screening for alcohol abuse

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[1][2][3][4][5][6][7][8][9][10][11][12]

Epidemiology

Indications

Procedure

  • screening begins with quantifying alcohol use
    • at risk drinking
      • men > 14 drink/week or > 4 drinks/occasion
      • women > 7 drink/week or > 7 drinks/occasion
    • increased use within recommended guidelines does not constitute positive screen even if spouse expresses concern
  • CAGE questions (score > 1 is positive)
  • 2 question screen
    • Have you ever had a drinking problem?
    • When was your last drink? (+ response is within last 24 h)
  • Alcohol Use Disorders Identification Test (AUDIT)
    • score >=4 for men & >= 3 for women is positive
  • Michigan Alcoholism Screening Test (MAST)
  • single-question screening for alcohol abuse (SASQ)
    • When was the last time you had more than X drinks in 1 day? X= 4 for women, 5 for men[3]

Validated questionnaire more sensitive & more specific than blood alcohol

Positive screen identifies candidates for further evaluation

Management

  • brief counseling indicated for those who screen positive

Notes

  • web-based screening with brief intervention minimally effective in reducing alcohol intake in University students[9]

More general terms

More specific terms

Additional terms

References

  1. ↑ Journal Watch 25(14):116, 2005 Canagasaby A, Vinson DC. Screening for hazardous or harmful drinking using one or two quantity-frequency questions. Alcohol Alcohol. 2005 May-Jun;40(3):208-13. Epub 2005 Mar 29. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15797883
  2. ↑ Coulton S et al, Opportunistic screening for alcohol use in primary care: Comparative study. BMJ 2006; 332:511 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16488896
  3. ↑ 3.0 3.1 Smith PC et al. Primary care validation of a single-question alcohol screening test. J Gen Intern Med 2009 Jul; 24:783. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19247718
  4. ↑ Medical Knowledge Self Assessment Program (MKSAP) 14, American College of Physicians, Philadelphia 2006
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  5. ↑ US Preventive Services Task Force Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse: U.S. Preventive Services Task Force Recommendation Statement DRAFT http://www.uspreventiveservicestaskforce.org/draftrec.htm
    Jonas DE et al Behavioral Counseling After Screening for Alcohol Misuse in Primary Care: A Systematic Review and Meta-analysis for the U.S. Preventive Services Task Force Ann Intern Med. 25 September 2012
  6. ↑ Vinson DC et al Clinician Suspicion of an Alcohol Problem: An Observational Study From the AAFP National Research Network. Annals of Family Medicine. Jan/Feb 11(1) 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23319506 <Internet> http://www.annfammed.org/content/11/1/53.full
  7. ↑ 7.0 7.1 7.2 Moyer VA. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2013 May 14; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23698791 <Internet> http://annals.org/article.aspx?articleid=1686100
    U.S. Preventive Services Task Force (USPSTF). Draft Recommendation Statement June 2018 Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions. https://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions
    Draft Evidence Review 2018 Draft Evidence Review for Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions. https://www.uspreventiveservicestaskforce.org/Page/Document/draft-evidence-review/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions
  8. ↑ 8.0 8.1 Centers for Disease Control and Prevention (CDC) Vital Signs: Communication Between Health Professionals and Their Patients About Alcohol Use - 44 States and the District of Columbia, 2011. MMWR. Jan 7, 2014 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e0107a1.htm
  9. ↑ 9.0 9.1 Kypri K et al. Web-based alcohol screening and brief intervention for university students. JAMA 2014 Mar 26; 311:1218. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24668103 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1849990
    Naimi TS and Cole TB. Electronic alcohol screening and brief interventions. expectations and reality. JAMA 2014 Mar 26; 311:1207 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24668101 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1849965
  10. ↑ 10.0 10.1 Siqueira L, Smith VC Binge Drinking Pediatrics. August 31, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26324872 <Internet> http://pediatrics.aappublications.org/content/early/2015/08/26/peds.2015-2337
  11. ↑ 11.0 11.1 McKnight-Eily LR, Okoro CA, Mejia R, et al. Screening for Excessive Alcohol Use and Brief Counseling of Adults - 17 States and the District of Columbia, 2014. MMWR Morb Mortal Wkly Rep 2017;66:313-3019 https://www.cdc.gov/mmwr/volumes/66/wr/mm6612a1.htm
  12. ↑ 12.0 12.1 12.2 US Preventive Services Task Force. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force Recommendation Statement. JAMA 2018 Nov 13; 320:1899. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30422199 https://jamanetwork.com/journals/jama/fullarticle/2714537
    O'Connor EA, Perdue LA, Senger CA et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 2018 Nov 13; 320:1910. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30422198 https://jamanetwork.com/journals/jama/fullarticle/2714536
    Bazzi A, Saitz R. Screening for unhealthy alcohol use. JAMA 2018 Nov 13; 320:1869 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30422181 https://jamanetwork.com/journals/jama/fullarticle/2714514
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