In the field of emergency medicine, substance abuse is a common encounter. Next to automobile accidents, it probably accounts for the largest single item call in the field. Alcohol abuse accounts for a large percentage of these calls. Why? “Currently, nearly 14 million Americans (1 in every 13 adults)abuse alcohol or are alcoholic”1, with several million more that engage in risky drinking behaviors. College students are at risk with “binge drinking” being a common practice.

There are no boundaries for Alcoholism and substance abuse. It crosses
the lines of social economic barriers, age, and race. A family of history of Alcohol
abuse increases the risk of alcohol problems, but there are studies that show it is
not just genetics. The environment in which the child is raised has a large effect
on the outcome. “Over one-half of the children of alcoholics do not become alcoholic.”2

“Alcohol is the most commonly used drug among our Nation’s young people, surpassing
tobacco and illicit drugs.” 3 A 1995 showed that 30 percent of forth through sixth
grade children report that they are pressured by peers to drink beer. Forty one
percent of ninth graders report that they have a drink of alcohol in the last month.
Along with Alcohol, persons often mix other drugs and medications either to increase
the effect or, because they have not understood the consequences.

The elderly are often taking several different medications at the same time and may not
consider the effects of mixing alcohol with these medications. These medications can be
prescribed or purchased over-the-counter. Alcohol and drugs can have a synergistic effect.
This means that the side effects of the drugs are multiplied at an exponential rate, and can
cause life threatening problems. It is important to remember, the mixture can be
intentional or accidental. Alcohol and drugs can also mask other medical problems of
the patient. For example “alcohol causes changes in the heart and blood vessels that
can dull pain that might be a warning sign of a heart attack.”4

Not everyone that drinks is an alcoholic. How do you know if you or your friends or family are at risk? The following are signs to look for:

  1. Drink to calm your nerves, forget your worries, or reduce depression
  2. Lose interest in food
  3. Gulp your drinks down fast
  4. Lie or try to hide your drinking habits
  5. Drink alone more often
  6. Hurt yourself, or someone else, while drinking
  7. Were drunk more than three or four times last year
  8. Need more alcohol to get "high"
  9. Feel irritable, resentful, or unreasonable when you are not drinking
  10. Have medical, social, or financial problems caused by drinking 5

OK, what can we do? First is the identification of all problems, and then as a medical first responder, provide proper treatment.

  1. What are the symptoms the patient is experiencing?
  2. Swaying and unsteadiness
  3. Slurred speech, rambling thoughts
  4. Flushed appearance to the face
  5. Nausea or vomiting
  6. Poor coordination
  7. Confusion
  8. Hallucinations
  9. Blackout and Altered Mental Status
  10. Confusion and restlessness




If you suspect that you or a friend needs help, call your doctor or your local department of health. Reference:

  1. NIAAA – publications – Alcoholism Getting the facts
  2. NIAAA – publications – A Family History of Alcoholism
  3. NIAAA – publications – Keep Kids Alcohol Free
  4. NIAAA – publications – AgePage-Aging and Alcohol abuse
  5. NIAAA – publications - AgePage-Aging and Alcohol abuse
Copyright © 2004
Dana Cox
please e-mail me @- EMS instructors
Revised - January 2004