From the January ACP Internist, copyright © 2013 by the American College of Physicians.
By Kathy Holliman
When it comes to patients' alcohol consumption, the "who" and "how much" are important, but the "what" is probably not.
Research on alcohol's health benefits and risks has shown that ethanol works the same whether it is consumed in a glass of red wine, a bottle of beer or a gin and tonic. The amount and frequency of consumption, along with the drinker's gender, age, medical condition and history, family history, and medications, are all linked with the effect of ethanol over time.
Patrick G. O'Connor, MD, MPH, FACP, professor of medicine and chief of internal medicine at Yale School of Medicine, advises primary care physicians to routinely screen every patient about daily and weekly alcohol consumption.
"It is such a common and fundamental issue that if you don't ask all patients, you are going to be missing many who could benefit from what you have to offer in terms of improving your patients' health," he said.
Long-term observational studies have highlighted a few key points about alcohol consumption: Benefit seems limited to the cardiovascular system in people over age 50 if they do not exceed the recommended number of servings per week. Risk includes development of breast cancer in women, particularly those who consume more than a few servings a week. Heavy drinking imposes significant risks for osteoporosis, many types of cancer, liver disease, hypertension, atrial fibrillation, stroke and multiple social and behavioral problems.