Explaining the risks and benefits of alcohol

Learn the current recommendations on alcohol use and abuse, the reasoning behind them, and how doctors can best talk to patients about the subject.

Conflicting reports on the benefits and risks of alcohol can leave patients, and even physicians, confused. Is it good for the heart? Does it increase breast cancer risk? As with many if not most areas of clinical concern, the right answer depends on the circumstances of each particular patient. For women with a family history of breast cancer, more than a drink a day is probably not a good idea, but for postmenopausal women at high cardiovascular risk, a glass of wine now and then might be beneficial. Then there's the related issue of how much “one drink” really is. Patients' ideas of a single serving of alcohol might in reality be closer to two, or even more. In our story, Kathy Holliman delves into the current recommendations on alcohol consumption, the reasoning behind them and how doctors can communicate them effectively to patients.

Next, Terri D’Arrigo tackles the topic of anxiety in the elderly, not an uncommon problem in primary care. Physicians caring for elderly patients need to use care and caution to suss out the disorder, which can be difficult to detect because its symptoms can be similar to those of other comorbidities. And determining the most effective treatment can be a challenge, too, since drugs such as benzodiazepines, which are commonly prescribed in elderly patients, may hurt more than they help. Read our story to learn more about how to detect anxiety in elderly patients and the best ways to go about managing it.

In our conference coverage section in this issue, Stacey Butterfield provides updates from the American Academy of Family Physicians' annual meeting, held in Philadelphia this past October. Our story includes tips on how to help improve older patients' memory, including using a diary or playing computer games, while our story on offers advice on creating a practice environment that's welcoming to gay, lesbian, bisexual and transgender patients.

Finally, in our residency column, Joshua Liao, MD, an ACP Associate Member and an internal medicine resident at Brigham and Women's Hospital, reflects on what he's learned so far in his first year of residency, including the importance of one's peers to a high-quality medical education.

It's the first issue of 2013, and the ACP Internist staff looks forward to another year of covering the most recent developments in health care and keeping you up to date. You can find us online, on our blog and on Twitter. We always welcome your comments.


Jennifer Kearney-Strouse