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The severity of unhealthy alcohol use in hospitalized medical patients

The spectrum is narrow
  • Richard Saitz
  • Naomi Freedner
  • Tibor P. Palfai
  • Nicholas J. Horton
  • Jeffrey H. Samet
Populations At Risk

Abstract

BACKGROUND: Professional organizations recommend screening and brief intervention for unhealthy alcohol use; however, brief intervention has established efficacy only for people without alcohol dependence. Whether many medical inpatients with unhealthy alcohol use have nondependent use, and thus might benefit from brief intervention, is unknown.

OBJECTIVE: To determine the prevalence and spectrum of unhealthy alcohol use in medical inpatients.

DESIGN: Interviews of medical inpatients (March 2001 to June 2003).

SUBJECTS: Adult medical inpatients (5,813) in an urban teaching hospital.

MEASUREMENTS: Proportion drinking risky amounts in the past month (defined by national standards); proportion drinking risky amounts with a current alcohol diagnosis (determined by diagnostic interview).

RESULTS: Seventeen percent (986) were drinking risky amounts; 97% exceeded per occasion limits. Most scored ≥ 8 on the Alcohol Use Disorders Identification Test, strongly correlating with alcohol diagnoses. Most of a subsample of subjects who drank risky amounts and received further evaluation had dependence (77%).

CONCLUSIONS: Drinking risky amounts was common in medical inpatients. Most drinkers of risky amounts had dependence, not the broad spectrum of unhealthy alcohol use anticipated. Screening on a medicine service largely identifies patients with dependence—a group for whom the efficacy of brief intervention (a recommended practice) is not well established.

Key words

hospital inpatient alcohol screening brief intervention 

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Copyright information

© Society of General Internal Medicine 2006

Authors and Affiliations

  • Richard Saitz
    • 1
    • 2
    • 3
  • Naomi Freedner
    • 1
    • 2
  • Tibor P. Palfai
    • 2
    • 4
  • Nicholas J. Horton
    • 5
  • Jeffrey H. Samet
    • 1
    • 6
  1. 1.Clinical Addiction Research and Education (CARE) Unit, Section of General Internal MedicineBoston Medical Center and Boston University School of MedicineBostonUSA
  2. 2.Youth Alcohol Prevention CenterBoston University School of Public HealthBostonUSA
  3. 3.Department of EpidemiologyBoston University School of Public HealthBostonUSA
  4. 4.Department of Psychology, College of Arts and SciencesBoston UniversityBostonUSA
  5. 5.Department of MathematicsSmith CollegeNorthamptonUSA
  6. 6.Department of Social and Behavioral SciencesBoston University School of Public HealthBostonUSA

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