Alcohol is the third-leading cause of preventable death in the United States after cigarette smoking and obesity. The effects of alcohol on the body and associated behaviors are well documented by research. Identifying individuals at risk for alcohol dependence is important in preventing morbidity and mortality related to alcohol consumption. The U.S. Preventive Services Task Force (USPSTF) found fair evidence and recommends (Rating B) screening and brief behavioral counseling interventions in primary care settings to effectively reduce alcohol misuse by adults and pregnant women. Evidence for adolescents, however, was poor and insufficient (Rating C) for a similar recommendation; benefits versus harm of screening and counseling were inconclusive with this population.
Numerous tools are available to assist healthcare providers in assessing alcohol use among their patients (National Institute on Alcohol Abuse and Alcoholism [www.niaaa.nih.gov]). The CAGE questionnaire is commonly used, consists of four straightforward questions, and takes only a few minutes to complete. Do you routinely ask your patients about alcohol use? Do you use CAGE or a different instrument? What tools have made it easier or more difficult for you to include a risk assessment for alcohol use in your primary care practice?