Alcoholics: where's the treatment?

Alcoholics: Where's the treatment?

Several researchers have noted that physicians often have negative attitudes toward alcoholics and vary widely in their willingness to treat alcohol abuse. Wayne D. Mitchell and his colleagues at the University of Colorado School of Medicine in Denver now report that although physicians at a university teaching hospital usually note symptoms of alcohol abuse, they often fail to refer alcohol abusers for appropriate treatment or to follow up on the condition of these patients.

The investigators examined the charts of 163 patients consecutively admitted to University Hospital in Denver. Alcohol abuse was checked for in 127 cases, and 27 patients were tagged as alcohol abusers. This screening record "is not discouraging,' they say. But of 39 patients identified as alcohol abusers and released from the hospital during the two months before the chart review, only eight received psychiatric consultations or treatment referrals Referral to Alcoholics Anonymous was never made.

What causes this neglect? Faculty seldom spend as much time teaching residents about alcoholism as about other disorders, note the researchers in the June PSYCHOSOMATICS. Alcoholics' initial denial of problems and resentment toward treatment are stoked by the inadequate efforts of these physicians; in a vicious cycle, as patients' denial increases, physicians become even more reluctant to pursue treatments.