Alcohol abuse and alcoholism in primary health care settings

Alcohol problems are common in primary care patients, yet they are often not detected and treated. Methods for improving the detection and diagnosis of alcohol problems in the primary care setting are reviewed in terms of pertinent history, physical examination, and laboratory findings. Screening instruments such as the CAGE questionnaire and the Michigan Alcoholism Screening Test are recommended for routine use by primary care physicians. Such instruments have been shown to have higher sensitivity than laboratory tests alone. Although less is known about intervention and management, earlier intervention with innovative (less costly) management techniques may be both efficacious and acceptable to the patient.