Doctors urged to ask about drinking habits more often

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VANCOUVER (NEWS1130) – When does a drink or two of wine or beer cross into problem territory?

With a new report finding up to one in five Canadians meet the criteria for an alcohol disorder, doctors are being urged to ask more about your drinking habits.

But a prominent addictions expert points out a disorder is not the same as alcoholism.

“What you call a ‘disorder” is very subjective,” says Dr. Tim Stockwell, director of the Centre for Addictions Research of BC at the University of Victoria.

“I think when you say it’s disorder, it makes it sound like you are an alcoholic or addicted. A large number of people in Canada drink more than what is good for their health, and a proportion will go on to develop dependence or have difficulties cutting down and have a range of social problems… but I think it’s better to frame it as a ‘health problem’ rather than a disorder or a disease — that makes it sound more mysterious than it is,” he tells News1130.

Stockwell says he does not want to dismiss the misuse of alcohol, but he worries about what he calls the “creeping medicalization” of many every day behaviours.

Current Canadian guidelines for low-risk drinking recommend no more than 10 drinks in a week for women (with no more than two drinks on most days) and no more than 15 drinks per week for men (with no more than three drinks on most days).

Research published in the Canadian Medical Association Journal finds seven per cent of all deaths in Canada are related to alcohol in some way and recommends that family doctors make questions about drinking a regular part of any exam.

Stockwell agrees that general practitioners could do more to ask about alcohol use.

“It is a big health concern and family doctors are probably as well-placed as any health care professional to intervene early and give people advice. That’s absolutely clear. The evidence shows that when they do that, it can work, people do cut down on their drinking and reduce their risks.”

He says there are strategies physicians can use to talk to patients about alcohol in a way that is not judgmental or confrontational.

“It can just be a regular part of general health care. What are the preventable risk factors for disease and injury and which ones do you have? Treat it like fast food, tobacco, or lack of exercise.”

“What I’d like doctors to do is not frame it as if they are looking for hidden alcoholics and people with disorders,” he tells us.

“You’re just looking at it as general prevention and health promotion. How many people in your waiting room are drinking outside the low-risk drinking guidelines? We need to treat it as a general health risk behaviour as opposed to a disease or disorder. For some people it will be, but let’s not ‘talk it up’ and label everybody as having disorders.”

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