The article in this issue of THE JOURNAL on the effect of brief physician counseling on problem drinkers' intake of alcohol and use of health services1 is important to primary care for 2 major reasons. First, evidence that intervention decreases alcohol intake and health problems should be a strong motivator for including alcohol screening in practice. Second, this article contributes to the literature on the powerful impact of physician counseling on behavior.
Most physicians care for patients with alcohol problems. During clinical training we have all been exposed to individuals who experience recurring health problems related to alcoholism. A patient's failure to alter the course of his or her addiction, even in the face of impending death, leads to an impression that patients with alcohol problems rarely respond to treatment. This impression is even carried into texts
See also p 1039.
of medicine. The most recent edition of Cecil
Parish DC. Another Indication for Screening and Early Intervention: Problem Drinking. JAMA. 1997;277(13):1079-1080. doi:10.1001/jama.1997.03540370069040