Widespread health condition deserves doctor’s attention

Don’t be surprised if your doctor asks at your next physical, “How many drinks do you have in a week?” And he’s not talking about milk.

“Asking about alcohol use is becoming just as common as checking your blood pressure,” says Safina Koreishi, MD, medical director for Columbia Pacific CCO. “Doctors have many health-related reasons to ask about drinking.”

  • Alcohol can complicate treatment of diabetes, heart disease and high blood pressure.
  • Alcohol increases the risk of cancers of the liver, breast, mouth and more.
  • Alcohol interferes with medications for anxiety, depression, arthritis and others.

Alcohol is one of humankind’s earliest achievements. We’ve been fermenting the grain and the grape for nearly 10,000 years. It’s part of our celebrations but we know the risks, too. We might raise a toast to health with one hand while the other hand reaches for someone’s car keys.

Substance use disorder. Doctors also ask because the patient may have a substance use disorder, or SUD. This term might be new to you, but health professionals have been using it for several years. It’s beginning to replace terms like “abuse” and “dependence.”

SUD reflects a better understanding of how substances like alcohol and opioids affect the brain. No one knows before the first drink or pill whether they might develop SUD.

“It’s body chemistry” says Dr. Koreishi. “Substance use disorder is organic, not a moral failing. If you had diabetes or heart disease, you’d get that treated. This disorder is no different.”

Social and health effects. Doctors are asking about alcohol use because SUD is common. It has a wide-spread and sometimes deadly effect. National Institutes of Health says:

  • One in eight people have this medical condition.
  • More than one in 10 children has a parent who is affected.
  • It’s the third-leading cause of preventable death.

Although headline after headline says “moderate” drinking might be healthy, statistics show many people drink more. According to the National Institutes of Health:

  • Moderate alcohol use is one drink a day for women, and two for men averaged over a week. That’s considered low-risk for developing a substance use disorder.
  • Binge drinking is five or more drinks in about two hours.
  • Heavy alcohol use is binge drinking five or more days a month.

About a third of teenagers and young adults are binge drinkers. That’s a serious health problem. Binge drinking affects brain development, especially the decision-making part of the brain.

Treatment integration

As understanding of this condition has evolved, so has treatment. SUD treatment addresses the complex emotional and behavioral as well as physical health issues. Some medical clinics have behavioral health specialists on site. They can spend time with patients and develop a plan, or connect them to resources for treatment.

“We want to see more integration in primary care clinics,” Dr. Koreishi said. “When the doctor recommends help for alcohol use, it’s much more likely to happen when treatment is just down the hall.”

So, when your doctor asks about your drinking, it’s a health question.

“Alcohol use is a normal and safe thing to talk about to your doctor,” says Dr. Koreishi.

Some health insurers, like the Oregon Health Plan (Medicaid), allow members to seek treatment without talking to their primary care provider. Check your member handbook or call the customer service number on your health plan card to learn about your coverage.

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