Are you a social, only-on-the-weekends kind of drinker? Even occasional alcohol habits matter more than you think.
Illustration by Dan Bob Thompson
Doctors have your number — your LDL, BMI, PSA, BP, and Lbs.
Now, they’re being asked to focus on another figure: how much you imbibe.
Doctor’s-office conversations about drinking should happen more often, a recent Centers for Disease Control (CDC) report says, because that confidential talk is shown to reduce drinking.
At least 38 million adults tipple too much. It’s a topic of growing concern — so much so that medical schools teach future physicians how to broach that topic, among others.
“Some people may think they’re fine because they don’t drink all week and only on the weekend,” says Dr. Maryjean Schenk, vice dean of Medical Education at Wayne State University’s School of Medicine. “But it’s also about how much you consume, the dose, and the health effects of that.”
Many people don’t know what constitutes binge drinking, which can be as harmful as too-frequent consumption.
Binge drinking is defined as five or more alcoholic beverages within 2 to 4 hours for men and four drinks or more for women in that same time period. Risky frequency is considered to be 14 drinks a week for men and seven drinks for women, the National Institute on Alcohol Abuse and Alcoholism and U.S. Department of Agriculture say.
Curtailed adult-beverage consumption could have widespread ramifications. Alcohol misuse ranks third among preventable-death causes in the United States (right behind tobacco use and being overweight or obese).
Overindulging also leaves a range of human wreckage in its wake. It can contribute to gastritis, liver disease and cirrhosis, pancreatitis, some cancers, anxiety, and depression. Alcohol is also a factor in falls, drownings, fires, vehicle crashes, homicide, and suicide, the U.S. Preventive Services Task Force says.
At WSU, first- and second-year medical students take an 18-month course on interviewing skills that can help patients feel more comfortable sharing information. “You ask questions and you interpret,” Schenk says. Doctors learn to ask related questions for clues to patients’ habits.
Doctors may have less opportunity to discuss drinking with younger adults, who generally have fewer doctor visits. If they come in for a sore throat, Schenk says, you should ask about drinking. But what to say?
“My doctors have never gone beyond the usual ‘how-much-alcohol-do-you-consume’ question,” says Mallory Tomaro, a 28-year-old Detroit-based attorney. “I think a reminder from a doctor [about recommended maximums] would be helpful, because American cultural-drinking norms are so different from what is medically optimal.”
Tomaro adds, however, that frequently overburdened doctors seem too busy to go beyond the basic inquiry.
“In my opinion,” she says, “alcohol screening and counseling would ideally come from a less strained part of the health care system, [perhaps a] para-medical worker.”
Andrea Haas, 30, a downtown Detroit project manager, says she also finds doctors ask the how-often question with no follow-up. “Maybe because I don’t drink too much,” she speculates.
Tomaro and Haas agree that a conversational nudge toward healthful behaviors would be welcome.
As Tomaro says, “Learning about recommended alcohol limits and subsequent regular reminders are an effective way for people to be deliberate about how much they drink.”