Chemical Dependency: Alcoholism
Center for Continuing Dental Education
Chemical Dependency: Alcoholism
Center for Continuing Dental Education
It is estimated that at least 20% of adults who visit a physician have had an alcohol problem at one time in their lives.
In a survey of patients admitted to an inpatient service, 12 to 30 percent screened positively for alcoholism. Yet, several recent studies indicate that physicians in various health care settings often do not recognize and treat alcoholism. These findings underscore the need for effective and accurate procedures that will enable all healthcare clinicians, including dental professionals, to screen for alcoholism.
Alcohol screening identifies individuals in a patient population who have begun to develop or who are at risk for developing alcoholism. Although all healthcare professionals customarily take a patient's medical history, routine use of a standard alcoholism-detection instrument is valuable because these instruments provide a structured, disciplined, and consistent means to detect individuals at risk. Two types of alcoholism-screening instruments are available. The first type includes self-report questionnaires and structured interviews; the second type includes clinical laboratory tests which can detect pathophysiology associated with excessive alcohol consumption.
The CAGE questionnaire, developed by Dr. John Ewing, is a self-report screening instrument that appears to be suited to a busy healthcare setting when there is limited time for patient interviews. The CAGE, which can be self-administered or conducted by a clinician, poses four overt yes-no questions and requires approximately 1 minute to complete. For routine health screening, the test may identify individuals with alcohol problems that might have been missed otherwise. (To help remember these questions, note that the first letter of a key word in each of the four questions spells "CAGE.")
Have you ever felt you should Cut down on your drinking?
Have people Annoyed you by criticizing your drinking?
Have you ever felt bad or Guilty about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?
One "yes" response suggests a possible alcohol problem. If someone responded "yes" to more than one question, it is highly likely that a problem exists. In either case, it is important that that they see their physician or other health care provider right away to discuss their responses to these questions. He or she can help them determine whether they have a drinking problem and, if so, recommend the best course of action.
Even if a person answered "no" to all of the above questions, if they are encountering drinking-related problems with their job, relationships, health, or with the law, they should still seek professional help. The effects of alcohol abuse can be extremely serious--even fatal--both to them and to others.
