Alcohol is not a pain remedy

DEAR DR. ROACH >> After treatment for prostate cancer my husband started self-medicating for pain with alcohol. Although we’ve had many conversations about the effects from long-term use and with numerous attempts to stop drinking, he refuses any type of rehab. He is not violent or abusive. He has periodic checkups at the Veteran’s Affairs hospital relative to the prostate cancer but is not frank or honest with his doctor about his alcohol consumption.

Having read a great deal about living with an alcoholic, I realize I have no control or power over his drinking.

Although he displays symptoms of alcoholism, at this point none, to my untrained eye, appear to be severe or debilitating. What signs/symptoms must I watch for to know what to do and when to do it? DEAR READER >> I understand why you are in a difficult situation, and I hope I can help.

The first thoughts I have are about the prostate cancer and its treatment. It isn’t normal that he should have so much pain and there certainly are better treatments for chronic pain than alcohol. That’s a question for his urologist, general physician or a pain specialist.

I also am concerned about a mental health disorder, especially depression, which he may be using alcohol as a self-treatment for. Unfortunately, alcohol is a very poor antidepressant as well. Many people have difficulty accepting the possibility of depression.

The organs that can be affected by alcohol are many, but the most important are the liver, heart, bone marrow and brain. Liver disease comes on slowly, and not every drinker will get cirrhosis, the endpoint of alcoholic liver disease. Signs of severe liver disease include a large, swollen abdomen (even if the extremities are thin), yellow color of the eyes and tremor. Heart failure from alcohol causes shortness of breath and fluid retention. Bone marrow disease causes easy bruising, bleeding and anemia. But the brain is the most profoundly affected, and the list of possible symptoms is very large. Ataxia (a particular type of unsteady walking), poor memory and many personality changes are common.

In order to help your husband, it is important for you to take care of yourself. Al-Anon provides support to people who have loved ones who are struggling with alcoholism. More information can be found on its website at https://al-anon.org/.

Contact Dr. Roach at ToYourGoodHealth@med. cornell.edu.