Screening Tool May Help Identify Alcohol Use

By McNamara, Damian | Clinical Psychiatry News, February 2007 | Go to article overview

Screening Tool May Help Identify Alcohol Use


McNamara, Damian, Clinical Psychiatry News


ORLANDO -- It is a good idea to routinely ask patients--particularly those with risk factors for dependence--about their alcohol use, George F. Koob, Ph.D., said at a psychopharmacology congress sponsored by the Neuroscience Education Institute.

However, patients are not always honest, copresenter Dr. Stephen M. Stahl pointed out. "Most of us try to screen patients for alcohol, but ... I can't tell you the number of times I've been bamboozled by patients.

"In clinical practice, there are a lot of people who are heavy drinkers who do not think of themselves as alcoholics. They will be completely insulted if you tell them," said Dr. Stahl of the department of psychiatry, University of California, San Diego, and chairman of the institute.

He and Dr. Koob, professor and chairman of the committee on the neurobiology of addictive disorders at the Scripps Research Institute, La Jolla, Calif, recommended use of the Alcohol Use Disorders Identification Test (AUDIT). However, 84% of those attending the meeting indicated they have never used the AUDIT screening tool, according to an electronic poll.

According to Dr. Koob, two neurologic systems reinforce alcohol dependence--both dopamine and serotonin pathways--and make it more difficult for people to stop drinking, and advances in neurobiology are offering new insights into how the brain is altered by alcohol use, dependence, and withdrawal.

"The neurobiology has led us where there are spectacular new targets for treatment of alcoholism," Dr. Koob said. Rewarding effects of alcohol may be mediated by dopaminergic and opioidergic systems.

Researchers have long proposed that the pleasure provided through the mesolimbic pathway explains why people initially drink alcohol or take drugs. …

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