Pep Talks for Alkies? Docs Might As Well Save Their Breath
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Pep Talks for Alkies? Docs Might As Well Save Their Breath


When you go in for a physical, typically the doc asks you questions about your lifestyle. What are you eating, how often are you eating it, what are you smoking or snorting, how often are you smoking or snorting, and how much do you drink. If you’re a drinker, and a heavy one at that, you might lie a bit to get the doc off your scent. If you do decide to tell the truth, the conversation will go something like this.

Doctor: How many times in the past year have you had five or more drinks in one sitting?

You: Like every day.

Doctor: What are some of the biggest downsides of your drinking?

You: I don’t know. The calories?

Doctor: Actually, drinking exacerbates health problems, can lead to liver damage and depression. Drinking that many drinks a day can wreak serious havoc on your mental state. Plus, you might overdo it and end up with a wet brain. There are many ways to stop drinking, or cut down, and I can help you get help.

You: That’s okay, I’ll take the risk. I still want to enjoy my twelve Miller High Lifes while I watch the Saints plow into the Pats.

At least, that’s you before you believe you have an alcohol problem.

Screening for Alcoholism

Back in the 1980s, researchers discovered that only six percent of people who suffered from what the medical profession is starting to call “Alcohol Use Disorder” (instead of alcoholism) actually got help. Medical professionals weren’t happy about that, so they put their big brains together and came up with a screening process that doctors could use during routine visits.

Studies have shown that this strategy improves self-reporting of alcohol consumption among drinkers with mild alcohol problems. But recently, when Dr. Joseph Glass, an expert on addiction and treatment at the University of Wisconsin-Madison, reviewed studies of “brief alcohol interventions” in general healthcare settings, he found no increase in the number of people who sought counseling or treatment after they were screened by a doctor.

“It’s a great, cost-effective intervention for people with mild problems, but it isn’t working for people with more severe problems,” he told the University of Wisconsin-Madison News. “This is definitely a practice that should happen, but we need to acknowledge it does not help everybody and so we need to find out how to reach people with the most severe alcohol problems.”

“Given the social, personal and economic costs of alcohol addiction, it’s vital that we figure out what would work,” Glass added.

Not a Small Habit

It’s easy to blow off alcohol use as not too big a problem, especially given all the attention drugs get in the media. We’re used to hearing about opiate overdoses, seeing harrowing photos of meth addicts and talking nonstop about marijuana legalization. But the unfortunate reality is that alcohol is, as Glass notes in his study, the third leading cause of death in the US, costing the nation around $230 billion a year.

With this in mind, doctors have been more than eager to try out conversational screenings on their patients, even spending a good five to 10 minutes asking about drinking habits and trying to help patients cut back.

“We expected to see some benefits, but there was no difference in the number of people who got care between those who got the screening and brief intervention and [those]who did not,” Glass reports.

More Than a Stigma

Glass surmises that people with drinking problems are too afraid of the stigma of alcohol abuse to pursue treatment. But as many alcoholics will tell you, we often don’t want to seek help because we really don’t want to stop. In fact, stopping often seems like the most nonsensical idea in the world. And how many smokers get bludgeoned by their doctors to quit the habit but still keep lighting up?

It’s noble of doctors to do screenings and interventions. But unless that person with “Alcohol Use Disorder” is sick and tired of being sick and tired, chances are a pep talk from a doctor won’t do a bit of good.

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About Author

Tracy Chabala is a freelance writer for many publications including the LA Times, LA Weekly, Smashd, VICE and Salon. She writes mostly about food, technology and culture, in addition to addiction and mental health. She holds a Master's in Professional Writing from USC and is finishing up her novel.