Most adults, including binge drinkers and pregnant women, say they have never been asked about their drinking by a doctor or other health professional, new survey data show.
It’s time for that to change, officials with the federal Centers for Disease Control and Prevention said.
“Drinking alcohol has a lot more risks than many people realize,” CDC Director Thomas Frieden said. “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.”
The new report is based on a survey of 166,753 adults older than 18 from 44 states and D.C. It was conducted in 2011.
The survey found just one in six adults said a health professional had ever discussed drinking with them. Among those who admitted to binge drinking – having more than four drinks at a time for men or more than three drinks at a time for women – the rate was a bit higher, but still just one in four.
Just 17 percent of women who were pregnant at the time of the survey said they had never been asked about drinking, even though most health authorities advise against any drinking during pregnancy.
Since 2004, the influential U.S. Preventive Services Task Force has recommended health professionals ask adults about their drinking habits. The Affordable Care Act says new insurance policies should cover such screening. The idea is not only to find people with alcoholism, but also to find and offer brief counseling to those whose drinking may not rise to the level of addiction but can cause or contribute to health and safety problems.
“For every one person who has alcoholism, there are at least six who are problem drinkers,” Frieden said, and those people face a variety of health and safety risks. Those include an increased risk of breast cancer, sexually transmitted diseases, unintended pregnancy, fetal alcohol disorders, vehicle crashes, violence and suicide, according to the CDC.
Studies show asking patients about their drinking and then offering brief counseling to those who drink too much can reduce problem drinking, the agency said.
So why aren’t doctors doing it?
“We know doctors’ offices are busy,” Frieden said, and some doctors may bring up drinking only with patients they think are at high risk. Many also may feel they won’t have time to follow up if they find problems, he said.
Making alcohol screening and brief counseling part of routine care will mean setting up health systems, so doctors, nurses, social workers and others can work together to get it done, he said.
The CDC push is welcome, but the health system should do even more to look for and help patients at any stage of substance abuse and with any substance, Susan Foster said, vice president and director of policy research at the nonprofit addiction research and advocacy group CASAColumbia in New York.
“Alcohol is the most frequently used addictive substance, but it’s not the only one,” she said. “We really need to be screening for all risky use. ... It’s just common sense.”
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