Many doctors refrain from discussing alcohol use with their patients—and it may be costing the American economy billions, according to a new CDC report.
One in six U.S. adults binge drinks, consuming eight drinks each time
The "Vital Signs" report, based on a national survey of 166,753 adults conducted in 2011, found that just one in six adults said their health professional had asked them about alcohol intake. Of the survey respondents who admitted to binge drinking, which is defined as consuming four or more alcoholic drinks in a two- to three-hour sitting for women or five drinks for men, about one in four had discussed their drinking habits with their doctor.
The data is troubling, officials warn. "Drinking alcohol has a lot more risks than many people realize," says CDC Director Thomas Frieden. In addition to an increased risk for alcohol-related injuries, drinking is linked to chronic diseases such as cirrhosis of the liver, pancreatitis, high blood pressure, sexually transmitted infections, mental health disorders, and cancers.
Overall, CDC estimates that approximately 38 million Americans drink to excess, meaning more than eight drinks per week for women and 15 drinks per week for men.
High alcohol intake causes approximately 88,000 U.S. deaths each year, and costs the U.S. economy about $224 billion when taking into account health care costs, property damage, and lost work productivity, according to the report.
CDC: Doctors must screen patients for problem drinking
Since 2004, the U.S. Preventive Services Task Force has called on health professionals to ask adults about their drinking habits. Under the Affordable Care Act, new insurance policies are required to cover such screenings, which aim to find and treat patients with alcoholism and offer counseling to people with problematic drinking that has not yet reached the level of addiction.
Studies have found that alcohol screening and brief counseling can effectively reduce drinking by 25% in people who drink too much. Yet, the new data show that the "health system is not doing a good job of finding out about these problems," Frieden laments.
Many doctor's offices are busy, so some providers may only bring up drinking with patients they consider high risk. Others—including Susan Foster, an expert in addiction—say part of the issue is that substance misuse is often framed as a moral shortcoming, rather than a medical condition.
Frieden calls for alcohol screening and counseling to be made a part of routine care. Doing so, he says, will require collaboration among doctors, nurses, social workers, and others, as well as the adoption of electronic screening and counseling tools. Health care systems should look to Kaiser Permanente Northern California and others that are leading the way on alcohol treatment programs.
"In the same way we screen patients for high cholesterol and high blood pressure, we should be screening for excess alcohol use and responding effectively," Frieden says (Painter, USA Today, 1/7; Jaslow, CBS News, 1/7).
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