The impact of a physician's warning on recovery after alcoholism treatment.

Objective. —To study whether alcoholic workers had seen physicians during the year they were identified by their company, whether they recalled physicians' warnings about drinking, and whether such warnings affected outcomes 2 years later. Design. —Workers were interviewed at intake and 2 years later: subgroups who did and did not see physicians and who did and did not recall warnings were compared. Setting. —A company-union employee assistance program. Participants. —Two hundred problem drinkers, newly identified on the job, predominantly male, blue-collar workers. Outcomes. —Drinking, drunkenness, average daily alcohol consumption, and impairment score. Results. —Among the 200 participants, 74% saw physicians in the index year; only 22% recalled warnings. Recall of a warning was associated with liver disease, continued drinking while ill, supervisors' job warnings, older age, and marijuana use. Two years later, those warned were more likely to be abstaining, and sober, and were less impaired. Conclusions. —Recalling a physician's warning at intake into alcoholism treatment was associated with better prognosis 2 years later. However, among this group of employees whose drinking was serious enough to be identified on the job, fewer than a quarter recalled physicians' warnings, even though more than three quarters had seen physicians in the year preceding intake. ( JAMA . 1992;267:663-667)