

Alcoholism

By Richard P. Holm MD 

There is good science showing a glass or two of wine per night protects against heart disease. But what can be helpful to some, can be poison for others. 

One study found 53% of people in the US have a close relative who has a drinking problem. At last count 17.6 million in this country are alcoholic or alcohol abusive. Alcohol excess causing auto crashes, homicide and suicide, liver-heart-brain-kidney illness, and brain damage to the unborn, costs the US about 185 billion dollars per year, not to mention incalculable human suffering. 

"Alcoholic" means four things: craving, can't stop, withdrawal symptoms, and needing more and more to get high. This is different from "abuse", which means a pattern of drinking which results in failed work or school responsibilities, driving while drunk, legal problems or social and family problems. Although separate by definition, many alcoholics also experience alcohol abuse.

The CAGE questions help identify when there could be a problem: C stands for "cutting down", A for "annoyed" be criticism about drinking, G for feelings of "guilt", and E for the "eye-opener" in the morning to steady nerves. One yes is worrisome, and two means someone needs help. 

There is a myth that alcoholism is a sign of moral weakness, and to seek help is to admit some type of shameful act. In fact, alcoholism is a disease like diabetes or asthma, and not a sign of weakness or ethical deficiency. 

Why is it that alcohol will take hold of some people, and not let go until it's destroyed their lives or the lives of those around them? We dont know the answer to that question but we do know is that if there is a problem with alcohol, there is help to be had. You just need to ask for it.

Ethics & Alcohol

By Shawn Vuong

Today, Dr. Craig Uthe, a Family Practice phsyician in Sioux Falls, came in to talk to the medical students during their Introduction to Clinical Medicine class.  The topic for the day was Substance Abuse in General Practice.  We learned lots about the addiction process, and the tough road through recovery.  

Most interesting to me was the dilemma brought up near the end of the class.

Lets say there is a man named Mr. Jones.  Mr. Jones seems like he works non-stop, and today he finally has a day off to catch up on some things around the house.  He gets up early, fixes that dripping faucet that needed fixing, enjoys a wonderful lunch with his wife and children, and plays some ball outside with his kids in the afternoon.  Later that afternoon, he decides the grass is looking a little long.  Mr. Jones gets out the old lawn mower and starts cutting grass.  About half way through, he grabs an ice cold beer and drinks the whole thing before continuing to mow.  At that moment, he gets a call from work.  Its an emergency, and he needs to come in right away.  

Now lets say Mr. Jones is a maintenance man at the local hospital, and the power is cutting out in one wing of the little hospital.  Does the fact that he had a beer effect his work?  Should he be coming into work at all?

Now lets say Mr. Jones is actually Dr. Jones, and he is coming into the local hospital to deliver your baby.  Does the fact that he had one beer effect whether or not you want him to deliver your child?  Should he have been called in at all?