Patient Story: Helping to Lift a Black Cloud

By Jonathan Zarov — 

Rachel Sanchez, BS, is the health educator at Gundersen Lutheran, where she has been helping patients since November 2009. Gundersen Lutheran began delivering services as part of WIPHL’s original Substance Abuse and Mental Health Services Administration (SAMHSA) grant. She tells this story…

I met with a female patient when she came in for her annual physical. She had mentioned to me at that time she was drinking more, due to depression from being unemployed and financially frustrated.

When I met with her in the clinic, she was beginning to become concerned with her alcohol use. As we talked, she started to realize she was drinking more to cope with her struggles. She spoke of how it had started out slowly, drinking wine; now it was becoming part of her daily routine. We discussed a change plan – brief, small steps she could begin taking. She had many goals and we worked through the ones she listed as priority. I provided her with follow-up weekly.

When I met with her again in the Gundersen Lutheran hospital (about 7 months later), she was in for a same day procedure, and she seemed a completely different person. Despite being in the hospital, she had a smile on her face. She had her husband and daughter with her, which was something she was struggling with when I had met her prior — lack of support and understanding. They were right by her side. She was really happy to see me! She even introduced me to her family, remembering my name. She filled me in on what had changed. She described her changes in alcohol use (decreased, would be considered low-risk). The “black cloud” had lifted. I could see this too.

Not only was she provided with SBIRT services in our clinic, but in the hospital! What a vital service!

Wisconsin Once Again Tops the List of States in Several Measures of Dangerous, Costly Drinking Patterns

By Richard L. Brown, MD, MPH

Binge drinking” refers to drinking above the recommended low-risk guidelines within a short period of time. Those limits are no more than four alcoholic drinks for men and no more than three alcoholic drinks for women. Data from the most recent nationwide survey ranks Wisconsin as the state with the highest percentage of adults who binge drink, with an estimated 25.6%. Wisconsin also came in highest for the average largest number of drinks within a short period of time among binge drinkers at nine drinks. For more about the risks to individuals and communities posed by misuse of alcohol, and effective strategies to address this problem, see the Center for Disease Control’s “Vital Signs” page on Binge Drinking.

Price and Drinking

By Richard L. Brown, MD, MPH

A study in the May 2012 issue of Addiction reports an analysis of drinking patterns in British Columbia as the price of alcoholic beverages varied over 20 years. The study suggests that raising the price of alcohol substantially decreases consumption. Recently Prime Minister David Cameron has proposed that the UK establish minimal alcohol pricing to address its increasing alcohol problems. Wisconsin, which leads the US in binge drinking, continues to have the second or third lowest beer taxes in the United States, at sixth-tenths of a penny for 12 ounces.

National Study Finds Little Receipt of SBIRT For Young, Risky Drinkers

By Richard L. Brown, MD, MPH

A national study, published in the September 2011 issue of the “Journal of General Internal Medicine,” reported on the proportion of about 4,000 18- to 39-year-old Americans who received medical care and alcohol screening and intervention in the prior year. Of the two-thirds who saw a doctor in the past year, only 14% of risky drinkers received advice to cut down.

Alcohol Screening and Intervention in EDs Reduces Risky Drinking and Intoxicated Driving

By Richard L. Brown, MD, MPH

A Yale University study compared drinking and intoxicated driving among risky and harmful drinkers patients who received brief intervention and a follow-up phone call, brief intervention without phone follow-up, and usual care. All patients who received brief interventions with or without phone follow-up manifested greater declines in drinking and intoxicated driving. The study, authored by Gail D’Onofrio, MD, MS and others, was reported online on March 30 by the Annals of Emergency Medicine.

Full study…

5 Steps for Respectful, Collaborative Patient Communication

By Mia Croyle, MA

Often in the process of talking to patients about behavior change, there comes a point when a practitioner needs to share some information with the patient. Here is a 5-step process for sharing information in a respectful, collaborative, and patient-friendly way:

  1. Ask the patient’s permission
    “Would it be OK if we spend a little time talking about the connection between alcohol use and managing your blood sugar?”
  2.  Explore what the patient might already know
    “First of all, what do you already know about the connection between alcohol and blood sugar?”
  3. Offer additional information, as needed.
    “So you’ve already noticed some connection, just from monitoring your blood sugar readings. You’re not so sure what a safe amount for you to drink might be. Let me tell you what my take on that is….”
  4. Explore the patient’s reactions to the information you have shared.
    “I wonder, what are your thoughts about that?”
  5. Reflect on what you hear from the patient.
    “So it sounds like reducing the amount you drink would be something you are willing to try, if it means your blood sugar will be better controlled.”