Kendell R E
University Department of Psychiatry, Royal Edinburgh Hospital, Scotland.
CMAJ. 1990 Nov 15;143(10):1042-7.
Physicians can play an important role in society's response to alcohol problems. In diagnosis, alcohol problems among patients are frequently overlooked. Physicians should routinely ask patients about alcohol intake. In light of evidence on the effectiveness of brief interventions, especially with heavy-drinking but nondependent patients, physicians' treatment efforts should be focused in this direction. Patients who are alcohol dependent might best be treated by nonphysicians. Research contributions of physicians should be concentrated on topics for which physician input is needed: longitudinal studies of health consequences, factors contributing to mortality and health service costs, biochemical markers of alcohol use and basic pharmacology. Strong evidence links population alcohol consumption levels to overall harm. Therefore, prevention efforts should be aimed at the population as well as at people who may be at risk. Physicians can contribute to these efforts by influencing public policy and by setting healthy examples in their own alcohol use.
医生在社会应对酒精问题方面可发挥重要作用。在诊断过程中，患者的酒精问题常常被忽视。医生应常规询问患者的饮酒情况。鉴于简短干预措施有效性的证据，尤其是针对重度饮酒但未成瘾患者，医生的治疗工作应朝此方向集中。酒精成瘾的患者可能由非医生进行治疗最为合适。医生的研究贡献应集中在需要医生参与的主题上：健康后果的纵向研究、导致死亡率和医疗服务成本的因素、酒精使用的生化标志物以及基础药理学。有力证据表明人群酒精消费水平与总体危害相关。因此，预防工作应针对全体人群以及可能处于风险中的人群。医生可通过影响公共政策以及在自身饮酒方面树立健康榜样来为这些努力做出贡献。
