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USPSTF: Screen all adult patients for 'alcohol misuse'


 

FROM ANNALS OF INTERNAL MEDICINE

There is good evidence that brief counseling interventions can induce patients to reduce their weekly alcohol consumption and adhere to recommended drinking limits, both in the short term and long term. They also decrease the proportion of patients who engage in episodes of heavy (binge) drinking, which in turn reduces the likelihood of traumatic injury or death, particularly involving motor vehicles.

The task force cautions, however, that these brief counseling interventions usually are not effective for the more severe forms of alcohol misuse.

Those include abuse, which is characterized by drinking that leads to recurrent failure in major home, work, or school responsibilities; drinking in physically hazardous situations, such as when operating heavy machinery; or having alcohol-related legal or social problems. Severe forms of alcohol misuse also include dependence, characterized by physical cravings and withdrawal symptoms; frequent drinking in larger amounts than intended over longer periods; and the need for markedly increased amounts of alcohol to achieve intoxication.

For this update, the USPSTF did not evaluate interventions – such as pharmacotherapy and outpatient treatment programs – for these higher levels of severity. "But the benefits of specialty treatment are well established and recommended" for such patients, Dr. Moyer and her colleagues said.

Reprints of the updated recommendations are available here.

No potential conflicts of interest were reported. The USPSTF is funded by the Agency for Healthcare Research and Quality under a congressional mandate. The voluntary group of clinicians and public health experts is independent of the federal government, and it compiles recommendations about preventive care for a range of health conditions.

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