title: The severity of unhealthy alcohol use in hospitalized medical patients. The spectrum is narrow.
abstract: 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.
authors: Section of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, MA, USA. rsaitz@bu.edu
authors: Richard
authors: R
authors: Saitz
authors: Naomi
authors: N
authors: Freedner
authors: Tibor P
authors: TP
authors: Palfai
authors: Nicholas J
authors: NJ
authors: Horton
authors: Jeffrey H
authors: JH
authors: Samet