Archive for April, 2017

Trauma Surgeon Provides Sober Context for Alcohol Awareness Month

Tuesday, April 18th, 2017

Dr. Terrence Curran is a trauma surgeon in Morristown, NJ.

There is a disease that causes approximately 88,000 deaths each year in the United States, shortening the lives of those who die of it by an average of 30 years. It is responsible for 10% of deaths among adults aged 20-64 years and kills more than 4,000 children each year. The economic costs are estimated at a staggering $250 billion annually. There are strategies to prevent it, and yet it continues at this alarming rate with many misconceptions about its epidemiology and impact.

Alcohol abuse and misuse is not a new phenomenon, and I am not calling for the return of Prohibition. But it is a major public health problem with known interventions that can diminish its impact.

The negative side effects of alcohol abuse ruin many lives each year. Impaired driving leads to motor vehicle crashes, both fatal and nonfatal, that devastate lives, unnecessarily consume healthcare and law enforcement resources, and have major financial impact on society. Decreased inhibition, impaired decision making and coordination lead to interpersonal violence, including homicide, suicide, sexual assault, and domestic violence.

Two areas where intervention can have a pronounced impact are on preventing drunk driving and preventing underage drinking.

The days of “one for the road” should be over but, unfortunately, statistics prove otherwise. In 2014, 9,967 people were killed in motor vehicle crashes related to alcohol impairment. In 2015 that number rose to 10,265. The number of victims of alcohol-impaired crashes is multiplied as family and friends are left to grieve.

Visiting the MADD website, one can experience a glimpse of the heartbreak endured by families devastated by drunk driving. Heartbreak that was avoidable. Effective interventions to reduce drunk driving include enforcement of impaired driving laws with sobriety checkpoints, ignition interlocks for all persons convicted of drunk driving, and mass media campaigns to highlight the dangers and legal repercussions of drunk driving.

Underage alcohol consumption is costly: 4,300 lives lost annually, and many times more lives affected.  Although the large majority of persons under 21 do not engage in alcohol consumption, the majority of underage drinking is done in a very risky fashion by a small proportion of youth starting at very early ages, even as young as 12. Underage drinking is strongly linked with death from alcohol poisoning, unintentional injuries, such as car crashes, falls, burns, and drowning, suicide and violence, such as fighting and sexual assault.

Other risky behaviors such as smoking, drug use, and unprotected sex are also more likely when children engage in alcohol use. Schools, families and communities can work together to foster an alcohol-free environment through education, a proper legal environment and offering age appropriate alternative activities.

April is alcohol awareness month. The Centers for Disease Control, the National Council on Alcoholism and Drug Dependence, and Mothers Against Drunk Driving are several of the organizations promoting April 21st as Powertalk21, a day for conversation about the dangers of underage alcohol use. It can also be used to discuss alcohol issues with those over the age of 21, focusing on injury prevention to help prevent deaths, injuries, and despair that are a result of avoidable, alcohol related trauma.

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Advocacy Should Be Part of Every Surgeon’s Job

Monday, April 10th, 2017

In a letter published in Trauma Surgery & Acute Care Open April 3rd, surgeons Lewis Kaplan, Erik Barquist, Donald Jenkins and Orlando Kirton argue that more surgeons should be advocating for the trauma profession and for the benefit of trauma patients. Members of national organizations. “…need to embrace advocacy with the same vigor and dedication as they do patient care, education, and scientific inquiry,” they say.

Decrying the limited participation in advocacy among the trauma society memberships, these surgeons believe that “advocacy efforts targeted at clearly defined aspects of care should be considered a professional activity, and given equal footing with administration, academic productivity and teaching.” They appeal to surgeons’ ethical imperative to do so, encourage surgical organizations to bring advocacy into the mainstream at national meetings and to provide training in advocacy, encourage professional journals to publish on advocacy efforts, and encourage academic medical centers to allocate time for this activity.

More surgeons will have to speak to their elected officials if the recent effort to build a national trauma care system and to achieve Zero Preventable Deaths (#TraumaZPD), per NASEM’s 2016 report, is to be successful, they argue.