Problem drinking

Abstract

Alcohol use contributes to a substantial portion of the global disease burden. Regulation of alcohol sales and beverage taxes has been shown to be effective in reducing excessive alcohol consumption and its related harms. Unhealthy alcohol use is not only directly responsible for acute conditions such as intentional and unintentional injury but also for chronic conditions such as cancers of the head and neck, liver, gastrointestinal tract, and breast. Existing evidence shows notable differences among racial and ethnic minority groups when it comes to alcohol use, related harms, and treatment service utilization. The Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition has shifted from use of the terms alcohol abuse and dependence to a spectrum of severity of alcohol use disorders (AUD). The emergency department (ED) serves as a unique opportunity to identify individuals with unhealthy alcohol use and to inform, guide, and motivate them to reduce their drinking and pursue treatment with the screening, brief intervention, and referral to treatment (SBIRT) model. ED SBIRT has shown promise in reducing alcohol use and alcohol-related injury, yet to date, it has not been rigorously evaluated specifically for the prevention of alcohol-attributable cancers. Nevertheless, experts believe the effects of alcohol ED SBIRT on preventing cancer may be potentiated by tobacco ED SBIRT. To better understand this, future studies are needed to evaluate the definitive role of alcohol ED SBIRT in cancer prevention.