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'Hazardous' drinking and drug use have serious health implications
Research has found that individuals with alcohol and drug dependencies have a greater occurrence of injuries,
hypertension, HIV, hepatitis, acid-related peptic disorders, liver cirrhosis, depression, anxiety disorders, and major
psychoses. These individuals also tend to have higher health care costs, particularly for more costly services such as
hospitalizations and emergency-room use. A study in the June issue of Alcoholism: Clinical & Experimental Research has found
that primary-care patients with less severe drinking and drug use also have several serious health problems.
"The World Health Organization defines 'hazardous drinking' as 'alcohol consumption which confers the risk of physical and/or
psychological harm,'" explained Jennifer R. Mertens, a researcher with the Kaiser Permanente Medical Care Program's division
of research and corresponding author for the study. "Hazardous drinking and drug use are much less severe, yet much more
common, than dependence disorders. For example, a hazardous drinker might be someone who drank four or more times a week,
drank three drinks on a typical day that they drank, and had a relative or friend, a doctor or other health worker express
concern about their drinking or suggest they cut down in the past year."
Mertens said there is a growing recognition of the importance of screening and intervention for individuals who have these
less severe, but still harmful, problems with alcohol and other drugs. "We know that screening for these problems provides an
opportunity to intervene, prevent worsening of problems, and improve overall health," she said. "Yet we know very little
about the associated health problems of those with these less severe alcohol and drug problems."
Researchers screened a representative sample of 1,419 patients (563 males, 856 females) who visited Kaiser Permanente
primary-care clinics in the Sacramento area from July 1999 to August 2000 for hazardous drinking and drug use. A comparison
group of 13,347 patients (5602 males, 7745 females) was selected from the same clinics during the same time period. Medical
conditions and health-care use during the year prior to screening were compared.
"First, we found that one in 10 patients in private, primary-care clinics were either hazardous drinkers or drug users," said
Mertens. "This was consistent with an earlier study in similar primary-care clinics for privately insured patients." The
prevalence of hazardous drinking and drug use was similar to hypertension and diabetes, she said.
"Second, we found that hazardous drinkers and drug users in primary care were more likely than other patients to have had
several serious health problems," said Mertens, "including injuries, hypertension, pneumonia, chronic obstructive pulmonary
disease, depression, anxiety disorders, and major psychoses." This finding would indicate that screening and brief
intervention at the lower threshold of hazardous drinking and drug use would sooner detect individuals with health risks, she
added.
"Third," she said, "hazardous drinkers and drug users had more visits to psychiatric clinics. This high prevalence of
psychiatric comorbidities and the accompanying use of mental-health care suggest that interventions for hazardous drinking
and drug use need to take into account the need for mental-health treatment in these patients."
In their totality, said Mertens, the study's findings suggest that there are important health benefits for screening in
primary care and conducting interventions among hazardous drinkers and drug users. "In addition," she noted, "the beneficial
effects of moderate alcohol consumption should be considered in the context of potential negative health consequences."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and
the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Hazardous Drinkers and Drug
Users in HMO Primary Care: Prevalence, Medical Conditions, and Costs," were: Constance Weisner of the Division of Research,
Kaiser Permanente Medical Care Program, and the Department of Psychiatry at the University of California, San Francisco; G.
Thomas Ray and Bruce Fireman of the of the Division of Research, Kaiser Permanente Medical Care Program; and Kevin Walsh of
The Permanente Medical Group in Sacramento. The study was funded by the National Institute on Drug Abuse and the Robert Wood
Johnson Foundation.
Alcoholism: Clinical & Experimental Research
http://www.alcoholism-cer.com
"Periculoase" de alcool ºi consumul de droguri au implicaþii grave de sãnãtate - 'Hazardous' drinking and drug use have serious health implications - articole medicale engleza - startsanatate