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A direct approach to alcoholism.

A direct approach to alcoholism

A substantial minority of people seeking medical care at urban clinics are alcoholics, and in many cases their condition may be missed by physicians who fail to ask one or two simple questions, according to a report in the Jan.1 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

Based on responses to a standard 25-item alcoholism questionnaire, 20 percent of 232 patients visiting a university medical clinic from October 1985 through January 1986 were alcoholic, say Michele C. Cyr and Steven A. Wartman of Brown University in Providence, R.I. This is much higher than some earlier alcoholism appraisals among medical outpatients, but matches a recent report from a family practice center. It is estimated that 5 to 10 percent of the general population suffers from alcoholism, and rates for hospitalized medical patients range from 10 percent to 50 percent.

Although detailed alcoholism questionnaires are not routinely given to medical clinic patients, physicians are taught to ask questions such as "How much do you drink?" and "How often do you drink?" But the researchers found that only 22 of 47 alcoholics diagnosed by the questionnaire responded to the former question with the expected "alcoholic" response of four or more drinks per day. And in response to the latter query, only 16 of the 47 alcoholics said they imbibed daily.

The straightforward question "Have you ever had a drinking problem?" was, however, answered affirmatively by 33 of 47 alcoholics. Even better was a combination of this question with "When was your last drink?" A total of 43 alcoholics admitted to having a drinking problem or to drinking within the previous 24 hours or both.

These results are unexpected, say the investigators, since it is generally thought that alcoholics deny or downplay their drinking problems. Cyr and Wartman suggest that the two direct questions employed in the study can be used by physicians to identify those patients requiring closer examination for alcoholism.
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Publication:Science News
Date:Jan 9, 1988
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