America's No. 1 Drug Problem

Death, Violence, and Alcoholism

F. Rene Modglin, M.D., is certified by the American Board of Pathology and has been a coroner's autopsy surgeon since 1956.


YOUNGSTERS ARE shown how wiggling worms straighten and stiffen when dropped into a glass of whiskey, and they may think that it means people should not eat worms while drinking whiskey. But there are other ways we are exposed to information about the evils of drinking alcohol. From various sources we learn about broken homes caused by drinking spouses, the high cost of policing the drunks, the staggeringly high direct cost of damage caused by drinking, and even how much more money is spent on booze than books. Health-science teachers present the effects on the brain, nerves, heart, liver, and esophageal blood vessels caused by the continued use of alcohol. In spite of the fact that all this is clearly presented, alcohol continues to leave an increasing trail of death, sickness and enormous expense.

There are certain problems associated with acute alcoholism that we hear little about, but from firsthand experience I can share some of them with you. Almost everyone knows that gasoline and whiskey don't mix, but only recently have meaningful figures been publicized that clearly point put that at least half of the traffic fatalities occur directly or indirectly as a result of alcohol alone or in combination with other drugs. Al most daily I examine mangled bodies resulting from vehicle accidents to determine the exact body injury that caused death, and am saddened to see so many non-drinking families destroyed by a drinking driver. Nine out of every ten drivers involved in single-occupant, single-vehicle accidents occurring from midnight to 4:00 A.M. have alcohol in their blood.

In times past, when there were fewer and slower cars and more byways than high-speed freeways, the number of possible collisions was lower. This resulted in a wider margin of safety, and the drinking driver caused fewer accidents. Today's roads and cars demand alert drivers, and because there are many more cars, the number of possible violent contacts is markedly increased and the safety margin is correspondingly decreased. Put drinking drivers behind the wheel, and the accidents are just looking for a place to happen.

Many of the deaths that result are newsworthy, but the associated role of alcohol is seldom, if ever, mentioned. House fires are sometimes caused by people falling asleep while smoking. At least 80 percent of these smokers have alcohol in their blood. Sedated by the alcohol in their systems, they more easily fall asleep, drop their lighted cigarettes in bed and start smoldering fires that more often than not kill them by asphyxia rather than burns.

About 70 percent of those who commit suicide by barbiturates, carbon-monoxide poisoning, gunshot wounds in the head or heart, or by whatever means, take alcohol to "steel their nerves" to go through with it. Alcohol used with other depressant drugs is the cause of an in creasing number of accidental deaths. Persons on tranquilizing drugs with or without barbiturates often drink alcoholic beverages inspite of their doctor's warnings and may get enough additional depression of the central nervous system from the alcohol to cause irreversible brain damage and death in a few hours. When the victim's blood is analyzed, one often finds three or even four different brain-slowing drugs, but none of them at a concentration capable of causing death individually. The additive effects (synergism) of all the drugs have been enough, figuratively speaking, to slow the brain to a standstill. Several internationally known celebrities have died from the synergistic depression of alcohol with other drugs. We have at least one death of this type each week.

Occasionally, and especially in an alleged recreation area, a physician is called to see a "drunk" who is not a regular patient of his. As part of the "sobering up" treatment the patient may receive an injection of a tranquilizing drug. Sometimes, one so treated is found dead a few hours later.

There is another, fortunately rare, example of interaction between medical treatment and alcohol: On high school graduation night a graduate quickly drinks down a pint of whiskey. Soon his inhibitions are gone and he wants to fight. There are no "takers," and he smashes his fist through an auto wind shield, lacerating tendons and blood vessels of the wrist. Already partially anesthetized by liquor, he is rushed to a small hospital in the early-morning hours, premedicated with a sedative and/or analgesic, anesthetized again, and dies on the operating table. Alcohol is doubly to blame through its synergism with other brain depressants given in treatment, and as the cause of the accident in the first place.

The drinking hunter, eager for a deer on the first day of hunting season, shoots at anything moving in the brush and kills another hunter. It may be a total stranger, but sometimes it's a father, son, or friend. One doesn't have to have the perception dimmed by alcohol to kill another hunter, but more often than not, alcohol is involved.

Under the influence of alcohol, some take chances they might otherwise not take. Too often nonswimmers will take to the water alone while under the influence of alcohol, get into situations beyond their control, and drown. Foolishly some take bets to swim across a river, go water-skiing or boating, get into swift water, and even try to rescue another, and drown. The alcohol lessened their appreciation of danger, slowed their responses, and disturbed their equilibrium, resulting in a disastrous combination for the would-be hero.

Several times a year adult drownings occur in family swimming pools. The victims have enough alcohol in the system to produce slurred speech and stumbling. Investigating a suspicious death, one occasionally hears a report from a neighbor who details a family argument, or from a hairdresser who states that the victim told her that the husband had threatened to kill her, or there is simply an anonymous phone call, all relating suspicion that a drunk wife was held under the water or pushed into the pool and intentionally drowned. Without proof, it may be impossible to ascribe the death to anything other than an alcohol-intoxicated woman stumbling into the pool in the dark and drowning.

Another sad association of alcohol with violent death occurs between drinking buddies. Arguing about such trivia as raising chickens, how to divide an about-to-be-found "lost gold mine," or girlfriends or boyfriends, they have strangled, shot, stabbed, and literally beaten the brains out of their buddy with hatchets, hammers, and even tire irons.

Three or four times a year our area has an infant death caused by a drinking boyfriend or stepfather who quiets a crying infant by strangling it, beating it, or smashing its head against the crib headboard or the wall. At least half of the planned murders are finally carried out when there is alcohol in the executor's blood.

I have catalogued a few brief personal and generalized experiences that have convinced me of the real danger and evil of alcohol. Philosophize as you may about a common-denominator personality disorder having more than one form of expression, to explain how both alcohol and violent deaths may be related without one causing the other, experience teaches me that alcohol helps re lease "social brakes" and makes it easier to be antisocial.

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F. Rene Modglin, M.D., is certified by the American Board of Pathology and has been a coroner's autopsy surgeon since 1956.

July 1977

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