This review for family physicians notes that about one in ten people aged 12 and over in the United States had alcohol use disorder in 2024, making it one of the commonest chronic conditions in primary care. It carries risks across the liver, heart and brain, and higher rates of anxiety, depression, trauma, suicide and injury.
The approach it sets out is practical. Screen adults with a brief validated tool such as AUDIT-C. For those with the disorder, examine for complications, check bloods and assess the liver for fibrosis, and estimate the risk of withdrawal. Everyone should receive brief behavioural counselling, with treatment or referral where indicated. Treating co-existing mental illness improves the chance of recovery from both. Routine vaccines, including pneumococcal vaccine from age 19, should be offered.
In Indian practice, alcohol use is often under-reported and rarely asked about in a short consultation. A single structured question set makes it routine rather than awkward.
- Screen adults for unhealthy alcohol use with AUDIT-C or a similar brief tool.
- For alcohol use disorder, check liver function and consider a fibrosis assessment.
- Assess withdrawal risk before advising anyone to stop drinking abruptly.
- Offer brief counselling to every patient with the disorder, and treat or refer as needed.
- Look for and treat co-existing depression and anxiety.
Why it matters
Alcohol use disorder is common, treatable in primary care, and often missed because no one asks.
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