Alcohol Use
Authors: E. Jennifer Edelman, David A. Fiellin
Journal: Annals of Internal Medicine (2016)

Letters6 September 2016Alcohol UseE. Jennifer Edelman, MD, MHS and David A. Fiellin, MDE. Jennifer Edelman, MD, MHSFrom Yale University School of Medicine, New Haven, Connecticut. and David A. Fiellin, MDFrom Yale University School of Medicine, New Haven, Connecticut.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0107 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the attention to our work and the opportunity to reply. First, we disagree with Drs. Braillon and Menkes' assertion that only experimental data should guide practice and policy—especially in areas of health that involve carcinogenic and addictive substances, where randomization poses ethical challenges. In such circumstances, methodologically rigorous observational studies can provide valid guidance (1). Such studies show that lower-risk alcohol use is cardioprotective (2). Regardless, because of adverse medical, psychiatric, and behavioral effects associated with alcohol and often seen in a dose–response fashion, we reiterate that "these data should not translate into recommendations for initiation ...References1. Concato J, Shah N, Horwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med. 2000;342:1887-92. [PMID: 10861325] CrossrefMedlineGoogle Scholar2. Roerecke M, Rehm J. Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers. BMC Med. 2014;12:182. [PMID: 25567363] doi:10.1186/s12916-014-0182-6 CrossrefMedlineGoogle Scholar3. Jonas DE, Garbutt JC, Amick HR, Brown JM, Brownley KA, Council CL, et al. Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2012;157:645-54. [PMID: 23007881] LinkGoogle Scholar4. Jonas DE, Amick HR, Feltner C, Bobashev G, Thomas K, Wines R, et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA. 2014;311:1889-900. [PMID: 24825644] doi:10.1001/jama.2014.3628 CrossrefMedlineGoogle Scholar5. Nunes EV, Levin FR. Treatment of depression in patients with alcohol or other drug dependence: a meta-analysis. JAMA. 2004;291:1887-96. [PMID: 15100209] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Yale University School of Medicine, New Haven, Connecticut.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2510. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAlcohol Use E. Jennifer Edelman and David A. Fiellin Alcohol Use Alain Braillon and David B. Menkes Alcohol Use David P. Dooley and Thomas M. Brown Metrics Cited byDefining the psychiatric and financial burden of mental and substance use disorders in cancer patientsAlcohol UseJoseph H. Donroe, MD, MPH, MHS, E. Jennifer Edelman, MD, MHSAssociation Between Alcohol Intake and Prostate Specific Antigen Screening: Results From a National Behavioral SurveyIntensive care utilization in patients with end-stage liver disease: A population-based comparative study of cohorts with and without comorbid hepatocellular carcinoma in TaiwanAltered neural dynamics in occipital cortices serving visual-spatial processing in heavy alcohol usersAn Interprofessional Substance Use Disorder Course to Improve Students' Educational Outcomes and Patients' Treatment Decisions 6 September 2016Volume 165, Issue 5Page: 379-380KeywordsAlcoholismAlcoholsDisclosureDrug therapyHyperlipidemiaMetabolic syndromeObservational studiesPatient Protection and Affordable Care ActPrevention, policy, and public healthThiamine ePublished: 6 September 2016 Issue Published: 6 September 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...