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Posted 03.31.05

MU Researcher Helps Doctors Identify, Treat Problem Drinkers

Doctor Developing Computer Program to Help Abusers Identify and Resolve Their Problems

COLUMBIA, Mo. - More than 17 million adults abuse alcohol or are alcohol dependent, an increase from 13.8 million only a decade ago. In addition, 85,000 annual deaths in the United States can be attributed to alcohol, according to recent research. One University of Missouri-Columbia medical researcher found that asking the right question can better diagnose alcohol problems and is developing a computer program to help alcohol abusers understand their problem and identify possible solutions.

Dan Vinson, professor of family and community medicine, found that simple questions, asked in the right way, can be effective at determining whether an individual has an alcohol abuse problem. For example, if asked about his or her average alcohol consumption over the course of a week, an individual who typically has two beers each night and two six-packs on the weekend might answer "two beers." Instead, doctors should rephrase their question to ask about the maximum quantity consumed during a specific time period, Vinson said.

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"We wanted to help doctors identify people who have hazardous drinking habits or engage in alcohol abuse," Vinson said. "Previous research has shown that one question is not sufficient to root out any problems. However, with the average doctor visit lasting about 15 minutes, there usually is not enough time to ask enough questions to identify abuse. In our study, we found that with the right phrase, doctors needed to ask only one question to get a relatively accurate answer. That question is, 'When was the last time you had more than 5 drinks (or 4 drinks for a female) in one day?'"

In his study, Vinson found that more common questions such as "How often do you drink?" and "How much do you drink on average" were helpful if the limit was set low enough. Vinson asked these questions of more than 2,500 patients, and found that if the cutoff quantity was set at an average consumption of two or more drinks, these questions were useful in soliciting helpful information.

"Of course, anyone answering 'yes' to this single question--drinking on average two or more drinks per occasion--does not mean that he or she has an alcohol problem," Vinson said. "Additional questions would determine the extent of the problem if one existed."

The National Institute on Alcohol Abuse and Alcoholism, a division of the National Institutes of Health, funded the study. It was published recently in the journal Alcohol and Alcoholism online. The paper version will be out later this year.

Building on this study, Vinson is developing a computer program that would ask those additional questions to determine if a problem might exist. Not only would this computer program help individuals determine if they had a problem, but it also would allow the physician and patient to continue to use most of their time together to address other issues that are important to both individuals.

"Once a patient answers the first question in such a manner that the doctor might believe there could be a problem, the patient might be asked to answer some questions on the computer," Vinson said. "While the patient is answering this 12-minute survey, the doctor could check with other patients. At the same time, the computer could determine if there was a serious problem with the patient and, when the doctor returned, the doctor and patient could discuss the problem further and any potential steps that should be taken."

Vinson will be testing the computer program in rural and metropolitan doctors' offices this summer.



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