THE INTEMPERATE use of alcoholic beverages is a serious problem for American society. In 1985 an estimated 10.6 million Americans were alcohol dependent, and 7.3 million more experienced some negative consequence of alcohol abuse such as arrest, accident, or impairment of health or job performance.1 Alcohol is involved in 35% to 50% of marital violence cases and 10% of occupational injuries. In 1984 at least 18 500 traffic deaths (approximately 40% ) were alcohol related. The National Institute on Alcohol Abuse and Alcoholism estimated that alcoholrelated problems cost our society $117 billion in 1983.
The impact on health includes increased morbidity from cirrhosis, gastrointestinal hemorrhage, trauma, cancer, and infection. Factors that contribute to the high incidence of infection among alcoholics include dulled mental function, breakdown of local protective barriers, aspiration, exposure, and malnutrition. Both malnutrition and cirrhosis of the liver are known to adversely affect the body's immune response, and so