Mr. Wilko is a 40-year-old salesperson with a wife and three teenage children. He has recently begun to have a beer at lunch and a few drinks after work to reduce his work-related stress. An economic downturn in the housing industry has reduced the need for new home appliances and his income and sales record has been affected. Several other salespeople have been laid off at his firm. He has been told that if his sales and attendance records do not improve he will be fired. He and his wife are constantly arguing about finances and the children’s increasing demands for money. His drinking has increased to several beers at lunch and continued drinking after dinner. When he returns to work with alcohol on his breath, he is dismissed from his job. He continues to consume alcohol during the day as he attempts a job search. His wife is very concerned, as are his teenage children.

• Mr. Wilko states he is a social drinker and “can stop at any time.” How accurate is his self-assessment?
• What stressors are present in Mr. Wilko’s case?
• Why does Mr. Wilko continue to increase his alcohol intake?
• What changes in liver function can Mr. Wilko expect if he continues to drink large amounts of alcohol?
• Mr. Wilko complains to his wife that all the stress is causing “indigestion.” How do stress and alcohol consumption affect GI function?
• Why is Mr. Wilko at greater risk of trauma?