The use of prescribed medication by problem drinkers: ‘painting over the rust’?

Abstract

Patients may not appreciate the contribution that alcohol makes to their symptoms, or they may minimize its significance.

Alcohol is a widely used substance which, when taken in moderation, may confer cardiovascular benefit. However, excessive consumption is a major cause of morbidity and is associated with a variety of physical problems which present with diverse symptoms. Heavy drinkers often remain undetected in general practice. Medication may be prescribed without recognition of the etiological significance of alcohol, and i unlikely to be effective if the primary cause remains unaddressed. Inappropriate prescribing may result in iatrogenic disease. This study involved a case note review of referrals to a specialist alcohol service treating excessive drinkers in the community. It sought to determine the frequency and range of medications prescribed by general practitioners. Of 280 individuals, 161 (58%) received prescribed medication. Of the 263 preparations, 68% could be attributed to alcohol-related illness, and 62% had a potential interaction with alcohol. The Significance of alcohol as the cause of illness should be considered, and screening questions regarding alcohol use should be asked routinely. Early detection increases the possibility of a favourable outcome and reduces health care costs. Appropriate interventions in primary care settings are effective and should be undertaken prior to, or in conjunction with, the prescription of medication for the symptoms of excessive alcohol use.