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Addressing Alcohol Use in Health Care

Alcohol is the most widely used and abused substance in the United States. We are used to having wine at the dinner table, toasting special occasions with champagne, relaxing with a beer and bringing out the hard liquor for parties.

Many people are able to consume alcohol in ways that pose little risk to themselves and others, but excessive drinking creates a host of problems.

Misuse and overuse of alcohol can have devastating effects on a person’s health. Excessive alcohol use is associated with liver damage, pancreatitis, various cancers, high blood pressure and psychological disorders. Alcohol can affect the way the brain looks and works – leading to changes in mood and behavior and making it harder for a person to think clearly and move with coordination.[i] The effects of alcohol are particularly concerning for children and youth, as adolescent alcohol use can lead to long-term or permanent brain damage and increases risk for developing substance use disorders as adults. This includes children exposed to alcohol in-utero, as alcohol passes through the placenta of pregnant women.

Health risks aren’t the only concern. According to the Center for Disease Control, excessive alcohol consumption in the United States cost $2.3 billion in 2006. These costs include loss of workplace productivity, health care expenses, law enforcement and other criminal justice expenses, and motor vehicle crash costs from impaired driving.[ii]

What can we do as primary care and behavioral health providers to prevent and reduce the risk of excessive drinking? Here are three ways you can start:

  • Screen for alcohol use for all patients, including pregnant women and adolescents. The CDC’s guide to implementing alcohol screening and brief intervention includes informational handouts for patients and links to a variety of evidence-based screening tools.

  • Educate patients regarding what constitutes a standard drink and discuss strategies for reducing or abstaining from alcohol in a non-judgmental, caring way. Reduce the risk of your patients drinking while pregnant by using an evidence-based intervention such asCHOICES for women of childbearing age.

  • Partner with community-based organizations to prevent youth substance abuse. Community coalitions often implement youth and family prevention education programs to address local conditions that contribute to underage drinking. By identifying opportunities for collaboration, we can strengthen and complement our respective mission and goals in preventing or reducing excessive drinking.

How else do you address alcohol use in your practice? What other prevention tips would you share with fellow behavioral health and primary care providers?

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