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Are You a Risky Drinker?

Alcoholism Only Small Part of U.S. Alcohol Abuse, Experts Say

What Is Risky Drinking? continued...

Safe drinking means not exceeding the recommended number of drinks. It isn't safe drinking if you drink to reach a certain effect, Schuckit says.

"A variety of things contribute to risky drinking," he notes. "One is the hollow leg -- the relative resistance to alcohol. People who are resistant to the effects of alcohol will drink more and hang out with people who drink more. So setting limits would control alcoholism."

At first, drinking makes a person feel good. After too much risky drinking, a person doesn't feel good until he or she has a drink.

"People say it doesn't feel good anymore, but I can't stop," Willenbring says. "At this point, people are not drinking to get high anymore. They are drinking to reduce stress. Once these changes occur, they may be permanent."

Current Treatment Inadequate

The health care system is failing people with drinking problems, Willenbring says.

"Only 24% of those who have ever had alcohol dependency seek treatment," he notes. "Only 12% of those who seek it ever receive any form of treatment. It is disconnected from mainstream health care. And reimbursement is almost impossible to obtain."

Even when people get treatment -- and can pay for it -- it's usually not good enough.

"Minimum standards for treatment of alcohol disorders are met only 11% of the time," he says. "That's the worst of all major causes of death in the U.S."

In fact, it's the worst treated of all major medical conditions, reports panelist Eric Goplerud, PhD, professor of health policy at George Washington University School of Public Health in Washington, D.C.

The findings come from a new study, released today, based on data from 64 health plans in 24 states covering 10 million Americans.

"The quality of care for alcohol disorders was 25th out of 25 conditions," Goplerud says. "Not only was alcohol treatment 25th nationally, it was 25th in every one of 12 communities looked at individually."

Goplerud notes that 8% of working people have an alcohol abuse disorder. But health plans report that only 1% of their members get diagnosed and receive alcohol-related services.

The findings, he says, aren't meant to put health care providers and payers in a bad light. They're meant to point the way to better care.

"The first couple of years we looked at diabetes care, health plans did a lousy job," Goplerud says. "It was the same thing with asthma and with heart disease. But they improved over time. We think the same thing will help with alcohol as people realize the quality of treatment for alcohol dependence has to get better."

Better Treatment

How can treatment get better?

"Right now, treatment of alcoholism in this country is seen as something done via mutual support and self-help, not through health care," Goplerud says. "And there is substantial stigma. But we are only just now developing medical treatments that are as helpful as mutual support and self-help."

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