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The US Preventative Task Force came out with updated recommendations for screening and behavioral counseling interventions regarding unhealthy alcohol use in adults and adolescents in November 2018: https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions.

JAMA has the full article. It defines the size of a drink and what the recommended maximum is in men and women, and recommends none in adolescents and none in pregnant women.

From JAMA:

"Unhealthy alcohol use means drinking more than the recommended amount of alcohol. This includes exceeding daily or weekly recommended limits as well as alcohol use disorder (alcohol abuse and dependence). According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA):

- healthy adult men aged 21 to 64 years should not drink more than 4 drinks a day or more than 14 drinks a week;

- healthy men aged 65 years or older should not drink more than 3 drinks a day or more than 7 drinks a week; and

- healthy adult women of all ages should not drink more than 3 drinks a day or more than 7 drinks a week.

A “drink” is considered to be 12 oz of beer, 5 oz of wine, or 1.5 oz of liquor. Drinking too much alcohol can lead to injury, illness, and early death. In pregnant women and all adolescents, any alcohol use is considered unhealthy. Drinking alcohol during pregnancy can lead to birth defects and future developmental issues in children. Among adolescents, drinking and driving is a major cause of injury and death."

The USPSTF also makes recommendations about screening tools, short questionnaires. Currently they have not favored one over others: https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions.

The recommendations always lag behind the new studies. I wrote Heart and brain and alcohol, 2018 in May, and the evidence is rising more and more alcohol is not good for you, any alcohol. Not good for the brain and not good for the heart. The USPSTF publishes the evidence and design of their study, also in JAMA, here. It interests me that they are still picking a limit on alcohol rather than saying none. Well, they say none for adolescents and pregnant women, but not the rest.

The biggest addiction killer in the US is tobacco, by miles and miles, but it is more indirect and takes time.... increasing heart disease, sudden death, emphysema, COPD, all cancers.... Again from JAMA: "Unhealthy alcohol use (including use that exceeds recommended limits, use that is having negative effects on health, or alcohol use disorder) was estimated to be the third leading preventable cause of mortality in the United States in 2000, with 9.8% of deaths attributable to alcohol consumption from 2006 to 2010."

Tobacco recommendations are being updated. The final research plan for adults is here: https://www.uspreventiveservicestaskforce.org/Page/Document/final-research-plan/tobacco-smoking-cessation-in-adults-including-pregnant-women-interventions and for children and adolescents, here: https://www.uspreventiveservicestaskforce.org/Page/Document/final-research-plan/tobacco-and-nicotine-use-prevention-in-children-and-adolescents-primary-care-interventions.

I do screen people and I do see people change. Over time, slowly.


IRON NODER: TOKYO DRIFT 25

All the references:
https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions
https://jamanetwork.com/journals/jama/fullarticle/2714532
https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions
https://jamanetwork.com/journals/jama/fullarticle/2714536
https://www.uspreventiveservicestaskforce.org/Page/Document/final-research-plan/tobacco-smoking-cessation-in-adults-including-pregnant-women-interventions
https://www.uspreventiveservicestaskforce.org/Page/Document/final-research-plan/tobacco-and-nicotine-use-prevention-in-children-and-adolescents-primary-care-interventions

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Alert readers point out a gender alcohol gap. However, Great Britain has a lower ceiling for men and the recommendations for men and women are the same: https://www.nhs.uk/news/lifestyle-and-exercise/people-who-drink-above-uk-alcohol-guidelines-lose-one-two-years-life/.

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