Discussing alcohol consumption with your physician is an under-utilized downstream intervention technique.

Discussing alcohol consumption with your physician is an under-utilized downstream intervention technique.

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Binge Drinking as a Behavioral Risk Factor
After reading that Binge Drinking was a choice of risk factors, my first thought was of a guy I met in college when I obtained my first undergraduate degree. He was a junior when I was a freshman. We were not close, but I considered him a friend. My friend devised a system to study and excel in his classwork that enabled him to binge drink as well. He would study intensely during the first part of the week until 11 PM on Thursday night. When asked if he wanted to join our group for flag football or some other extra-curricular activity, he would always give the same reply, “Nope. I’m saving it for the weekend, baby!” Come 11 PM on every Thursday night, he put his textbooks away. Then, he would shower, dress to go out, and commence to binge drinking. He would party all weekend. Unless he was sick, this was his routine week in and week out. He could consume massive amounts of alcohol from Thursday night through Sunday evening. Our group of friends affectionately referred to him as “Brainiac” during the week and “Maniac” on the weekends.
Binge drinking is rampant on college campuses today. Having more than four drinks in one instance is classified as binge drinking for males. Drinking more than three drinks in one incident is regarded as binge drinking for females (Jennison, 2004). Overindulging introduces numerous possibilities for immediate harm to students such as drinking and driving, alcohol poisoning, potential violence, and unsafe sexual activity. Long term effects of binge drinking may develop into alcohol dependence (Jennison, 2004). Chronic alcohol abuse has been shown to cause brain damage, cirrhosis or other forms of liver damage such as liver cancer. In Georgia, 51,000 youths age 12-17 participate in binge drinking, approximately 6% of the population. In stark contrast, 35% or 376,000 of Georgia’s 18-25-year-olds binge drink (“KIDS,” 2014).
Interventions
Downstream or individual interventions for binge drinking include encouraging attendance at Alcoholics Anonymous support groups. These self-help groups can be cathartic and impactful. Providing evidence-based information on the effects of alcohol can be another intervention. Frank discussion of the harmful effects of binge drinking is a valuable technique to decrease risky behavior. Discussion can originate from reading hardcopy pamphlets, television and radio commercials, or viewing blurbs via social media networking (Kovner, Knickman, Weisfeld, & Jonas, 2011). Discussing alcohol consumption with your physician is an under-utilized downstream interventional technique. “Only 10.5% of adults seen in primary care settings were screened for alcohol misuse and referred for treatment” (Kovner et al., 2011, p. 141). This account regarding physician interaction was paraphrased from a McGlynn et al. study published in 2003 (McGlynn et al., 2003). Creating a dialog about drinking with your primary care provider is certainly beneficial. The exchange of ideas may prevent misuse or result in seeking treatment for dependence if needed.
Population-level inhibition of behavioral risk factors is referred to as midstream interventions (Kovner et al., 2011). Many elementary and middle schools in Georgia implement Drug Abuse Resistance Education (DARE) programs. These programs are examples of midstream interventions that can prevent alcohol misuse. The cognitive and behavioral ideals taught to children in the DARE program will hopefully be carried into adulthood.
Upstream interventions are broad scale. These interventions work on the state or national level (Kovner et al., 2011). Television commercials condemning the effects of alcohol represent effective means of upstream mediation. Every original container of alcohol has a government warning printed somewhere on the labeling of the bottle or can. This warning has advice from the United States Surgeon General in reference to the harmful effects of alcohol. A final example of upstream intervention would be the state of Georgia placing a substantial tax on alcoholic beverages similar to the tax imposed upon tobacco products. Markedly increasing the price for alcohol would be an effective deterrent to consumption.

References
Binge alcohol drinking among youths by age group. (2014). Retrieved from https://datacenter.kidscount.org/data/tables/38-binge-alcohol-drinking-among-youths-by-age-group?loc=1#detailed/2/2-52/false/909,857,105,118,104/30,31/14407,315
Jennison, K. M. (2004, August 1). The short-term effects and unintended long-term consequences of binge drinking in college: a 10-year follow-up study. The American Journal Of Drug And Alcohol Abuse, 30(3), 659-684. Retrieved from https://web.a.ebscohost.com.ezp.waldenulibrary.org/ehost/detail/detail?vid=3&sid=9d2441b6-3211-4af6-a4ba-a21ebd281c3a%40sessionmgr4003&hid=4107&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=mnh&AN=15540499
Kovner, A. R., Knickman, J. R., Weisfeld, V. D., & Jonas, S. (Eds.). (2011). Jonas & Kovner’s Health care delivery in the United States (10 ed.). New York, NY: Springer Publishing Company.
McGlynn, E. A., Asch, S. M., Adams, J., Keesey, J., Hicks, J., DeCristafaro, A., & Kerr, E. A. (2003, June 26). The Quality of Health Care Delivered to Adults in the United States. The New England Journal of Medicine, 348(26), 2635-45. https://dx.doi.org/10.1056/NEJMsa022615