Management of heavy drinkers.

1. The amount of alcohol consumed per capita in the UK has approximately doubled since 1950. 2. One unit of alcohol is equivalent to around 8 g of pure alcohol (half a pint of beer, a single bar measure of spirits or glass of wine). 3. Consumption of above 21 units a week for men and 14 units a week for women carries an increasing risk of alcohol-related damage. Pregnant women are usually advised to abstain. 4. Newly registered patients should be asked if they have consumed any alcohol in the last three months and if so how much they consume in an average week using a quantity frequency scale. 5. In those in whom there is concern about their drinking a systematic 7-day history gives the best estimate of consumption. 6. Heavy drinking should also be considered in a wide range of clinical circumstances, including hypertension, injuries and accidents, marital disharmony and child abuse, dyspepsia, hepatic damage, memory impairment and dementia. Sudden withdrawal may cause fits which may lead to a mistaken diagnosis of epilepsy. 7. Laboratory tests pick up only 30-50% of heavy drinkers but may be useful in monitoring progress and in motivating patients to cut down. 8. It is important to decide whether a patient is dependent on alcohol as dependent drinkers are unlikely to be able to keep their consumption at modest levels. The possibility of psychological and social problems due to alcohol should also be considered. The use of drugs should be explored in dependent drinkers.(ABSTRACT TRUNCATED AT 250 WORDS)