Unhealthy alcohol use is a serious public health challenge that requires full attention.1 In its recommendation statement,2 supported by an evidence report and systematic review,3 the US Preventive Services Task Force (USPSTF) “recommends screening for unhealthy alcohol use in primary care settings in adults 18 years or older, including pregnant women, and providing persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce unhealthy alcohol use (B recommendation).”2 One in 8 adults in the United States reports unhealthy alcohol use.4 Unhealthy alcohol use includes “at-risk” alcohol use, defined by the National Institute on Alcohol Abuse and Alcoholism as alcohol use greater than 4 drinks per occasion or 14 drinks per week for men aged 21 to 64 years and 3 drinks per occasion or 7 drinks per week for women of all ages and for men 65 years or older. It also includes alcohol use disorder, defined by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) based on the presence of 2 or more of 11 criteria, such as loss of control of use and withdrawal symptoms.4 About 6% of US adults have drinking patterns and associated symptoms that are sufficiently severe to meet criteria for alcohol use disorder. Globally, 1 in 20 deaths are related to alcohol use.1
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Edelman EJ, Tetrault JM. Unhealthy Alcohol Use in Primary Care—The Elephant in the Examination Room. JAMA Intern Med. Published online November 13, 2018. doi:10.1001/jamainternmed.2018.6125
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: