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Without screening, doctors may miss alcohol problems
January 15th, 2013
05:12 PM ET

Without screening, doctors may miss alcohol problems

Clinicians are missing alcohol problems in almost three out of four patients because they don't screen for the behavior and instead go with their gut feelings to catch the problem, according to a study published this week in the Annals of Family Medicine. Experts say asking patients a few questions about their drinking habits can lead to interventions that may help patients cut back on their risky behavior.

The study

Researchers wanted to find out how well doctors identified drinking problems in their patients. Almost 1,700 adults from 40 different primary care practices completed questionnaires at the end of an office visit. They were asked a variety of lifestyle questions and several addressed drinking habits, such as how often they drank alcohol, how many drinks they had on a typical day, and if their drinking ever put them in danger of getting hurt or causing an accident.

When doctors relied on their best guess or hunch about whether or not a person was drinking too much, they missed almost three out of four patients who screened positive for alcohol problems. When the doctors did suspect a drinking problem, however, their instincts were usually right.

"This study provides proof of what a lot of people have known, that systems and offices should really develop a way to do simple screening (for alcohol use) along with taking vital signs. It could be part of team-based care," says Dr. Dave Mersey, a family physician in Tucson, Arizona.

The bottom line

Though alcohol screening is recommended by the U.S. Preventive Services Task Force, it is generally not part of routine primary care, according to Mersey. 

When doctors fail to identify cases of risky drinking they are missing out on opportunities to help patients change their drinking habits. Previous studies have shown that when family doctors identified and then provided brief counseling sessions, that patients were more likely to cut back on their alcohol.

"I hope that by papers like this, it's going to be a nudge to physician to say ... 'Maybe I should start screening.' It's not that hard to do," explains study author Dr. Daniel Vinson, professor of family and community medicine at the University of Missouri School of Medicine in Columbia, Missouri.

Risky drinking

The National Institute on Alcohol Abuse and Alcoholism, or NIAAA, describes heavy or risky drinking as more than 14 drinks a week for men and more than seven a week for women. When it comes to daily consumption, five or more drinks for men and four or more for women is considered excessive. Heavy drinking contributes to many illnesses, including high blood pressure, liver disease, and breast and esophageal cancers. More than 85,000 deaths per year are tied to the misuse of alcohol. It is the estimated third-leading cause of preventable death in the United States, according to experts.

Drink responsibly

If you drink, do so responsibly. Drink slowly and be sure to eat enough while consuming alcohol. Avoid alcohol completely if you plan to drive, take medications that interact with alcohol, have a medical condition that can be aggravated by alcohol, or are pregnant or trying to become pregnant.


soundoff (7 Responses)
  1. empresstrudy

    Addicts lie? Where ever do you such wacky ideas?

    January 15, 2013 at 22:19 | Report abuse | Reply
  2. jenplease

    This article goes a bit overboard and how is it that when men drink double what women drink its equal?? While its responsible, basic patient care to inquire about daily consumption, sometimes physicians will just pass off symptoms of a serious medical condition if a patient consumes alcohol as the cause and send them off to some wacky AA 'counseling' racket.

    January 16, 2013 at 12:04 | Report abuse | Reply
  3. neuroscienceaddict

    Addiction is a chronic, progressive brain disease. It's treatable. Perhaps not as successfully as one might like, but on a par with other chronic diseases that require substantial behavioral change, like diabetes and hypertension.

    Unfortunately, many people still don't believe addiction is a disease. That's why science-based education is so important.

    For a not-for-profit website that discusses the science of substance use and abuse in accessible English (how alcohol and drugs work in the brain; how addiction develops; why addiction is a chronic, progressive brain disease; what parts of the brain malfunction as a result of substance abuse; how that malfunction skews decision-making and motivation, resulting in addict behaviors; why some get addicted while others don't; how treatment works; how well treatment works; why relapse is common; what family and friends can do; etc.) please click on http://www.AddictScience.com.

    January 16, 2013 at 13:27 | Report abuse | Reply
  4. larry5

    Some people would be helped if they were put in jail for a DUI and their picture and name published on a Web site. The rest of us would be better off as well. A family down the street, a husband, wife and 2 little girls lost the mother and one child to a drunk that was arrested 3 times and had no license but never spent any time in jail, until after he killed 2 people. The other child will be disfigured for life, missing one leg and and part of an arm and stuck in a wheel chair. There is no excuse for this kind of accident. In fact it was not an accident at all. It was premeditated murder. He was twice over the limit and knew he was drunk when he got behind the wheel. The neighbors including my wife babysit the little girl while the father goes to work. I have zero tolerance for anyone that drinks even the smallest amount of alcohol and drives. These people need to be in jail, not on the road.

    January 17, 2013 at 03:23 | Report abuse | Reply
    • Morgan

      check your definition of premeditated murder

      February 13, 2013 at 17:29 | Report abuse |
  5. Nobody

    What if you...wonder, but your drinking doesn't cause job or family problems? I enjoy a drink after work. Thing is, my portion control is fairly lenient...as it is with food. I've left work earlier than I would have a few years ago in order to buy a drink before the 2 am deadline. But I don't EVER come to work having had a drink within 12 hours (with one notable exception, and even then I [yes] blame management, and trust me, you may have left to grab a drink that day too, kid you not). That was 4 years ago.

    But I wonder where I'm headed. And yet, there is NO way in h e ll I would trust my doctor with my concerns (or leave my medical records to posterity). And for the record, I only drive because I dont have a car-nothing related to drinking-and just sort of feel like I...deserve? a...break? lol...after walking 3 miles to and from my 3rd shift job every day. Alcohol sorta is like a carrot after a long day-and they're ALL long days. I don't worry. Still, sometimes, I do...wonder.

    Thanks for letting me have my say. My dad was an allkie, and I don't want to end up like him. Or worse, already be like him, but in denial.

    January 19, 2013 at 06:19 | Report abuse | Reply
  6. Nobody

    Meant-I only *drink* because I DON'T drive. Oh man...sorry. That would be a rotten thing to do...my dad once took me and my 4th grade friends in his 68 Buick wagon at 101 mph whike drunk. I thought we would die...even at that age, I knew better. My friends parents never let me near them again, and I dont blame them. It was impossible for me to have friends after that, so maybe word got round.

    Yes, I am texting while loopy. 40 oz of beer over 4 hours. lol sorta normal for me sorry. Thats how I can be honest. When I wake up...things will seem...different.. :<

    January 19, 2013 at 06:31 | Report abuse | Reply

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