Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

The Appropriateness of Care

If an injured worker uses alcohol to control pain, mixes alcohol with prescribed narcotics for pain or uses alcohol to deal with emotions following depression, you have a very severe problem.

Those who know they are alcoholic are very reluctant to admit it. If they have a history of DUIs and other problems from alcohol, they may rationalize that their current alcohol consumption is much less. “So it is not a problem like it used to be.”

If they are in denial of their alcoholism, they will rationalize that they do not drink every day, do not drink until sundown, and “can quit any time I want.”

Unless you regularly tested for alcohol, you (nor anyone treating the patient) would have no way of knowing.

Unfortunately, those treating the patient rarely ask.

When a patient consciously denies a problem that may complicate their recovery, it’s called dissimulation. This is actually a form of malingering.

It is important to know, for the safety of patient and his/her family, if they are abusing alcohol or boosting their narcotic high by adding alcohol.

There are ways of obtaining these data from the patient in interview, but unfortunately, few of those treating the patient are even likely to ask.

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