At-risk drinking among patients making routine primary care visits

Background: Addressing non-alcoholic, at-risk patterns of alcohol consumpti on that are associated with increased morbidity and mortality is an importa nt health care priority. Objective: The objective was to describe the prevalence and characteristics of at-risk drinkers in a population-based sample of adults with routine pr imary care visits. Methods: Three thousand four hundred thirty-nine patient s with advance appointments in 23 primary care practices completed a health survey prior to their visit. At-risk drinking was defined as consuming an average of two or more drinks per day (chronic drinking), or two or more oc casions of consuming five or more drinks in the past month (binge drinking) , or, in the past month, one or more occasion of driving after consuming th ree or more drinks (drinking and driving). Results: Prevalence was: 11% at-risk drinking; 63% light to moderate drinki ng; 26% abstinence. Abstainers differed from alcohol users on demographics (older, fewer Caucasian, lower income, more unemployed), other health behav iors (less exercise, lower rates of smoking, and marijuana and cocaine use) , and family history of alcohol problems (lower). Abstainers also reported poorer physical and psychological health. Compared to light to moderate dri nkers, at-risk drinkers were more likely to be male, unmarried, and to use other substances (tobacco, marijuana, and cocaine). Among at-risk drinkers, those with two or more risk factors were more likely male, consumed more a lcohol per week, had higher AUDIT scores and were more motivated to change their drinking. Among those with only one risk factor, binge drinkers repor ted high rates of tobacco and marijuana use, relatively poor perceived heal th, and the highest proportion of negative consequences from drinking. Conclusions: At least 1 in 10 patients making routine primary care visits h ave drinking practices that place them at risk for negative consequences fr om drinking. Three drinking patterns that can be used to define at-risk dri nking are relatively distinct, (C) 2000 American Health Foundation and Acad emic Press.