Severity of Unhealthy Alcohol Use in Hospitals and Implications for Brief Intervention

The severity of unhealthy alcohol use in general-hospital patients identified by screening may have implications for the suitability of brief intervention (BI) in these settings. Researchers in Germany screened an urban population-based sample and consecutive general hospital admissions from the same geographic area to determine the prevalence and severity of unhealthy alcohol use. In the population sample, unhealthy alcohol use and risky consumption were determined by diagnostic interviews. In the hospital sample, interviewees were selected by screening questionnaires.

• In the population-based sample, 7.6% had unhealthy alcohol use: 1.3% met criteria for alcohol dependence, 1.2% met criteria for abuse, and 5.1% drank risky amounts.*

• In the hospital sample, 14.5% had unhealthy alcohol use: 5.5% met criteria for dependence, 2.8% met criteria for abuse, and 6.2% drank risky amounts.

Comments:

Unhealthy alcohol use is more common in hospitalized patients than in the general population. As such, it would appear to be a place where screening and BI make sense. But these data also point out that most hospitalized patients identified with unhealthy alcohol use by screening have an alcohol use disorder, whereas the minority of those in the general population do. Perhaps more important, the efficacy of BI among patients with dependence and in this setting is unclear. At a minimum, if screening is implemented in hospitals, clinicians should be prepared to address dependence in a substantial number of patients.

Richard Saitz MD, MPH

Reference:

Bischof G, Reinhardt S, Freyer-Adam J, et al. Severity of unhealthy alcohol consumption in medical inpatients and the general population: is the general hospital a suitable place for brief interventions? Int J Public Health. February 9, 2010 [Epub ahead of print].