To Your Good Health
DEAR DR. ROACH: Can a weakness toward alcoholism be inherited and run through a family for generations? Or is each person a separate case, and subject to his own behavior and health career? — N. M.G.
ANSWER: A family propensity to alcohol use disorder has long been known. Both environmental effects and genetic predispositions have been identified. One study on twins estimated that just over half the increased liability to alcohol use disorder is due to genetics. However, it is important to know that there isn't an "alcoholism gene" and that, as you say, a person's own unique situation has a major impact on whether they will develop a problem with alcohol consumption.
There is no certainty about who will have the predisposition to develop problems with alcohol, but a person with a family history needs to be more careful than others to recognize when they are beginning to develop problem behaviors. Many people with problem drinking do not recognize it, and may resent attempts by family members to help
young people meet criteria for problem drinking, but that behavior often ceases. If a person continues to problem drink after age 25 or so, especially binge drinking (more than four drinks at a time for a woman, five at a time for men), then they are at significant risk for having problems throughout life and should consider getting help. This may be some counseling from your family physician, a mutual help group such as Alcoholics Anonymous, referral to a mental health professional or addiction specialist, and in some cases medication.
DEAR DR. ROACH: I am 78 and have some difficulty swallowing. I must take calcium and magnesium tablets, and they are very large. I have to chew them to get them down properly. I have actually choked on pills in the past. But chewing some tablets gives a terrible taste. Any suggestions? — P. P. L.
ANSWER: Older people often have difficulty swallowing for several reasons, including loss of elasticity of the tissues, dryness and neurological changes reducing sensation, and nerve and muscle changes in the muscles involved with swallowing.
Some general advice might be helpful. A proven method of swallowing tablets is to place the tablet on your tongue and suck water from a flexible water bottle.
Capsules can be swallowed more easily by tilting the chin slightly toward your chest. These techniques are illustrated at Tinyurl.com/swallow-advice.
Many, but not all, large pills can be crushed and mixed with thick liquid like applesauce or yogurt. Pill crushers can be bought at any pharmacy, or you can get a mortar and pestle. Ask your pharmacist if your pill can be crushed. If not, perhaps you can get a prescription for several smaller-sized tablets.