Doctors Reminded to Screen for Alcohol Problems Primary care doctors and nurses should screen their adult patients to determine whether they are misusing alcohol, and provide counseling when risky behavior is detected, a panel of medical experts reaffirmed on Monday. About a third of Americans misuse alcohol, though far fewer are addicted, according to the panel, the United States Preventive Services Task Force. The misuse results in an estimated 85,000 deaths a year, making illness related to alcohol abuse the third-leading cause of preventable death in the United States, after smoking and obesity. After reviewing recent research, the panel concluded that primary care doctors and nurses could help patients cut down on drinking by offering a brief counseling session or a series of sessions. Doctors would determine whether counseling was needed by asking a simple set of questions about alcohol use during the patient's primary care visit. The National Institute on Alcohol Abuse and Alcoholism considers more than 14 drinks a week excessive for men and more than seven drinks a week excessive for women. It says daily consumption should not be more than four drinks for men and three for women. The questions that doctors should ask, the task force said, include, "How often do you have a drink containing alcohol?" and "How often do you have five or more drinks on one occasion?" The task force did not recommend the same screening and counseling for adolescents because, it said, it was less clear whether the benefits would outweigh the potential harm, like anxiety or the stigma of being singled out. Susan Curry, a panel member, emphasized that the recommendation was preventive, designed to keep people who drank more alcohol than they should from becoming alcoholics. People who are already addicted need more extensive help, she said, like therapy in rehabilitation clinics. "This says, "Let's pay attention," " said Dr. Curry, who is the dean of the College of Public Health at the University of Iowa. " "You may want to take a look at how you are drinking. If it escalates, you're at risk, but you can change that now." " The panel based its recommendations on a review of research that showed counseling helped reduce binge drinking. According to those studies, the number of adults with risky drinking behaviors who reported no heavy drinking within a year was 12 percent higher among those who received counseling than those who did not. The research also indicated that several sessions of counseling were more effective than only one. It also found that counseling helped patients who drank more than the recommended limit reduce their weekly consumption. Patients who had received counseling consumed an average of 19 drinks a week, down from 23, the panel said, while those who received no counseling did not change their level. The task force is a group of 16 experts, who are appointed by the government but independent, that makes recommendations about screening tests and other efforts to prevent disease. The strongest of the panel's recommendations are now hard-wired into the country's health care system through the Affordable Care Act, which requires health insurance companies to cover many of the services or treatments free of charge to the patient. The recommendation about alcohol screening falls into that category. The recommendations, issued in draft form on Monday, will be published in a final version after a public comment period. They are not new; the panel is reaffirming its advice from 2004. While few dispute the value of offering alcohol counseling to those who need it, primary care doctors are not always able to take the time to follow through. A 2004 study published in the American Journal of Preventive Medicine that used national data estimated that 45 percent of adults reported being asked about their alcohol use during a routine primary care visit. Among those with risky drinking patterns, about 60 percent reported being asked. Alcohol misuse contributes to many illnesses, the panel said, including hypertension, liver disease and breast and esophageal cancers. The studies were not designed to measure the effect that counseling had on mortality rates, the panel said.