[Alcoholism and the practicing physician]

Abstract

Alcoholism is a major public health problem in Switzerland as in most Western industrialized countries. The general practitioner should be a key person in screening for alcohol abuse and dependency. Yet, the general practitioner should provide information and counselling upon the consequences of excessive alcohol consumption. In a strategy of routine screening by general practitioners, asking the patient about the quantity and the frequency of alcohol consumption, clinical examination and laboratory testing are less effective than a standardized questionnaire. Examples of questionnaires include the Michigan Alcoholism Screening Test (MAST) and the CAGE questionnaire. The rationale for systematic screening is that early pathological injuries due to excessive alcohol consumption are reversible. Yet, the prognosis seems to be more favourable where therapy begins early and the amount of psychosocial problems is limited. An early therapeutic intervention could be started as a multidisciplinary approach, targeting the patient and emphasizing the role of the patient's physician.