Screening for alcohol abuse among women in childbearing years : preventing fetal alcohol syndrome
Fetal alcohol syndrome (FAS) is the leading cause of birth defects, including mental retardation, in the United States. There is no known safe level of alcohol consumption during pregnancy; therefore, prevention is of paramount importance. This study was designed to determine the extent of screening by obstetricians/gynecologists for potential alcohol abuse among patients of childbearing years. The subjects were obstetricians/gynecologists practicing in Illinois who responded to a survey asking questions about screening processes for alcohol abuse among female patients 15 - 44 years of age. Hypothetical situations, personal opinions on the treatment of alcoholism and demographics were also included in the survey. One- hundred-nine surveys were returned representing a 13.6 percent return rate. Seventy-eight percent of the respondents reported always asking their patients about drinking alcohol, 74 percent preferred a verbal inquiry, and 21 percent preferred a verbal and written inquiry. Eighty-four percent reported always asking patients if they drank since becoming pregnant, 72 percent preferred a verbal inquiry, and 22 percent a verbal and written inquiry. Physicians were asked if they utilized any of the 3 established screening methods to assess alcohol abuse (CAGE, Michigan Alcohol Screening Test [MAST] and The Ten Question Drinking History [TQDH], which is specifically designed to identify heavy drinking among obstetric patients). Eighty-one percent reported not using any type of questionnaire, 10 percent indicated •'other" category. Each of the formal screening methods was used less than 1 percent. Strong support for the value of screening and early diagnosis is provided by numerous studies indicating the benefits of intervention and treatment for persons selected through the screening process. This study found that obstetricians/gynecologists inquire about alcohol consumption among their patients; however, they are not routinely using tools which have been shown effective in identifying alcohol abuse.