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USPSTF recommends screening adults for unhealthy alcohol use
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The U.S. Preventive Services Task Force said today that clinicians should screen pregnant women and adults older than 18 years for alcohol use, and that the evidence is insufficient on screening and counseling for alcohol use in teenagers aged 12 to 17 years.
These draft recommendations received ‘B’ and ‘I’ grades, respectively, and are based on a review of 45 studies with 277,881 patients. The draft recommendations mirror the USPSTF’s 2013 final recommendations on these same topics and age groups.
“This is an important public health issue that impacts many Americans,” Carol Mangione, MD, MSPH, chief of the division of general internal medicine at the David Geffen School of Medicine at the University of California, Los Angeles and task force member told Healio Family Medicine.
“About 88,000 people die each year from alcohol use. Drinking alcohol during pregnancy can also cause birth defects and serious developmental problems for the baby. Additionally, drinking and driving is particularly dangerous among adolescents as one in five teen drivers involved in fatal car accidents had alcohol in their system at the time of the accident,” she said.
The National Institute on Alcohol Abuse and Alcoholism states that men should not drink more than four drinks a day and 14 per week, and women should not drink more than three drinks per day and seven per week. In addition, women who are pregnant and adolescents aged 12 to 17 years should abstain from drinking all together, Mangione added.
She described conversations that primary care physicians can have with their patients as a result of the draft recommendations.
“Clinicians should take time to ask their patients questions about how often they drink and other drinking patterns, such as the typical amount of drinks they have in one sitting. These questions take a few minutes to answer and asking even a single question is effective at detecting unhealthy alcohol use.
“If a clinician finds that a patient is drinking more than they should, they should conduct a brief primary care counseling intervention such as two 10- to 15-minute clinician discussions and a follow-up phone call. The task force found that these types of interventions decreased consumption of alcohol more than usual care, and the effect persisted for more than 2 years. Another option when a patient is found to have symptoms or is already showing the health consequences of unhealthy alcohol use is referring the patient to brief counseling and evaluating whether any other steps should be taken,” she said in the interview.
The American Academy of Family Physicians, CDC and Substance Abuse and Mental Health Service Administration also provide guides to assist clinicians in discussing these matters with their patients, the USPSTF stated.
The USPSTF’s draft statement and evidence review has been posted for public comment on the USPSTF website: www.uspreventiveservicestaskforce.org. Input will be accepted through July 2, at www.uspreventiveservicestaskforce.org/tfcomment.htm. - by Janel Miller
Disclosure: Mangione reports no relevant financial disclosures. Please see the USPSTF website for all other task force members’ relevant financial disclosures.