Tom: There are four reasons
that doctors should screen patients.
I'm going to start with a quotation from a wonderful book,
Goeffrey Rose's Preventive Medicine.
Here's what Dr. Rose wrote:
"Of all the threats to human health, it is alcohol
"which causes the widest range of injury.
"It shortens life, shrinks the brain,
"and impairs the intellect.
"It causes failure of the liver, heart,
"and peripheral nerves, contributes to depression,
"violence, and the breakup of personal and social life,
"and it has been blamed for a quarter of all deaths
"on the road."
In addition, alcohol causes a wide range of problems
that aren't even mentioned there,
including gastroesophageal reflux, hypertension,
heart attack, fetal alcohol syndrome,
sudden infant death, and it increases the risk
of sexually transmitted diseases, including HIV.
Further more, drinking causes at least 88,000 deaths
per year, more than $200 billion of societal costs,
and at least 18% of all adults have
binge drinking patterns that may be very harming.
Furthermore, and very encouragingly,
alcohol screening and brief intervention
can substantially reduce the likelihood
that patients will have problem drinking.
This simple technique of 5, 10, or at most, 15 minutes
of counseling, even as few times as a single time,
can have a real impact in improving
your patient's health.
Fourth, drinking doesn't just cause
alcohol related problems.
It causes problems with adherence to medications
for diabetes, for hypertension, a whole host
of medical problems.
Alcohol use should not get a free pass,
because alcohol is actually the fourth leading
underlying cause of death in this country,
following smoking, poor nutrition, and physical inactivity.
It's important and if you don't screen for it
in your practice and address excess drinking,
I don't think you're providing as good care as you could
to your patients.
Director of the U.S. Centers for Disease Control and Prevention