Push to address alcohol problems outside rehab

By Megan Rauscher

NEW YORK (Reuters Health) - When was the last time your doctor asked you about your drinking habits? Chances are he or she has never brought up the topic, which doesn't sit well with a group of doctors who think it's high time that drinking and drinking problems were addressed routinely in mainstream medical practice rather than solely in specialized treatment centers.

According to Dr. William R. Miller, the doctor's office is a good place to address alcohol problems, because people with alcohol problems often say "no thank you" when referred to rehab, but may accept help or at least talk about their drinking with their primary care doctor.

Only a small minority of people with alcohol disorders enter specialized treatment centers; most are seen in regular health care settings or social services, yet alcohol problems are seldom screened for or systematically addressed in these settings, Miller and colleagues note in February issue of Alcoholism: Clinical and Experimental Research.

Miller, a professor of psychology and psychiatry at the University of New Mexico, believes screening and intervention for alcohol problems during routine office visits can be especially effective for individuals with mild-to-moderate alcohol problems noting that most people who drink too much don't think they have a problem.

For people who wonder whether they drink too much, Miller suggests taking the "drinker's check-up," available online at www.behaviortherapy.com.

In several studies, Miller and colleagues offered the drinker's check-up to people who wondered if they were drinking too much and "100 percent of those who took it were, in fact, drinking to a harmful extent, and most of them substantially reduced their alcohol use after the check-up," Miller said.

"The bottom line is if you wonder whether you drink too much, you probably do."

What constitutes "too much" drinking? According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines, women should have no more than one standard drink per day and men should have no more than two per day. A standard drink is about 10 ounces of beer, 4 ounces of wine, or 1 ounce of spirits.

SOURCE: Alcoholism: Clinical and Experimental Research, February 2006.