Alcohol Problems Increase While Physician Attention Declines

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Abstract
• Physician intervention holds the potential to arrest excess drinking in medical patients, but little information has been available on trends over time in medical attention to this problem. Three epidemiologic studies in which nationally representative samples of US adults were interviewed about their drinking practices and problems provide some data on this issue. Analyses of data from these three studies (conducted in 1967, 1979, and 1984) indicate that multiple alcohol problems and at least one occasion of recent heavy alcohol consumption have increased over time in the general population. At the same time, the probability of a physician recommending reduction in drinking declined for both males and females. When only male subjects with multiple alcohol problems were considered, physician recommendations to reduce drinking did not decline significantly between 1967 and 1984. However, the sharp decline over time in physician's medical advice to female subjects with multiple alcohol problems was statistically significant. Similar results were found for physician attention to drinking among the more inclusive group of subjects with at least one recent occasion of heavy drinking. Implications of these findings are discussed. (Arch Intern Med. 1990;150:397-400)