Recognizing the Alcoholic or Substance-Abusing Patient in Your Practice

Some 6 to 9% of adult Americans are believed to be alcoholics, and at least 5% of adult Americans use some drug daily, with 30% using drugs occasionally. Thus every medical practice involved with persons over age 10 as patients or parents has these problems. It is estimated that only half the active alcoholics and one fifth of those using drugs are recognized in medical practice. A survey conducted in 1987 indicated that 51% of eighth-grade students and 63% of tenth-grade had tried smoking tobacco. Seventy-seven percent of eighth-grade and 89% of tenth-grade students had used alcohol, and 38% of the tenth graders had had five or more drinks on a single occasion in the most recent two weeks. Twenty-six percent of eighth-grade students and 38% of tenth-grade students had used marijuana; 4% of eighth-grade and 8% of the tenth-grade students had used cocaine. ¹ Such data indicate that the problem is pervasive.