ACP Calls for Multipronged Effort to Recognize and Treat Alcohol Use Disorder

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In updated policy brief, ACP recommends addressing alcohol use disorder as a treatable chronic medical condition using evidence-based initiatives

May 17, 2024 (ACP) -- The American College of Physicians is calling for policy changes to reduce excessive alcohol use and help recognize and treat alcohol use disorder.

"Excessive alcohol use and alcohol use disorder are serious health issues in the United States," said Dr. Omar T. Atiq, immediate past president of ACP. "Deaths attributed to alcohol use are partly to blame for declining life expectancy in the United States."

In addition, excessive drinking has substantial societal costs, with increased spending on health care and the criminal justice system and reduction in workplace productivity, according to data cited in a newly updated ACP policy brief published in the Annals of Internal Medicine. According to the Centers for Disease Control and Prevention, total excessive alcohol use-attributed costs were estimated at $249 billion in 2010.

"ACP believed it was time to update its policy to highlight and mitigate alcohol-related health and other societal issues that have a higher adverse impact than all other drugs combined," Atiq said.

Alcohol use disorder (AUD) is a treatable chronic medical condition, and ACP recommends it should be addressed through evidence-based public health and health care initiatives. This starts with removing barriers to accessing treatment and implementing measures to curb binge drinking and heavy drinking among young adults and other high-risk populations, according to Atiq.

ACP is calling for training, payment and delivery system policies that would allow physicians and other health care professionals to screen, diagnose, and treat patients for AUD. Training in screening and treatment of substance use disorders, including AUD, should be part of the medical education curriculum.

Finally, ACP is calling on federal, state and local governments to do their part and implement evidence-based policies to prevent and treat excessive alcohol use and AUD.

"Increasing local, state and federal excise taxes on alcohol products is an effective strategy for reducing excessive alcohol use and alcohol use disorder and alcohol-related morbidity and mortality," Atiq said.

Other actions include reducing the legal blood alcohol concentration limit, maintaining limits on days and hours of alcohol sales, regulating alcohol outlet density, which caps the number of alcohol-selling establishments in a community, and implementing commercial host liability, which would hold purveyors of alcohol legally accountable if an accident results from an alcohol sale, he added.

ACP also recommends evidence-based policies to curb underage drinking, including establishing stringent blood alcohol content levels for young drivers, suspending driving privileges for underage drivers with alcohol violations and performing compliance checks to determine whether retailers are selling alcohol to underage people.

Internal medicine physicians can implement the Brief Alcohol Screening and Intervention for College Students (BASICS), which is targeted to college-age young adults, to increase knowledge of alcohol harms, gauge use and reduce consumption, Atiq said.

"Policymakers, public health organizations, physicians and other health professionals and private and community organizations all have a substantial role to play in reducing excessive alcohol use and AUD," conclude the authors of the policy brief.

More Information

The policy brief, "Excessive Alcohol Use and Alcohol Use Disorders," is available on the Annals of Internal Medicine website.

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