Drinking Too Much? Don't Count On Your Doctor To Ask

By Nancy Shute

Published January 7, 2014 at 1:11 PM CST

Most of the people who have problems with drinking aren't alcoholics, and having a brief chat with a doctor is often all it takes to prompt excessive drinkers to cut back.

But, it turns out, doctors aren't bringing the topic up. More than 80 percent of adults say they've never discussed alcohol use with a health professional, a survey finds.

Young people and binge drinkers were most likely to be asked about alcohol use, according to a survey by the Centers for Disease Control and Prevention.

But even then, just 13 percent of binge drinkers said they had been asked about their drinking in the past year. Among people who binge drink 10 times or more a month, just one-third said they've ever been asked.

The results were published Tuesday in Morbidity and Mortality Weekly Report.

"The goal here is not to tell people to never have another drink," Dr. Tom Frieden, the head of the CDC, said in a press briefing. But, he added, "The health system is not doing an effective job finding out about these health problems."

No kidding. These numbers haven't budged in years, despite a 2004 recommendation by the U.S. Preventive Services Task Force that all adults be asked about alcohol use, and that people who look like they're having difficulties be offered a brief intervention.

That a fancy term for talking for 10 or 15 minutes about how one might cut back, and coming up with a practical plan to do that.

"It may be going from six drinks on a Friday night to three or four," Frieden said. "It might mean spacing them out, or having something to drink besides alcohol."

Studies have found that having that conversation and making a plan can cut a person's alcohol consumption by up to 25 percent. That could make a substantial dent in the 88,000 deaths each year caused by alcohol, as well as $224 billion in economic costs. Most of those problems are caused by drinkers who aren't alcoholics, Frieden sad.

People are considered at risk if they're drinking more than 15 drinks a week on average for men, and 8 drinks a week for women. That also includes any alcohol use by pregnant women or by people under age 21.

Binge drinking is defined as five or more drinks in a session for men, and four or more drinks for a woman.

Frieden expressed hope that insurance coverage for brief interventions under the Affordable Care Act could increase the numbers of health providers asking about alcohol use.

But if you'd rather not wait for that to happen, the simple screening tests that doctors use, like the four-question CAGE test, are widely available online and take about a minute.

Here's one test from the National Institute on Alcohol Abuse and Alcoholism that lets you compare your drinking habits to the rest of the country. And here's another screening test from the Partnership at Drugfree.Org.

For the DIY approach to healthier drinking, the NIAAA offers a list of strategies including " drinking tracker wallet cards" and the classic "pace and space," alternating booze with non-alcoholic beverages.