Screening for disease has become a mainstay of today's preventive health care, with roots in medical practice that extend back to the 1930s and 1940s (1). As screening's effectiveness continues to be demonstrated, the demand for these assessments also has increased. The result is double-edged. Increased screening enables clinicians to step in early to prevent and treat a wide range of public health problems before they become too serious. But the time available for conducting those screens has steadily declined. Deciding whether a particular screen is warranted, choosing the best one for an individual patient, and administering it in a cost-effective way are key issues for clinicians to address. Routine screening for problems with alcohol is a relatively recent practice, but has a solid base of support. In 1990, the Institute of Medicine's landmark report (2) on broadening the base of alcohol and other drug abuse treatment recommended that patients in all medical settings be screened for the full spectrum of problems that can accompany alcohol use and, when necessary, be offered brief intervention or referral to treatment services. This Alcohol Alert focuses on the use of routine alcohol screening in a variety of medical settings. The next issue of the Alcohol Alert will examine the role of brief inter ventions in these same settings.
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