Americans are dying from alcohol-related causes at an alarming rate, with numbers doubling from 1999 to 2017, a national study released early this year showed.
Kaiser Permanente Northern California is seeing long-term success, however, in getting people to cut back on drinking by asking simple questions about alcohol use. If the answers point to at-risk drinking, the doctor conducts a brief interventional conversation.
The protocol is showing positive results in both the physical and mental health of adults and teens, and has been used on a massive scale in Northern California since it started 8 years ago, said Connie Weisner, associate director of Behavioral Health, Aging and Infectious Diseases at the Kaiser Permanente Northern California Division of Research.
“Since 2013 Northern California members have been asked about their drinking during primary care visits more than 10 million times,” said Weisner, who has conducted alcohol research for 36 years and is an expert advisor to the World Health Organization on alcohol and other drugs.
Successful Teen Interventions
Results of a Kaiser Permanente study by researcher Stacy Sterling released in 2019 showed teens visiting the Pediatric Department in Oakland, California, who completed an alcohol screen and received a brief intervention had a lower percentage of hospital stays, emergency department visits, and psychiatry appointments. They also had fewer mental health and substance abuse diagnoses after 3 years than teens who were not screened.
“That is so important because we know that most adults who are diagnosed with alcohol use disorder started drinking before they were 18,” Weisner said.
A second Kaiser Permanente study in 2017 conducted by researcher and Senior Data Consultant Felicia Chi showed adults with high blood pressure who were screened for alcohol use and received a brief intervention from their primary care physician for risky drinking were 17 times more likely to get their blood pressure under control than those who did not receive the intervention.
“We found that a simple conversation makes a big difference,” Weisner said.
National Institutes of Health and Kaiser Permanente healthy drinking guidelines for men call for no more than 4 drinks at a time, and no more than 14 drinks a week, and for women no more than 3 drinks at a time, or 7 drinks a week. A Kaiser Permanente self assessment for drinking is also available online.
Alcohol Deaths Rising
The National Institute on Alcohol Abuse and Alcoholism study, which tracked death certificates mentioning alcohol as a cause, showed alcohol-related deaths rose from 35,914 in 1999 to 72,558 in 2017. In California, alcohol deaths rose 17% between 2006 and 2013, according to the California Department of Public Health.
Weisner said researchers worldwide struggle to answer why more people are dying from alcohol-related causes such as liver damage, alcohol and opioid combined overdoses, car crashes, suicides, homicides, and falls.
“We do know that there are high rates of drinking among older and middle-age people, and a big issue is the connection between suicides and alcohol,” Weisner said.
Indeed, death certificate data shows the highest rates of death from alcohol were in the 45 to 74 age range, but there were also large increases in deaths of people aged 25 to 34.
“We really don’t know why people are drinking more, but it is encouraging that our health system is proactively addressing it,” Weisner said.
Weisner said she recently returned from a meeting in Geneva of the World Health Organization where the consensus among experts was that, “Yes, people are drinking more, and it’s affiliated with other drug use like marijuana and opioids. The good news is at the same time, we are also seeing a movement toward healthy living among young people, so that is somewhat reassuring.”
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Outstanding piece. Thank you very much.
Dr. Weisner and Sterling’s research is so important to understanding how to begin to treat Substance Use Disorders in primary care settings. It is great to see the organization implementing treatment based on these studies. I hope that we can continue to implement this in other pediatric locations.