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Research Summary

Most Medical Inpatients With Unhealthy Alcohol Use Have Dependence

Practice guidelines recommend that clinicians screen and conduct brief intervention for nondependent unhealthy alcohol use. Whether a substantial proportion of medical inpatients with unhealthy alcohol use has nondependent use—and thus might benefit from brief intervention—is unknown. To explore this issue, researchers in Boston conducted alcohol screening of 5813 medical inpatients.

  • Seventeen percent of inpatients screened were drinking risky amounts.*
  • Of those drinking risky amounts, 97% exceeded per occasion limits,** and most scored >=8 on the Alcohol Use Disorders Identification Test (which strongly correlates with a diagnosis of current alcohol abuse or dependence).
  • Of the 341 inpatients who drank risky amounts and received more detailed evaluation, 77% had alcohol dependence.

Comments:

According to this study, almost 1 in 5 medical inpatients has unhealthy alcohol use, a number identical to that found in a recent systematic review of hospital alcohol screening studies. Of note, most medical inpatients with unhealthy alcohol use have alcohol dependence. Because brief intervention—the currently recommended practice—has established efficacy only for nondependent unhealthy alcohol use, new strategies to address alcohol dependence on a medicine service are warranted.

Peter D. Friedmann, MD, MPH
Rosanne T. Guerriero, MPH
*>14 standard drinks per week or >=5 drinks per occasion for men (>11 and >=4, respectively, for both women and people >=66 years)
**>=5 drinks for men, >=4 for women and people >=66 years

Reference:

Saitz R, Freedner N, Palfai T, et al. The severity of unhealthy alcohol use in hospitalized medical patients: the spectrum is narrow. J Gen Intern Med. 2006;21(4):381–385.

Roche AM, Freeman T, Skinner N. From data to evidence, to action: findings from a systematic review of hospital screening studies for high risk alcohol consumption. Drug Alcohol Depend. 2006;83(1):1–14.


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