The severity of unhealthy alcohol use in hospitalized medical patients. The spectrum is narrow.
BACKGROUND
Professional organizations recommend screening and brief intervention for unhealthy alcohol use; however, brief intervention has established efficacy only for people without alcohol dependence. Whether many medical inpatients with unhealthy alcohol use have nondependent use, and thus might benefit from brief intervention, is unknown.


OBJECTIVE
To determine the prevalence and spectrum of unhealthy alcohol use in medical inpatients.


METHODS
Interviews of medical inpatients (March 2001 to June 2003).


METHODS
Adult medical inpatients (5,813) in an urban teaching hospital.


METHODS
Proportion drinking risky amounts in the past month (defined by national standards); proportion drinking risky amounts with a current alcohol diagnosis (determined by diagnostic interview).


RESULTS
Seventeen percent (986) were drinking risky amounts; 97% exceeded per occasion limits. Most scored > or =8 on the Alcohol Use Disorders Identification Test, strongly correlating with alcohol diagnoses. Most of a subsample of subjects who drank risky amounts and received further evaluation had dependence (77%).


CONCLUSIONS
Drinking risky amounts was common in medical inpatients. Most drinkers of risky amounts had dependence, not the broad spectrum of unhealthy alcohol use anticipated. Screening on a medicine service largely identifies patients with dependence--a group for whom the efficacy of brief intervention (a recommended practice) is not well established.
Saitz
Richard
R
Section of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, MA, USA. rsaitz@bu.edu
Freedner
Naomi
N
Palfai
Tibor P
TP
Horton
Nicholas J
NJ
Samet
Jeffrey H
JH