Screening for alcohol abuse.(Women's Health Adviser)

Alcohol misuse is the root of numerous problems--societal, psychological, and physical. In the United States alone, it generates about $185 billion in costs each year. But many who drink don't meet the criteria for alcoholism. These people engage in risky drinking behavior--for women that means consuming more than two drinks per day or seven drinks per week, or binge drinking of more than three drinks per occasion.

These patterns of problem drinking are widespread; epidemiologic studies have found a prevalence of up to 25% across a primary care population. Because of the prevalence of alcohol use, and because studies have also shown that screening followed by brief interventions can effectively reduce risky drinking, the U.S. Preventive Services Task Force (USPSTF) and the American College of Obstetricians and Gynecologists now recommend alcohol screening as part of routine patient care.

Identifying Patients at Risk

The USPSTF recommendations stress that screening is appropriate for all patients. However, certain patient populations have a higher risk of problem drinking behavior.

Age is a major risk factor. Young adults aged 18-25 years have the highest prevalence of both binge and heavy drinking. Biological and social factors play a part as well. The risk is increased for a woman whose biological parent(s) or spouse are substance abusers. Recent traumatic life events, including divorce or separation, death of a significant other, job loss, retirement, rape or sexual abuse, or witnessing a traumatic event, increase the risk of problem drinking.

Women with a disability or psychiatric disorder are at increased risk. All women who are pregnant or who are planning to conceive should be screened.

Screening Tools