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Discussion

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Discussion

Alcohol abuse is the third greatest cause of avoidable deaths in the United States,

accounting for roughly 88,000 deaths per year. Around 15% of pregnant women drink alcohol,

and this number has climbed to as high as 20% in recent decades. According to (CDC) Centers

for Disease Control and Prevention, there is no safe level of alcohol to consume while pregnant

or attempting to conceive. There is also no known time during pregnancy to consume alcohol

(U.S Preventive Services Task Force, n.d.). All types of alcohol are considered harmful including

beer and wines. In a study conducted by CDC, 30 % of more than 12,000 women who consumed

alcohol in their third trimester argued that they were not advised by their healthcare providers on

the effects of alcohol on unborn children.

As a result, screening methods related to alcohol abuse in the main care settings have

been developed. The (USPSTF), United States Preventive Services Task Force outlines specific

approvals about the efficacy of various precautionary measures for individuals who have no

visible signs (U.S Preventive Services Task Force, n.d.). It proves that clinical decisions

necessitate more than just looking at the evidence and points out that policy and coverage

decisions take into account a variety of factors in addition to knowledge about clinical benefits

and drawbacks.

The USPSTF recommends that everyone aged 18 and above, including pregnant women,

have their alcohol usage checked in a primary care environment, and that people who are

drinking dangerously should receive behavioral counseling to help them stop. The USPSTF also

indicates that current data is not enough to scrutinize the pros and cons of alcohol addiction

screening and communicative psychoanalysis in primary care settings among teenagers between

12- 17 years (U.S Preventive Services Task Force, n.d.). Screening methods are crucial because
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they aid in the identification of a wide range of manners, from perilous drinking habits to alcohol

abuse disorder (AUD). Hazardous drinking is defined as consuming more alcohol than is

recommended on a daily, weekly, or occasional basis, resulting in significant health risks yet

failing to fulfill the criteria for AUD.

The USPSTF determined that of the existing screening methods, three screening tools

provide the most accurate findings in determining harmful alcohol intake in adults aged 18 and

above. These include the Single Alcohol Screening Question (SASQ) and the Alcohol Use

Disorders Identification Test-Consumption (AUDIT-C). While conducting tests of unhealthy

alcohol consumption across diverse groups, the AUDIT-C is believed to be more specific and

sensitive (U.S Preventive Services Task Force, n.d.). This tool has ten questions with three

focusing on the regularity of alcohol consumption, the typical volume of alcohol consumed, and

the instances of drinking heavily.

The remaining seven queries focus on any signs of alcohol dependency and

complications linked with alcohol consumption. The test usually takes 2-5 minutes to administer.

Preliminary research suggests that the USAUDIT-C is more successful in detecting college

drinkers who are at risk than the USAUDIT. SASQ also offers enough peculiarity and sensitivity

on all unhealthy alcohol use range, and it just takes one minute to administer (U.S Preventive

Services Task Force, n.d.). USPSTF gathered enough pieces of evidence to close the gap

between behavioral counseling therapies in adults that have positive results and are connected to

less harmful alcohol consumption.

Short psychotherapy involvements improved the possibility that pregnant women did not

drink alcohol while pregnant, and the degree of these benefits was reasonable. According to

epidemiological evidence, there is a link between reduced alcohol consumption and lower rates
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of morbidity and mortality, which helps to improve various health outcomes. The USPSTF has

different grades and levels of evidence (certainty) that show the preventive services to be

administered at different rates of alcohol consumption (U.S Preventive Services Task Force,

n.d.). These grades include A, B, C, and D and each has a different definition while levels of

certainty include high, moderate, and low. Each with a different recommendation regarding net

benefit.

If patients show a positive result on any screening tool, it is up to clinicians to offer a

follow-up routine and an in-depth risk assessment to affirm that the results are correct and then

determine what to do next. Clinicians are advised to use a short-term screening tool that has

higher sensitivity and low specificity and then proceed to a longer tool with greater specificity. It

is important to note that different populations have different screening tools.

(TWEAK) Tolerance, Worried, Eye-opener, Amnesia, Kut down, (NET) Normal drinker,

Eye-opener, Tolerance, Tolerance, Annoyed, Cut down, Eye-opener (T-ACE), and Parents,

Partner, Past, Present Pregnancy (4P's Plus) are some of the tools used to test pregnant women.

Adolescents, on the other hand, can be assessed using the (CRAFFT ), Car, Relax, Alone, Forget,

Family, Friends, Trouble. Counseling involvements for harmful alcohol intake in adults and

pregnant women are modest, according to the USPSTF. The US Surgeon General, the CDC, the

ASAM, and the National Institute on Alcohol Abuse and Alcoholism (NIAA), on the other hand,

encourage routine screening for harmful alcohol use and provide the required interventions (U.S

Preventive Services Task Force, n.d.). Clinicians should familiarize themselves with these

screening tools to ensure that they can intervene in most cases involving unhealthy alcohol

consumption.
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References

U.S Preventive Services Task Force. (n.d.). Recommendation | United States Preventive Services

Taskforce. Www.uspreventiveservicestaskforce.org.

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/unhealthy-

alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions