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Richard D. Moore, MD, MHSc; Lee R. Bone, MPH; Gail Geller, MHSc; Joyce A. Mamon, PhD; Emma J. Stokes, PhD; David M. Levine, MD, ScD

JAMA. 1989;261(3):403-407.

Abstract
As part of an institution-wide program to enhance the education of physicians in diagnosing and treating alcohol dependence and abuse, a comprehensive survey was conducted in which all new admissions to the adult inpatient services of The Johns Hopkins Hospital were screened for alcoholism. The prevalence of screen-positive alcoholism, by department, was as follows: medicine (25%), psychiatry (30%), neurology (19%), obstetrics-gynecology (12.5%), and surgery (23%). Detection rates by the house staff and faculty physicians caring for those patients who screened positively were less than 25% in surgery and obstetrics-gynecology, between 25% and 50% in neurology and medicine, and greater than 50% in psychiatry. However, physicians were less likely to identify as alcoholic those patients with higher incomes, higher education, or private medical insurance; women; and those who denied heavy alcohol intake. Physician-instituted treatment rates for those patients diagnosed by the physician as having nonrecovered alcoholism were less than 50% in surgery and obstetrics-gynecology, between 50% and 75% in medicine and neurology, and 100% in psychiatry. The extent to which the physicians intervened while the patient was hospitalized correlated with the patient's reported change in alcohol use after discharge. Recommendations based on these data are being incorporated into the medical education curriculum.

(JAMA 1989;261:403-407)

Author Affiliations
From the Department of Medicine, The Johns Hopkins University School of Medicine (Drs Moore and Levine and Ms Geller); the Blades Center for Practice, Teaching and Research in Alcoholism (Dr Stokes); and the Department of Health Policy and Management, The Johns Hopkins School of Hygiene and Public Health (Dr Mamon and Ms Bone), Baltimore.

Footnotes
Reprint requests to The Johns Hopkins Hospital, 1830 E Monument St, Eighth Floor, Baltimore, MD 21205 (Dr Moore).

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