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Subst Abus. 2017 Jul-Sep;38(3):253-256. doi: 10.1080/08897077.2015.1048922. Epub 2015 Jul 9.

Patient perceptions of risky drinking: Knowledge of daily and weekly low-risk guidelines and standard drink sizes.

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a Missouri Institute of Mental Health , University of Missouri , St. Louis , Missouri , USA.
b Department of Family and Community Medicine , University of Missouri School of Medicine , Columbia , Missouri , USA.



Effective intervention for risky drinking requires that clinicians and patients know low-risk daily and weekly guidelines and what constitutes a "standard drink." The authors hypothesized that most patients lack this knowledge, and that education is required.


Following primary care visits, patients completed anonymous exit questionnaires that included the 3 Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questions, "How many drinks (containing alcohol) can you safely have in one day?" and questions about size, in ounces, of a standard drink of wine, beer, and liquor. Descriptive analyses were done in Stata.


Of 1,331 respondents (60% female, mean age: 49.6, SD = 17.5), 21% screened positive on the AUDIT-C for risky drinking. Only 10% of those accurately estimated daily low-risk limits, with 9% accurate on weekly limits, and half estimated low-risk limits at or below guidelines. Fewer than half who checked "Yes" to "Do you know what a 'standard drink' is?" provided accurate answers for beer, wine, or liquor. Patients with a positive screen were twice as likely to say they knew what a standard drink is, but only a third gave accurate estimates. When asked about plans in the next month regarding change in drinking behavior, 23% with a positive AUDIT-C indicated they were at least considering a change.


Most patients in primary care don't know specifics of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines for low-risk drinking. Exploring patient perceptions of low-risk guidelines and current drinking behavior may reveal discrepancies worth discussing. For risky drinkers, most of whom don't know daily and weekly low-risk guidelines or standard drink sizes, education can be vital in intervening. Findings suggest the need for detailed and explicit social marketing and communication on exactly what low-risk drinking entails.


Alcohol abuse; drinking guidelines; patient knowledge

[Indexed for MEDLINE]

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