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    Are You a Risky Drinker?

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

    Current Treatment Inadequate continued...

    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."

    The first step, the AMA panel agrees, is for doctors to routinely screen patients for alcohol risk.

    "The best screening test to date is by asking validated questions," Saitz says. "This is the shortest: When was the last time you had four or more drinks, if a woman, or five or more drinks, if a man? A positive result is any time in the last year. The test does not mean alcoholism. It is an indicator of risky alcohol use."

    Whom should doctors ask? Everyone who steps into their office. That's because alcohol use is linked to a number of medical conditions. It does not cause all of them, but it does increase risk.

    "Once we identify unhealthy alcohol use, we can do something about it," Saitz says. "And I'm talking about the early stages. Ten or 15 minutes talking with a doctor can significantly decrease alcohol consumption a year and even four years later."

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