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Alcohol:
Wellness Professionals
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Wellness professionals provide valued information to clients about ways to improve their overall health. This presents a good opportunity to educate about alcohol: how different levels of consumption affect various other health risks, what are lower-risk levels of alcohol consumption, the dangers of risky drinking, and the health effects of each. Discussing alcohol risks as they relate to general health issues puts alcohol in a health-maintenance or disease perspective, in contrast to approaching alcohol usage as a moral or religious issue. This reduces the stigma of discussing alcohol for both the client and the counselor, increasing the opportunities for open and honest communication about drinking patterns. When wellness professionals have information about alcohol use guidelines and some experience in asking alcohol-related questions, personal discomfort with the issue or concern that the client may become upset if alcohol is discussed fades away. Wellness professionals discover that most clients welcome alcohol education when it is provided in this content.
Health risk factors such as high blood pressure, lack of exercise, high cholesterol, and/or excess weight can be partly a function of excessive alcohol use. Regular high-risk drinking can result in greater risk for higher triglyceride levels, impaired liver function, heart failure, stroke, and certain cancers. It also increases the risk of accidents, violence, suicide and the risk of birth defects.
Just as we provide specific numbers or ranges which clients should strive to reach in controlling cholesterol, blood pressure and weight, it is important to provide appropriate guidelines for safer drinking. In the past we have only said to drink moderately but there has been confusion as to what is meant by moderate alcohol consumption. The National Institute for Alcohol Abuse and Alcoholism, one of the Public Health Service's National Institutes of Health, offers these guidelines for moderate or low-risk drinking:
| NIAAA Guidelines for Moderate Drinking 1,3 |
| Men |
No more than 2 drinks/day and at least 1 day each week with no alcohol 2 |
| Women and those over 65 |
No more than 1 drink/day and at least 1 day each week with no alcohol 2 |
| For everyone |
Avoid even moderate drinking in certain situations such as driving, caring for children, or taking certain medications |
Another area of risky drinking involves occasional heavier alcohol consumption. What is sometimes called binge drinking includes consumption of 5 or more drinks on one occasion for men and 4 or more drinks on an occasion for women. Many people understand that this level of drinking is dangerous if it happens often. People may not realize, however, that this level of alcohol consumption damages liver function, even if it happens only a few times a year, such as at weddings or during holidays. Too rapid consumption of alcohol, even in lesser amounts, is also detrimental. (It should take at least one hour for an average person to consume one drink).
When conducting a health assessment, it is easy to include questions regarding alcohol use. Information provided during the course of the assessment can frame alcohol risks in relation to other, less stigmatized risks such as high blood pressure. A health assessment by itself, however, often produces little behavior change, but provides an opportunity to establish rapport and to gain permission to proactively follow up with clients who have health risks. The Wellness Counseling Protocols listed below provide a framework for addressing various health risks during follow-up counseling.
The above recommendations about alcohol moderation stem from a study that examines the impact of wellness counseling on alcohol risk reduction and the impact of alcohol risk reduction on overall health. It was funded by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) through its Center for Substance Abuse Prevention (CSAP).
Notes:
- How to Cut Down on Your Drinking, a pamphlet published by the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD. Updated February 2001.
- A drink equals 12 ounces of regular beer, 4 ounces of table wine, 3 ounces of fortified wine, 12 ounces of wine cooler, or 1½ ounces of liquor.
- Individuals with a personal or family history of alcoholism are more at-risk for alcohol dependency and should use more caution in applying these guidelines.
- Broadening the Base of Treatment for Alcohol Problems. Institute of Medicine. Washington, DC: National Academy Press, 1990.
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