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Ninety medical records of patients with an alcohol-related diagnosis who were admitted to a major city teaching hospital over a 12-month period were reviewed to assess the ways in which the problem had been recognized and managed by hospital staff members. The overall frequency of an alcohol-related diagnosis of 1.8% suggested an under-reporting of this medical problem. Those patients who were identified were, in general, well managed, but patients with less obvious and permanent clinical problems, such as non-dependent abuse of alcohol or acute alcoholic intoxication, were more likely to have minimal or no attention directed to the drinking problem. Our review suggests that medically trained staff members identify significant organ damage readily. It also suggested that more attention needs to be directed to the education of medical students and staff members in the recognition of the early stages of alcohol dependency and misuse, so that its more serious complications might be minimized by effective intervention.
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