gin and valium

I met a fabulous new patient today. I think a doctor would have to have a heart of stone not to have established an instant rapport with her. She had lots to talk about but was so much fun to be around that I didn’t mind that I was running behind. She signed off with, “I must let you escape to your gin and valium, I’m sure you need it”.

Legend has it, and the stats back it up, that doctors have some of the highest rates of alcoholism and drug abuse of any profession. I learnt in medical school that we are second only to publicans, and perhaps journalists, when it comes to alcohol intake. It’s a very real risk, and reflects the stress of absorbing the emotional and physical pain of people who are in need. I almost always go home and get the children into bed so I can head straight to the bottle of wine, just to “wind down”. Ever aware of health issues, I try to have a couple of dry nights a week, and stick to a small glass a night when I do. Middle class harmful alcohol use is not a new phenomenon, but recognition was slow to dawn.

I’ve been trying to ask more of my patients about their drinking, as I live and practice near some of the alarmingly-labelled hazardous drinking hotspots of the south east. It doesn’t surprise me, but it often surprises my patients, just how little alcohol it takes to take you over the weekly limit. Tonight I did the quiz on the Drinkaware website and it tells me that I’m drinking responsibly. Then I redid it, pretending I drank three small glasses of Rioja, six nights a week. I’m still drinking “responsibly”, but clearly that level of drinking would take me well over the weekly recommended value. But because I’m sitting at home in front of Location Location Location, and not throwing up in a dustbin and falling into a taxi, I might be tempted to feel smug. As it is, I try to be careful and I hope my liver will thank me for it.

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8 Comments

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8 responses to “gin and valium

  1. I guess it’s no surprise that gin and valium have similar effects since alcohol and benzodiazepines work on the same receptor sites. As such I’ve mellowed over time and I’m much more accepting of folk having “a wee tot” at bed time. Got to be better to self medicate with a decent night cap than taking temazepam every night, eh?

  2. NiceLadyDoctor

    Very true. I’ve inherited a pile of elderly patients on benzos from the outgoing partner (no wonder his patients loved him so much!); I might suggest they swap to sherry instead. I suppose it’s when “a wee tot” becomes half a bottle of 14% abv that we start worrying.

    Aside: do they still let docs prescribe “a wee tot” on inpatient drug cards? I always enjoyed writing up ‘Guinness, 1 bottle nocte prn’ on drug charts when I was a house officer.

  3. It’s difficult enough to know where responsible drinking ends for ourselves, let alone our patients. I generally have a single glass of wine most days (between 1.5 and 2 units) but, like you, have the occasional day when I just drink water with my meal.

    I tend to be more indulgent with my patients, but of course we have a duty to warn them if they are likely to damage themselves.

    I’m glad you have acquired a jolly patient. Every doctor needs a few. 🙂

  4. Madsadgirl

    One of the things that I became aware of almost immediately after I started suffering from depression was how easy it would be to turn to alcohol as a crutch to help me through the darkness, so I immediately poured all the alcohol in the house down the sink. If it wasn’t there, I couldn’t be tempted. It was a very long time before I bought the occasional bottle of wine which I would make last several days (thank goodness for vacuum seals so that the red wine doesn’t get too metal tasting. Eventually, I even started bring back bottles of duty free spirits and liqueurs from my trips abroad, and now although there is wine (always red), vodka, gin, and Tia Maria (I don’t actually like the taste of most drinks) in the house, I very rarely indulge. Even after all this time, I am still aware how easy it would be to start drinking and not stop, so when I get very depressed and think that I may get to the stage of craving a drink, or two or three, then I put the booze in the garage. If it is there, I can resist the urge, and know that I will have something there to enjoy when I am in a better frame of mind.

  5. In Australia I have seen drinks written up. Scotch and coke, nocte, red wine, nocte.

  6. This made me laugh because I could have written this (not the bit about the jolly patient so much – though I have one who brings me bottles of wine “for your lunch doctor”) but the bit about getting home and the kids in bed so you can have your glass of wine….

  7. TheShrink

    do they still let docs prescribe “a wee tot” on inpatient drug cards

    Indeed yes! I’ve had a handful of patients this year who’ve had something medicinal prescribed of an evening for them 8)

  8. pedestrian08

    In Melbourne, Australia, like a lot of places around the world we are struggling to cope with ubiquitious available alcohol and the effects it has on our various populations including children.
    The Pedestrian 08 Campaign has been setup in order to push the line that ‘responsible drinking ends at 08’ – a BAC level of 08 – the point where your chances of being killed or injured as a pedestrian are about double that of someone sober.
    Our most effective drug use change program is our point 05 motorist campaign. Whole MCG carparks have been breathalysed and not a single driver has registered as over point 05.
    The Pedestrian 08 Campaign seeks the same success for those other road users – pedestrians.
    Some 70% of acts of violence in Australia have alcohol at its core. One veteran researcher in the field was asked about the efficacy of having a point 08 pedestrian limit. He simply stated that alcohol related violence would ‘dry up’.
    It would be good to get as many medicos behind this campaign as possible.
    The site is http://www.pedestrian08.org
    Regards
    Mike Cockburn

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