Here are excerpts from the show notes:
Above is from CoreIM
- Unhealthy alcohol use is a catch-all term meant to describe a spectrum of drinking ranging from risky use all the way to alcohol use disorder.
- The DSM-IV terms alcohol abuse and dependence have been replaced by the DSM-5 term alcohol use disorder, which is defined as a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by psychosocial, behavioral, or physiologic features
- According to National Institute on alcohol Abuse and Alcoholism (NIAAA), risk for alcohol use disorder is thought of as daily and weekly alcohol limits:
- For men less than 65 years: more than 4 drinks/day or 14 drinks/week for
- For women and men over 65 years: more than 3 drinks/day or 7 drinks/week
. . . the terms alcohol abuse and dependence has been replaced by the by idea of alcohol use disorder, which is a problematic pattern of alcohol use leading to clinically significant impairment or distress. Even more broadly, we have the concept of unhealthy alcohol use, which encompasses a broad spectrum of drinking patterns even beyond alcohol use disorder, and includes things like binge drinking.
- The United States Preventive Services Task Force (USPSTF) has recommended that all adults in primary care be screened for unhealthy alcohol use
- The AUDIT-C tool is the recommended screening tool for unhealthy alcohol use, and consists of the following questions:
- How often did you have a drink containing alcohol in the last year?
- How many drinks containing alcohol did you have on a typical night when you were drinking?
- How often did you have six or more drinks on one occasion in the past year?
- A single-item screening question has also been validated. It is the most sensitive question for unhealthy alcohol use.
- For men, how many times in the last year, have you had more than four drinks in a day?
- For women, how many times in the last year, have you had more than three drinks in a day?
- The negative health impacts of alcohol include most types of cancer [including breast cancer] with the exception of thyroid cancer.
- Patients are often diagnosed with comorbid medical conditions that may be reversible if the underlying alcohol use disorder is diagnosed and treated appropriately
- Labs values* can be a useful tool for assessing alcohol use and educating patients on end-organ damage; however, they are not recommended for routine diagnosis of the disease
*See Laboratory Studies from emedicine.medscape.com. The following table is from this resource:
Returning now to excerpts from 5 Pearls Of Unhealthy Alcohol Use:
- Population health research has identified a ‘J-curve’ of potentially beneficial alcohol use, leading to a trend in ‘healthy alcohol use.’ Low levels of alcohol are associated with decreased risks for cardiovascular disease and type 2 diabetes.
- Few medical professionals would recommend ‘healthy drinking’ however; the goal remains moderation or minimal intake.
The fifth pearl is related to a previous 5 Pearls about Hepatitis B.