Should Doctors ‘Prescribe’ a Drink a Day? No.

From the NYTimes:

The evidence regarding wine versus other beverages like grape juice is mixed.

For most people, low-risk drinking is not harmful to health — and may be helpful. However, I would discourage people from drinking in order to improve their health.

Compared with non-drinkers, men who consumed wine, beer, or spirits had a 36% lower risk of all-cause mortality and a 34% lower risk of cardiovascular mortality.

Before you recommend wine for cardiovascular risk reduction, consider this:

- One in five men at risk of drinking problem during their lifetimes

- Women have an 8 to 10 percent chance of becoming dependent on alcohol during their lifetimes

- Men have 15% lifetime risk for alcohol abuse, 10% risk for alcohol dependence. Each cuts your life short by 10-15 years.

- Heavy drinking increases risk of depression by 40%, and 80% of people dependent on alcohol are smokers

Alcohol literally kills: Gary Moore had 380mg/dL in his blood, Winehouse 416mg/dL when she died surrounded by 3 empty vodka bottles. Telegraph UK, 2012. 

References:

Should Doctors ‘Prescribe’ a Drink a Day? NYtimes, 2010.

A glass of wine daily may prolong life. How can you predict which patient will have a bottle daily though?

Before you recommend wine for CV risk reduction, consider this: 1 in 5 men at risk of drinking problem
Rethinking Drinking - NIH interactive website
Image source: Wikipedia, public domain.

Comments from Twitter:

OMC ‏ @charlesayanleke: That's a recommendation most peeps can get behind

Tibor Banyai ‏ @tibor75: Do u tell your AF pts to be 100% abstinent? Curious RT @drjohnm: RT @DrVes: Should Doctors ‘Prescribe’ a Drink a Day? No.

John Mandrola, MD ‏ @drjohnm:  No I don't rec abstinence but I don't feel that alcohol adds to health. Mild intake prob neutral. Worry about cancer risk

When physicians prescribe a new medication... confusion ensues

According to a 2006 study of physician-patient communication during primary care visits, when physicians prescribed a new medication they:

- did not tell the patient the name of the new medication in 26% of the cases (the other way to look at the data is that the physicians stated the specific medication name for 74% of new prescriptions)

- did not explain the purpose of the medication to patients in 13% of cases (explained the purpose of the medication for 87%)

- did not tell patient about adverse side effects of the medication in 65% of cases

- did not describe to patients how long to take the medication in 66% of cases

- did not tell patients the number of pills to take in 45% of cases

- did not tell patients about medication dosing and timing in 42% of cases

References:

Hospitals: Check doctor's communication skills before buying the practice. ACP Blog.

Physician Communication When Prescribing New Medications. Arch Intern Med. 2006;166:1855-1862.

Image source: Wikipedia, public domain.