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May 10, 1995

Should Physicians Counsel Patients to Drink Alcohol?

Author Affiliations

National Institute on Alcohol Abuse and Alcoholism Bethesda, Md
Centers for Disease Control and Prevention Atlanta, Ga

JAMA. 1995;273(18):1415. doi:10.1001/jama.1995.03520420027014

To the Editor.  —We agree with the recent Editorial by Dr Pearson and Mr Terry1 that certain patients, such as pregnant women, should abstain entirely from alcohol. However, we wish to comment on their suggestion that physicians might advise other population subgroups to initiate moderate alcohol consumption.Epidemiological findings indicate that although women are less likely to drink, drink less heavily, and develop fewer alcohol-related problems than men, they develop alcohol dependence more rapidly.2 Women metabolize alcohol less efficiently than men, probably because of reduced first-pass metabolism. Together with less ethanol dilution attributable to lower body water content, this metabolic difference increases bioavailability of alcohol and may enhance sensitivity to alcohol-induced physiological impairment. There also seems to be a greater risk for liver cirrhosis for women than men at comparable consumption levels; and women contract pancreatic disease after shorter periods of consumption and liver disease at lower consumption

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