Stefan Wermuth/ReutersEach year, 88,000 people in the U.S. die due to excessive drinking.
Alcohol is the fourth-most-common underlying cause of death (smoking is number 1), and a Jan. 7 report from the Centers for Disease Control (CDC) estimates that at least 38 million Americans drink too much (even if they aren't alcoholics).
Not only is that bad for our health, but it's also an expensive problem: In 2006, excessive drinking cost the economy $224 billion.
The good news is that brief screenings and interventions — a quick conversation with a health provider (or even filling out a form) and some structured follow-up — work well in curbing problem drinking.
The bad news? The vast majority of doctors aren't broaching the topic with their patients. Only one in six doctors say they routinely ask their patients about their drinking habits, a number that hasn't budged in years.
As a result, two-thirds of those who binge drink on a regular basis — the kind of people who might not be traditional alcoholics, but need help controlling their drinking — say they haven't discussed their drinking with their doctors.
Alcoholics aren't the only problem drinkers
For every one alcoholic, there are six problem drinkers, and "the vast majority of harms from alcohol are caused by people who are not alcoholics," said CDC director Dr. Thomas Frieden in a conference call about the report.
Binge drinking is generally defined as more than four drinks at a time for men or more than three drinks at a time for women; excessive drinking means 15+ drinks per week for men or 8+ drinks per week for women. Drinking and driving, underage drinking, and drinking while pregnant are also counted as problems.
"We're not saying that no one should drink," said Frieden. "But for many people who drink, they drink too much at a time or too much overall. The health system is not doing an effective job finding out about those problems."
A simple solution
The Affordable Care Act requires that new health insurance plans cover brief alcohol interventions with a health provider without charging a copay, and Frieden said he hopes such conversations become as routine as blood pressure checks.
When an excessive drinking problem is discovered, sometimes a 6-15 minute counseling session is all that's needed.
The CDC report suggests that such interventions can be effective in reducing alcohol consumption (by 3.6 drinks per week) and days spent in the hospital. Binge drinking was reported in 12 percent fewer patients, and "adherence to recommended drinking limits" was reported in 11 percent more patients.
These counseling sessions don't have to be complicated. They usually involve a discussion of why people drink too much, what the health dangers are, and how consumption can be reduced. Even simple strategies, Friedan said, such as suggesting that drinkers consider "drinking things besides alcohol when they're thirsty," can be helpful.