Resident Doctors Failing to Screen for Risky Drinking
Recent findings from a group of American researchers indicate that primary care residents are not very likely to identify people who participate in binge drinking, a dangerous practice associated with serious short-term harm and heightened chances of developing alcohol abuse/alcoholism.
Doctors known as residents are often the first medical professionals to interact with people who binge on alcohol. These doctors can potentially help binge drinkers with fairly simple procedures called brief alcohol interventions. However, according to the results of a study published in February 2015 in the Journal of General Internal Medicine, very few residents screen their patients for binge drinking or provide interventions that could help binge drinkers stop drinking or reduce their alcohol intake to safer levels.
Binge Drinking in the U.S.
All binge drinkers consume enough alcohol to become legally drunk in just a couple of hours. Because they process alcohol differently than men and typically weigh less, women need to consume less alcohol than men to meet this standard definition. In the U.S., binge drinking is largely a function of age. Peak rates for the practice (43 percent of the total population segment) appear in young adults in their early 20s. With minor exceptions for people in their late 40s, rates of binge drinking drop steadily for older adults before reaching a low in people over age 64. Only roughly 9.1 percent of all adults over this age binge on alcohol in any given month.
People who binge drink multiple times per month increase their long-term chances of developing either alcoholism or diagnosable alcohol abuse (two interlocking aspects of a condition officially designated as alcohol use disorder by the American Psychiatric Association). Binge drinkers also increase their short-term exposure to a range of serious, severe or potentially fatal life outcomes, including injuries incurred in accidents, intentional injuries incurred in physical attacks, alcohol poisoning, and rapes and other versions of sexual assault. In addition, habitual binge drinkers increase their long-term risks for heart problems, nerve damage, diabetes complications and altered liver function.
Brief Alcohol Interventions
Doctors and public health officials use the term brief alcohol intervention to refer to rapidly deployable techniques that allow a health professional to identify someone who drinks excessively, discuss the short- and long-term pitfalls of excessive alcohol intake and provide advice on the next steps for changing dangerous drinking patterns. Primary care doctors are often the first or only medical professionals to come into close contact with people who binge on alcohol or otherwise consume too much alcohol on a daily or weekly basis. For this reason, these doctors are in a prime position to provide brief alcohol interventions to their patients. In hospitals and clinics, many primary care doctors are residents, physicians who have completed medical school but still need to complete training in their advanced areas of medical specialization.
Resident Doctors and Binge Drinking Detection
In the study published in the Journal of General Internal Medicine, researchers from the Wake Forest School of Medicine, Georgia Regents University, the Mercer University School of Medicine and the Medical Center of Central Georgia used survey information submitted by 210 residents to help determine how often these doctors-in-training detect binge drinking in their patients. Some of these residents were in training in family medicine programs, while others were in training in internal medicine programs. All of the study participants answered questions regarding such things as their tendency to use screening tools designed to identify problematic alcohol use, their use of brief alcohol interventions in at-risk patients and their self-perceived ability to provide effective help for affected individuals.
Sixty percent of the study participants reported using alcohol-related screening tools when first encountering a new patient. However, only 19 percent of the participants reported using screening tools specifically intended to identify cases of binge drinking. Only 21 percent of the responding residents believed they could provide useful assistance to problematic alcohol consumers. In addition, just 24 percent of the responding residents administered complete or near-complete brief alcohol interventions to their patients with identified alcohol-related risks.
The residents taking part in the survey identified insufficient training as their primary reason for not administering brief alcohol interventions to their patients. The study’s authors believe their findings illustrate the pressing need to improve brief alcohol intervention training for residents, especially since these doctors-in-training will almost certainly encounter people at risk for serious alcohol problems on a regular basis.