20% OF ADULTS DRINK HEAVILY, STUDY SAYS

UW researches surprised at high concentration of at-risk drinkers within 100
miles of Madison

Nearly 20% of adults living within 100 miles of Madison -- including
Milwaukee -- are knocking back so many drinks, or are binge drinking, they
are considered "at-risk" for a host of medical problems.

The findings surprised researchers from the University of Wisconsin's
Center for Addiction Research and Education and prompted them to urge
physicians nationwide to take extra steps to ferret out such at-risk
drinkers and work with them to curtail their drinking.

The study was based on surveys voluntarily filled out by more than 19,000
patients of 89 physicians practicing in 22 clinics in the defined area. The
study represents one of the few large-scale efforts to examine the drinking
habits of patients belonging to community-based primary care clinics.

The study, published in this month's American Journal of Public Health,
found that 19.7% of adult patients ages 18 to 60 were "at-risk" drinkers,
according to standards set by the National Institute of Alcohol Abuse and
Alcoholism.

For men that meant 14 or more drinks in a week or a history of occasional
binge drinking; for women that meant seven or more drinks a week or a
binge-drinking history. The study defined binge drinking as six or more
drinks at a single sitting.

"I think that is pretty impressive," said Mary Dufour, deputy director of
the institute, about the high number of at-risk drinkers. "We suspected it
was that high, but people hadn't collected the data."

Drinking at that level puts a person at higher risk for a wide variety of
ailments and disorders including cirrhosis of the liver, stroke, high blood
pressure, accidental injuries, domestic violence, sleeping disorders,
depression, chronic headaches and more.

The article points out that men who consume more than two ounces of liquor
a day -- equivalent to approximately two beers or eight ounces of wine --
have 2.2 times the risk of liver cirrhosis than those who drink less. Women
have an even higher risk.

For daily drinkers of both sexes, for approximately every ounce of liquor,
single beer or five ounces of wine consumed, there is a perceptible rise of
roughly 1% to 2% in blood pressure.

Michael F. Fleming, of the UW addiction center and principal investigator
for the study, said that he was not only surprised by the high numbers, but
"that (respondents) were so honest about their drinking habits."

"There is a notion that most people do not want to tell their physician
about how much they drink," he said in an interview. "But most people are
willing to tell their level of use."

Dufour said that although physicians are trained as students to ask
questions about drinking history, as physicians "they are notoriously bad"
in doing so.

"This emphasizes again that alcohol is American's No. 1 drug of abuse and
you have to ask every patient about it," she said.

Fleming said the findings support tighter screening of patients for their
drinking patterns. "You should ask 'how many days do you drink, what is the
average number of drinks per drinking occasion and do you have four or more
at a single time?' " he said. "Quantity, frequency and binge drinking,
that's what you need to know."

If an at-risk drinker is identified, the physician needs to devote at least
some time to a serious discussion of the topic. Previous work by Fleming
and his colleagues has shown that a 15-minute discussion -- a so-called
brief intervention -- could reduce drinking by 30% or more in problem
drinkers.

Advice on how to cut down on drinking, booklets and other related resources
can be used as well, he said.

The article concludes that "since the majority of alcohol-related problems
occur in at-risk non-dependent drinkers, public health policy must shift
toward . . . focusing on the identification of this population."