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Aim: Assessing acceptance of controlled drinking (CD) among French alcohol specialists. Methods: On-line survey of 547 French alcohol specialists. We searched factors associated with acceptance of CD, and factors that affected the specialists' selection of treatment goal. Criteria for success used by specialists in clinical practice were compared with criteria expected to be used in clinical trials. Results: CD was accepted as a treatment goal by 48.6% of alcohol specialists (n = 105, n = 216), and 61.9% practiced CD for their own patients (n = 130, n = 210). Factors in selecting outcome goals were: patient's choice, perceived self-efficacy, relapse history and severity of dependence. Age, profession and basis of specialists' opinion on CD were associated with acceptance of CD. Conclusion: Half of French alcohol specialists accept CD as a goal. Acceptance was associated with specialists' personal and professional characteristics. The criteria for success specialists use in their clinical practice differ from those they expect to be used in clinical trials. [ABSTRACT FROM PUBLISHER]

— The health costs of alcohol-related problems in France were estimated using two cost evaluation approaches: (1) estimate based on the proportion of cases attributable to alcohol abuse (the alcohol abuse factor); (2) estimate based on prevalence of alcohol abuse for in- and out-patients. For a 10% prevalence of alcohol abuse in the general population, the minimum cost in 1996 was about US$ 2300 million; for a prevalence of 15% it was US$ 2700 million. This cost concerns the health disorders that are linked directly or indirectly to alcohol abuse. It did not allow for injuries from accidents caused by alcohol intoxication and undervalued the cost of out-patient care. Based on the prevalence of alcohol-related disorders seen at hospitals, a percentage of the total in-patient and out-patient costs due to effects of alcohol could be estimated. However, this did not permit an estimate of the cost of care in which alcohol abuse was a risk factor only. Based on the available data showing that between 3% and 10% of inpatients have a directly alcohol-related condition, estimates of in-patient treatment costs varied from US$ 1300 to 2100 million. Among adult out-patients, 20% present with a disorder in which alcohol is a factor or suffer from an alcohol-related illness, which corresponds to a cost of about US$ 1600 million. Thus, these methods yield minimum year's cost estimated between US$ 2500 and 3300 million. These costs are high, compared to the low level of financing for the specialized facilities offering treatment to people in difficulty due to alcohol excess, which was US$ 23 million in that year. As regards social and total costs, estimates from four Western countries have found that about 75% of the total costs of alcohol abuse was attributable to social harm, and 25% to medical costs. Applying this ratio to the French data gives an estimated total cost to French society of about US$ 13 200 million, i.e. 1.04% of the gross national product. [ABSTRACT FROM PUBLISHER]

The prevalence of alcohol use disorders in hospital patients was studied in all the hospitals of one area of France. Alcohol disorders were diagnosed by the head nurse or a physician in the hospital where the patient was being attended, and by means of the CAGE self-questionnaire This descriptive survey, carried out on one particular day, concerned 7626 patients. The prevalence of alcohol disorders was 18%, whereas only 6% of the admissions were for alcohol-related pathologies. Prevalences were 25% in men and 7% in women, 10% in persons aged under 25 years and 43% in men aged between 36 and 55 years. In all, one patient in two was diagnosed directly, though only one in four in the age range under 25 years. These results suggest that too few patients with alcohol use disorders are identified in hospitals, especially in certain age groups and certain types of ward [ABSTRACT FROM PUBLISHER]