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Medical Conditions Doctors Miss

So you're sleepy a lot and maybe a little blue, and your blood pressure is on the high side. It could be stress, or these and other common symptoms could be signs of serious medical conditions that doctors sometimes overlook.

Alcohol Abuse and Dependence continued...

Although 17.6 million Americans have an alcohol use disorder, only 7% are receiving treatment, says Mark Willenbring, MD, director of the National Institute on Alcohol Abuse and Alcoholism's Division of Treatment and Recovery Research.

Research shows most doctors don't screen for alcohol dependence among regular drinkers, and even if they do identify dependence, they don't usually refer people to treatment.

Patients also don't talk to their doctors about the issue. Even if they know they have a problem, they don't seek help. In a 2003 survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), substance abusers in general cited non-readiness for treatment, cost, access barriers, stigma, and lack of time and confidence in treatment as reasons for not seeking care.

Fortunately, most people appear to recover without treatment in a substance abuse center. "Approximately 40% of people who develop alcohol dependence are able to drink normally 20 years later, or at least that's what they report," says Willenbring.

Experts do not fully understand the phenomenon, but they do know patients often turn to informal sources of support, such as a family doctor, family members, a minister, or a mental health therapist.

Certain events, such as a conviction for driving under the influence (DUI or DWI) or health problems, can be strong enough incentives for some people to make a change in their drinking habits, says Willenbring. However, not everyone can recover from alcohol dependence on their own.

People can help themselves by talking to their doctors about their alcohol use. Some patients can even try to set up brief, focused sessions with a primary care doctor, a nurse, or a social worker. "The goal of those conversations is to get the person to set goals to reduce their drinking," says W. Oslin, MD, assistant professor of psychiatry at the University of Pennsylvania Medical Center. "There's a lot of [scientific] literature showing those are very effective in the context of primary care."

You can also ask your doctor about medications to treat alcohol dependence. There are various treatments options including detoxification to get the alcohol safety out of your system and medications such as Antabuse, ReVia, and Campral.

Other strategies include asking family and friends about your drinking, undergoing psychotherapy, and educating yourself about the problem through the Internet. Oslin recommends going to alcohol abuse and dependence screening sites that are sponsored by reliable sources such as government agencies, academic centers, and professional organizations.


There is a small, butterfly-shaped gland just beneath the Adam's apple that controls key functions of the body. When that gland, called the thyroid, isn't working properly, metabolic processes go awry and can affect nearly every organ.

Hypothyroidism, or an underactive thyroid gland, happens when the thyroid gland doesn't release enough hormones into the bloodstream, and metabolism slows down. This is the most common of the thyroid diseases.

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