Comorbidities and Other Conditions

Trauma, grief and mental health

Health professionals should be mindful of transgenerational trauma and grief, ongoing stress, and how alcohol use may be triggered by this, or may relieve or exacerbate symptoms. Trauma-informed (or healing-informed) care should focus not only on the individual but consider family, community and culture. Where needed, the clinician should seek cultural advice.  

If a patient  has recently ceased dependent alcohol use, stress can be heightened by the withdrawal. Supportive care may be the most appropriate in the short-term, with offer of specific counselling or treatment for trauma later, when the patient is more stable.  

Physical Comorbidities

An alcohol use disorder can interfere with a person’s ability to manage their other health conditions, such as diabetes. The clinician must also consider the impact of alcohol or alcohol withdrawal on physical comorbidities and offer treatment or advice accordingly. For example, consumption of alcohol on an empty stomach can cause hypoglycaemia in a person on diabetes medication, but chronic heavy use of alcohol can increase insulin resistance. Alcohol use also tends to be associated with increased smoking, which further increases risk of vascular disease.  

Pregnancy or Breastfeeding

For women of childbearing age, it is important to check awareness of the risk of alcohol to the unborn child. Contraception should be available to women who want to drink alcohol or who cannot stop drinking, to reduce the risk of FASD. For a pregnant woman who consents to have family involved in her care, informing partner or family members of her need to stay abstinent may allow them to support her. Women who are dependent on alcohol typically need access to residential treatment.  

If a woman is breastfeeding it is important to check that she is aware of the risks of breastfeeding after drinking and of ways to minimise these risks.