We lack knowledge on the effects of alcohol

Editor-Last month's, Yasmina Dadi's article "Bad medicine" stated that "the use of alcohol as a stress reliever starts at university" and that medical students cope with stress by drinking.¹ Medical students experience a lot of stress and as the author states "the student's own psychological traits play an important role."

Sadly, use of alcohol starts before medical school and is worsened by the drinking culture in university. One survey found that alcohol consumption in final year medical students was lower than preuniversity levels,² and final year students drank less than second year students. The final year is the most stressful, so this raises the question of to what extent the stress of medical training contributes to drinking. In the same study, about a third of students overestimated safe levels of drinking; perhaps ignorance may be an important cause. In another survey 32% of medical students and 30% of doctors did not know the correct safe drinking limits.³

Research on the cause of drinking has also focused on inheritance,⁴ and researchers are putting more weight on "nature and nurture," saying that having alcoholic parents or childhood events, such as marital breakdowns, can increase the chance of excessive drinking.

"Bad medicine" painted a negative picture of medicine as being a disproportionately more stressful course. But the culture in medical school merely encourages alcohol misuse in medical students. To improve the situation, recognition of other important factors, such a student's actual knowledge of alcohol and psychological predisposition, may be more effective. The former is being targeted successfully. For example, medical schools at Imperial College, London, have a whole day dedicated to teaching the effects of alcohol, which helps to tackle the lack of accurate knowledge.

1. Dadi Y. Bad medicine. studentBMJ 2005;13:29. (January.)
2. Jeremy E. A follow-up survey of alcohol consumption and knowledge in medical students. Alcohol Alcohol 2001;36:540-3.
3. Myszor M, Hosker H, Foster H, Record C. Alcohol and health: do we know enough? Health Trends 1990;22:23-7.
4. Flaherty JA. Substance use and addiction among medical students, residents and physicians. Psychiatr Clin North Am 1993;16:189-97.

       

           

Responses published this month Articles Responses LETTERS We lack knowledge on the effects of alcohol       Etienne Laverse (February 2005) Deepthinath R (February 03, 2005) Read this response LETTERS We lack knowledge on the effects of alcohol       Etienne Laverse (February 2005) Deepthinath R (February 03, 2005)       Lecturer, Department of Anatomy, Melaka Manipal Medical College, Manipal, Karnataka, INDIA rdnath@yahoo.co.in I agree with the editor Yasmina Dadi's article "Bad medicine" stating that "the use of alcohol as a stress reliever starts at university" and that medical students cope with stress by drinking. But here are some effects of alcohol on the body, About 20 percent of alcohol is absorbed through stomach, and most of the rest is absorbed through the small intestine. Alcohol molecules are carried through the bloodstream and come into contact with the cells of virtually all the organs. When someone drinks on an empty stomach, the blood absorbs the alcohol rapidly. The body also absorbs higher concentrations of alcohol, such as mixed drinks or shots, very quickly. After drinking, people usually feel pleasure and become talkative at first. The feelings are usually replaced by drowsiness as the alcohol is eliminated from body, and the drinker may become withdrawn. This pattern often encourages people to drink more to keep the buzz going. Immediate medical attention is necessary if a person becomes unconscious, is impossible to arouse or seems to have trouble breathing. Drinking a high concentration of alcohol in a short period of time can suppress the centers of the brain that control breathing. It is dangerous to combine alcohol with other drugs, especially those that make sleepy. Most alcohol is metabolized in the liver and then excreted. When someone drinks more alcohol than their liver can handle efficiently, the additional alcohol accumulates in the blood and body tissues.