Screening for alcoholism in family practice

491 consecutive adult patients who consulted their family physician for routine medical problems completed a five item screening questionnaire for alcoholism and a checklist of 12 commonly occurring symptoms. More than 11% showed definite evidence of alcoholism while another 6% showed probable evidence. Review of the medical record for that visit revealed that a large proportion of the alcoholics detected through this method were not diagnosed as such nor was alcohol charted as a significant factor in their medical problems. Patients who reported common symptoms such as blackouts, tremors, temper outbursts, chest pain, unsteadiness, loss of appetite, vomiting, sadness and "stomach pain" had significantly higher rates of alcoholism than those who did not report these symptoms. In order to detect alcoholism in family practice, it may be useful to routinely ask a few inoffensive questions to increase significantly the detection rate.