Drs. Blazer and Wu Reply

To the Editor: We appreciate the comments of Drs. Waszkiewicz and Szulc. They mention the public health concerns that we underscored in our article. We would like to address two of the issues they point out. First, the limitations of usual screening instruments, such as CAGE, could lead to missed cases of binge drinking in middle-aged and older adults. We do believe that one or two questions specifically directed to patients about multiple drinking during a short period of time may disclose binge drinking. Family members may also provide information, either spontaneously or when asked to further identify these cases. Second, the use of biomarkers is an interesting proposition. It should, as the authors suggest, be researched further. Yet in this era of cost containment, simple questioning of our patients remains the most effective and cost-effective means for identifying binge drinking.