Wednesday, March 30, 2016

Do medical students have drinking problems?

A study from the Mayo Clinic says one-third of US medical students drink too much alcohol and something must be done about it.

In 2012, the authors sent a survey with questions about alcohol abuse, burnout, depression, fatigue, suicidal ideation, and quality of life to 12,500 medical students of whom 4402 (35.2%) responded.

Of those responding, 1411 (32.4%) “met diagnostic criteria for alcohol abuse/dependence.”

According to the Mayo Clinic’s press release, “Nationally, that translates to about one-third of those responding, compared to only 16 percent of peers not in medical school, and double the rate of alcohol abuse or dependence of surgeons, US physicians or the general public based on earlier research by this team.”

The paper also found that burn out, depression, high educational debt, being unmarried, and being younger were associated with dependence on or abuse of alcohol.

The authors called for a multifaceted approach “addressing burnout, medical education costs, and alcohol use.”

Here are some problems with this study.

The criterion for designating a medical student as of using or dependent on alcohol was based on a three-question screening document called the Alcohol Use Disorders Identification Test (AUDIT-C).

An individual who has a single alcoholic drink two or three times a week would get a score of 3 and having one drink per day on four or more days per week results in a score of 4. The bar is set unusually low [particularly for women] because a score of 3 for a woman and 4 for a man is considered positive for alcohol abuse/dependence.

However, many instructions for administering the AUDIT-C state, "If all points are from Question 1, assume the patient is drinking below recommended limits and the medical provider should review the patient’s alcohol intake during the past few months." I don't think that was possible for the 1411 medical students assumed to be problem drinkers.

Do medical students indulge in alcohol in greater degrees than their peers?

Although not based on the AUDIT-C screen, the following table, taken from the Substance Abuse and Mental Health Services Administration (SAMHSA) 2014 National Survey on Drug Use and Health, is interesting.

The table shows that 39.0% and 37.9% of full-time college students engaged in binge drinking in 2013 and 2014, respectively. That is more than the 32.4% of medical students considered problem drinkers.Note that the percentages rise as ages increase from 18 to 22.

Do we have a problem with young people drinking too much? Yes. Do medical students drink more than their peers? I don't think so. Should we do something about medical school tuition? Yes, but exactly what should we do? What about burnout? Good luck with that one. Maybe puppies?


artiger said...

I thought it was tradition for med students to drink a lot. I know we sure did. It's one of those things most of us grew out of. Perhaps if work hours were increased there would be less time for drinking.

Anonymous said...

I think the concern I have is that they are using alcohol as a crutch instead of relying on relationships to solve issues. By the time you hit medical school, I would think that emotional maturity would be there enough to know that.

Skeptical Scalpel said...

Artiger, I agree. QWhen the paper first came out and was all over Twitter, I tweeted that I was surprised it was only one-third of med students.

Anon, yes they are using alcohol to blow off steam. I think many med students may not be emotionally mature. A lot of my classmates were what we would now call nerds. We did a lot of studying in college and were not great at relationships.

Anonymous said...

I hate to be a tattletale, but check out the level of consciousness instructional video on Is that a beer she is sucking on while delivering the lecture? Seems ironic to me. Is this how acceptable alcohol consumption in medical/nursing personnel has become?

Anonymous said...

I'm a nerd, and the nerds I knew didn't drink. Now and then but they drank less than others and studied. Maybe the culture we came from?

I could see it of the freshman/sophomores in college, but medical school?

artiger said...

It is possible to be a studier and a partier at the same time.

Skeptical Scalpel said...

April 1 anon, haven't you heard? There's enormous crushing pressure on med students today. Burnout and all too.

Artiger, I knew many who fit that description.

William Reichert said...

If you are an orthopedic surgeon , starting Friday you will probably be drinking a lot more than these medical students.

Anonymous said...

I understand there is burnout and pressure. The way to deal with that is to build relationships & do things that will help you. Destroying your liver and learning early that resorting to destructive methods of dealing with issues & life is not a good thing.

I didn't.

Dr. Reichert ROFL.

Skeptical Scalpel said...

I wasn't recommending drinking to solve problems. I was just acknowledging that it happened a lot.

webhillizzy said...

"The bar is set unusually low..." ha ha very funny. They should just raise the bar. Keep it a little bit out of reach. Make them work for it.

Skeptical Scalpel said...

Yes. Incentives are good.

William Reichert said...

I cannot imagine drinking alcohol during the week if you are in medical school ( if you are taking your schooling seriously).
When I went to med school in NYC ,many years ago, we studied
every night. Maybe went out for a beer or two on Saturday night.
Alcohol is a poison. Wake up.

artiger said...

I don't know, Reichert, some consider red meat to be a poison, amongst other things. It's more about the amount than the time of consumption.

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