Past Experience of Advice and Treatment for Drinking Problems of Patients with Alcoholic Liver Disease

Summary Using a standarised questionnaire we interviewed 156 patients with newly‐diagnosed alcoholic liver disease to establish whether they had been advised in the past to reduce their alcohol consumption and if they had been referred for treatment of an alcohol problem. A detailed assessment of their lifetime alcohol intake and severity of alcohol dependence was also undertaken. Most patients has a long history of excessive drinking (mean duration 17.3 years), yet only 69 (44%) said thay they had been advised by their general practitioners to reduce or stop drinking. This was corroborated by a review of a case records. Only 35 patients (22%) had been referred to a hospital clinic and 16 (10%) had attended an alcoholism counselling service or Alcoholics Anonymous. Patients who had received some intervention had a relatively higher mean daily alcohol intake and were more severely dependent on alcohol. These results suggest that most patients who develop alcoholic liver disease escape detection for many years because they have a relatively mild alcohol dependence syndrome. To limit the increasing morbidity from alcoholic liver disease emphasis must be placed on trying to identify and treat a broader spectrum of excessive drinkers than has been the case hitherto.