The National Institutes of Health have issued new guidelines for American doctors to diagnose and treat alcohol “abuse”:

With alcohol abuse […] most physicians don’t go looking for trouble and don’t recognize it until it’s breathing in their face. Over-drinking patients often don’t think of looking for help even if they know they are heading in the wrong direction. And society as a rule looks at alcohol treatment as a last-chance, 90-degree corner taken only at high speed.

All this will change if American physicians adopt the new guidelines for “Helping Patients Who Drink Too Much” promulgated by the National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health.

The idea is to simplify the screening for excessive alcohol use in general medical practice and to convince clinicians and patients that early intervention for drinking that hasn’t yet wreaked havoc is both possible and useful.

“We’re trying to increase the accessibility and attractiveness of treatment to a much broader spectrum of people,” said Mark L. Willenbring, a psychiatrist who directs the Division of Treatment and Recovery Research at NIAAA.

Those especially targeted in the guidelines are heavy drinkers who are not yet physically dependent on alcohol but are at risk for becoming so.

a.k.a. - People who don’t have a problem.

“We know that that group responds very, very well to what we call facilitated self-change and brief motivational counseling. We could make that very widely available without much cost,” Willenbring said.

“Facilitated self-change?” That makes about as much sense as ‘mandatory volunteerism.’

A big part of the new strategy is to make primary care physicians — people without specialized training in addiction medicine — think about alcohol abuse the way many now think about depression, anxiety and obsessive-compulsive disorder.

Yes, because it makes all the sense in the world to equate a conscious decision to drink with an overwhelming desire to kill yourself, helpless panicking, and insatiable need for order.

Look, if your doctor wants to hector you about your drinking, that’s between you and your doctor. But the NIAAA is just another government organization establishing new rules to justify its own existence (read funding).

Heavy drinking isn’t a disease…it’s just a rack of disciprine.

Filed under: Profiles in Governance