Alcohol use and abuse are widespread and if undetected by physicians, can compromise quality of care for common medical conditions:
- Most Americans drink alcohol, with 20% consuming at least 3 drinks weekly.
- “Unhealthy alcohol use” (more than 4 drinks/day or 14 drinks/week) is common in adults (~20%).
- Unhealthy alcohol use compromises the diagnosis, course, treatment and outcomes of many common chronic illnesses such as diabetes, several forms of cancer, and sleep disorders.
- A 2006 report by the Institute of Medicine stated pointedly that primary care physicians’ failure to address alcohol’s effects on general medical illnesses compromises quality of care for Americans.
PRISM is the first program of its kind to address the gap between addiction and primary health care by systematically evaluating the evidence (both positive and negative) for alcohol’s effects on common chronic clinical conditions including diabetes, sleep disorders, hypertension, depression, and bone disease. PRISM has also commissioned systematic reviews exploring the impact of illicit drug use on common conditions such as back pain (narcotic drugs) and lung disease (marijuana). Nine reviews have been published. Among the findings:
- Alcohol use within sensible drinking guidelines may adversely affect certain patients (e.g., those with sleep disorders, breast cancer).
- Low-level alcohol use may reduce the risk of some clinical conditions (e.g., diabetes, hypertension).
- Clinical alertness to insomnia as a symptom of nascent, current or past alcohol problems might facilitate timely intervention and lead primary care physicians to evaluate sleep complaints more thoroughly.
PRISM is premised on the well-founded belief that physicians will consider and address alcohol and illicit drug impacts if given sound evidence and appropriate educational programs, quality standards, and practice designs. Through its collaboration with four of the most prestigious medical societies in the country, PRISM is developing a model of care that integrates clinically relevant, evidence-based information about the effects of alcohol and illicit drug use on common chronic conditions.
