At-risk drinking in an HMO primary care sample: prevalence and health policy implications.

OBJECTIVES: This study was designed to determine the prevalence of at-risk drinking using varying alcohol use criteria. METHODS: A period prevalence survey was conducted in 22 primary care practices (n = 19372 adults). RESULTS: The frequency of at-risk alcohol use varied from 7.5% (World Health Organization criteria) to 19.7% (National Institute on Alcohol Abuse and Alcoholism criteria). A stepwise logistic model using National Institute on Alcohol Abuse and Alcoholism criteria found male gender, current tobacco use, never married status, retirement, and unemployment to be significant predictors of at-risk alcohol use. CONCLUSIONS: Public health policy needs to move to a primary care paradigm focusing on identification and treatment of at-risk drinkers.