The rise to prominence of rehabilitation clinics and Alcoholics Anonymous spreads the idea that alcohol problems can only be overcome with a transformational experience at rock-bottom. However, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) has stepped up its advocacy for a preventative strategy that stops excessive drinkers before they become physically dependent on alcohol. Their latest attempt to change the paradigm is an update of the 2005 clinician’s guide, “Helping Patients Who Drink Too Much”.
The guide advises primary care doctors that it is both feasible and wise to regularly ask patients about their drinking habits so that they can intervene before a patient careens into a crisis. The screening steps were refined in this version to better outline the natural progression of a doctor-patient conversation. For example, previous evaluations were often diverted by confusion, such as when patients had different ideas of what alcoholic beverages were important enough to mention. The new suggested first question is the simple but inclusive: “Do you sometimes drink beer, wine, or other alcoholic beverages?”
The NIAA even produced a tutorial video showing doctors how to assess heavy drinkers and help them cut back. Actually seeing their peers ask the crucial questions will hopefully go far towards emboldening doctors to get over fears of “prying” and treat alcoholism just like any other disease. Therapy and medication have both shown a powerful ability to reduce drinking, especially if problematic behavior is caught in the earlier stages. Even a simple discussion with a physician, who is usually a respected authority figure, can bring patients to reevaluate the consequences of their habits.
Once alcoholism becomes so bad that it can be detected without questions, if it has ravaged organs enough to show up on tests, then the addiction will be so entrenched that emergency intervention might be the only path out. But if a few simple questions are asked early on, doctors may be able to steadily divert a patient long before they sink into the bog of alcoholism.
