• Primary-care doctors do not typically talk to their patients about problem drinking.
• A new study tests the effectiveness of doctor-initiated advice generated by a routine patient visit.
• Advised patients show a significant decrease in alcohol use, accidents, and health-care utilization.
• Benefit-cost analysis estimates a $43,000 reduction in future health-care costs for every $10,000 invested in early intervention.

People who drink above what could be considered a healthy level - that is, more than two to three drinks per day - are at risk for a number of health and safety problems. Excessive alcohol use has been implicated as a cause of liver disease, stroke, cancer, infant neurodevelopmental disorders, and hospital admissions in older adults as well as a leading factor in domestic violence, marital conflict, child abuse, accidents and injuries. A study in the January issue of Alcoholism: Clinical & Experimental Research takes a method also used for smoking cessation - physician intervention - and applies it to problem drinking.

"I was interested in finding out if what I did as a physician made a difference with my patients," said Michael F. Fleming, director of the Family Medicine Research Program at University of Wisconsin - Madison and lead author of the study. "What happens when I talk to my patients for a few minutes about their drinking? Do they decrease their alcohol use? Do they have fewer health problems? Are they hospitalized less often? Do they get into fewer accidents?"

During a routine visit to the doctor, Wisconsin patients (ages 18 - 65) were given a questionnaire to establish at-risk alcohol behaviors. Of the 774 who screened positive, 382 were assigned to a control group and 392 received an intervention program called Project TrEAT (Trial for Early Alcohol Treatment), a protocol originally developed in England that was modified by Fleming and his co-authors. Project TrEAT consis
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15-Jan-2002