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Alcohol Use Disorder: A Medical Perspective Case Study

LukeNotes, Winter 2023

Father Martin, age 42, was ordained a Catholic priest ten years ago. He served as parochial vicar in two parishes before being assigned to his current pastorate, where he is responsible for two parishes on the outer reaches of the diocese, far away from family and friends. In addition to being isolated from his previous support system, he found it challenging to build relationships with either parish community, as neither had a particularly healthy relationship with their prior pastor.

An intense feeling of loneliness set in, which he alleviated by drinking more in the evenings. At first, he enjoyed his after-dinner drink, as it gave him a feeling of euphoria and relaxation. He had something to look forward to after a taxing day of dealing with parishioners and staff.

Over time, he needed several bourbons to relax and fall asleep, and he would frequently awaken during the night. He became more irritable with the staff during the day. In the evenings, he felt depressed and agitated, ruminating about any minor negative experience from the day. He needed a drink to settle down, more often several drinks. Gradually, he developed a habit of finishing off half a bottle of bourbon in an evening. If he did not drink, he was absolutely miserable. Eventually, he began to think about his evening bourbons during the day. He became preoccupied with going to the liquor store and selecting new and different varieties of bourbon.

Father Martin did not consider his drinking a problem, nor had alcohol been a significant part of his upbringing. He remembered hearing stories of his maternal grandfather’s drunken behavior and his mother’s brothers, who often brawled in bars. He did not behave that way. He said daily Mass, heard confessions, visited the sick, and kept tabs on the parish finances. He was an attentive, responsible pastor. While he knew that he was often irritated and raised his voice with his staff, it did not strike him as unreasonable behavior.

Eventually the bishop got wind of Fr. Martin’s hostile outbursts and confronted him. Fr. Martin insisted he was within the bounds of being an effective leader. However, with the support of the administrative staff, a maintenance man presented the bishop with photos of the whiskey bottles in the recycle bin.

Fr. Martin arrived at Saint Luke Institute insisting his alcohol use was manageable. However, during his evaluation, his blood pressure and heart rate were significantly elevated, and he had a noticeable tremor. He was sent to an emergency room, where he was diagnosed with alcohol withdrawal syndrome. He was admitted to the hospital for a few days of detox and given IV fluids and a benzodiazepine for alcohol withdrawal. After his discharge, he resumed the evaluation at SLI.

Fr. Martin’s blood pressure and heart rate eventually returned to normal. His liver enzymes indicated a toxicity that lingered for several weeks. Cognitive tests indicated a mild memory problem, which could have been contributing to his frustrations in parish meetings. This appeared to be in the early stages and likely reversible, given time.

Fr. Martin entered the intensive outpatient program at Saint Luke Institute. He continued to notice intermittent cravings for alcohol, so his doctor prescribed daily naltrexone to decrease these urges. He also was treated for an underlying depression with an antidepressant. Gradually, his liver enzymes returned to normal, and his memory improved.

Fr. Martin received comprehensive treatment for his alcohol use disorder. In addition to the medical and psychiatric treatment he received, he also participated in group therapies. These included a general psychotherapy process group, psychoeducational groups, art therapy, psychodrama, and Case Study continued exercise. He participated in individual psychotherapy sessions twice per week, met with a spiritual integrator weekly, and attended spirituality groups.

Although Fr. Martin had developed an alcohol use disorder, it was discovered early enough for him to recover fully.

For confidentiality reasons, names, identifying data, and other details of treatment have been altered.