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McHenry County providers treat alcohol use as definitions change

McHENRY – Falls, car accidents and fights will sometimes land heavy drinkers in the emergency room at Centegra Hospital – McHenry.

Alcohol is “a major factor in our business after 7 p.m.,” said Dr. Joseph Keenan, the director of emergency services at Centegra Health System.

The patients who come into the hospital with alcohol-related issues, though, are often there of their own volition and ask to go through detox, Keenan said.

That’s in sharp contrast to many other care providers – like The Counseling Center in Woodstock where Linda Tansey is a certified alcohol and drug counselor – who have most of their clients come through the door because treatment has been court ordered.

“That might be the first time they realize it might be a problem,” Tansey said. “Their families might be complaining, but they think it’s not a problem until they’re arrested.”

For many of Heidi Dooley’s patients, their health is the trigger that gets them help.

Dooley is a behavioral health consultant with Centegra Health System where she works with inpatients, more than half of whom have requested to go through detox and the remainder who come in for other medical issues.

Excessive alcohol consumption can cause pancreatitis, gastrointestinal bleeds, high blood pressure and esophageal pain, she said.

“The pain is just so great it drives them in,” Dooley said.

Excessive alcohol use causes about 88,000 deaths a year nationwide and more than 3,000 a year in Illinois, according to 2013 reports from the Centers for Disease Control and Prevention.

More than half of the deaths nationwide are the result of binge drinking, which is five or more drinks per occassion for men and four or more per occassion for women, the report said.

Binge drinking is more common among adults in Illinois, an estimated 23 percent in 2011, compared to the nationwide rate of 18.3 percent, though it has been on the decline over the last few years, according to the 2013 Illinois Prevention Status Report.

The perception of alcohol abuse and misuse has been shifting “very slowly,” Tansey said.

“When it was determined that it was a disease, it was supposed to relieve some of the stigma,” she said. “It’s very slowly becoming that if you need help, it’s perfectly normal to get help.”

The classification of alcohol abuse is changing again, Dooley said.

The Diagnostic and Statistical Manual of Mental Disorders – a giant tome published by the American Psychiatric Association and serves as a diagnostic guide – will switch from the previous classification of alcohol abuse and alcohol dependence to a continuum called alcohol use disorder.

The diagnosis of alcohol use disorder is based on 11 criteria, Dooley said.

If a patient meets two or three of the 11 in 12-month period, the diagnosis is mild alcohol use disorder, she said, adding that the more criteria the patient meets, the more severe the disorder.

Dooley doesn’t see the change as making too big of a difference, but she added that it could be a good thing because when patients are told their alcoholics, they immediately push back.

The new definition also allows more flexibility in treatment as people move along the continuum, she said.

People dealing with alcohol-related issues, though, are less likely to have resources, including support at home or insurance, Keenan said.

The 11 criteria of alcohol use disorder Meeting two to three of the criteria is classified as a mild case of alcohol use disorder while four to five is moderate and more than five is considered severe, according to Centegra Health System behavioral health consultant Heidi Dooley.

1. Tolerance

2. Persistent efforts to stop

3. Cravings

4. The time spent on using, obtaining and recovery

5. Failure to fulfill obligations

6. Continued use despite social or legal consequences

7. Decrease in social or occupational activities

8. Engaging in dangerous activities due to use

9. Continued use despite physical or mental health problems

10. Consuming larger amounts or over a larger period of time then intended

11. Physical withdrawal symptoms

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