What to advise patients about drinking alcohol: the clinician's conundrum

Physicians may individualize patient advice regarding alcohol consumption to promote the beneficial effects of alcohol while minimizing the adverse consequences. The positive and negative health effects of alcohol are well-reported and complicate physicians' recommendations to patients about its use. Research indicates that alcohol protects against heart disease and many people may derive cardiac benefits from moderate alcohol consumption. High consumption of alcohol, however, seems to be related to higher death rates. For this reason, public health advocates do not support alcohol use. Physician-patient alcohol counseling offers a solution to this dilemma. Physicians must determine a patient's history of alcohol consumption and probe for dependency in the patient or family members. Alcohol abstinence must be recommended for patients with certain diseases, pregnant women, and those on some medications. In appropriate patients, alcohol consumption of one ounce per day may be recommended with regular patient follow-up.