Alcohol, Arsenic, and (Rapidly) Old Kidneys

The staggering social impact of alcoholism on patients and their families is seen daily by physicians in the office and the hospital. A myriad of medical problems from cirrhosis to tuberculosis to malnutrition plagues patients with alcoholism. In men 25 to 44 years old, alcohol is a major factor in the four leading causes of death (murder, 60%; accidents, 50%; suicide; and cirrhosis). The 10 million or so alcoholic patients in the United States are thus major contributors to the violence of present-day American life through vehicular deaths, murders, and suicide. The excessive mortality from alcohol abuse alone is estimated to account for approximately 7% of male deaths in the United States. Finally, the economic cost attributable to or associated with alcohol abuse (ie, lost work production, direct health care cost, and fire and accident losses) in the United States has been estimated by Berry^' to have been approximately $31.4