- Alcohol use common among orthopaedic patients: 67.9% report use; 29.2% of AUDIT-C screens positive; 2.5% report prior AUD.
- Systematic screening and clinician discussion are rare: only 11.1% of 718 flagged patients had documented alcohol-related conversations.
- Integrate validated screeners such as AUDIT-C into routine intake and provide clinician training and referral pathways to improve safety and outcomes.
J Am Acad Orthop Surg Glob Res Rev. 2026 Jul 28;10(8). doi: 10.5435/JAAOSGlobal-D-25-00483. eCollection 2026 Aug 1.
ABSTRACT
INTRODUCTION: Alcohol use disorder (AUD) is a prevalent, relapsing condition. Despite well-documented links between alcohol misuse and adverse health outcomes, the role of AUD in orthopaedic surgery is underexplored, and systematic screening remains uncommon. The aim of this study was to examine the incidence of alcohol use and potential misuse among orthopaedic patients and assessed whether patients flagged for risk engaged in documented discussions about alcohol use with their care teams.
METHODS: We retrospectively reviewed intake data from orthopaedic trauma, spine, bone health, and general registries between May 2020 and April 2025. Alcohol use was initially assessed with a nonstandardized intake questionnaire and later with the validated Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) tool. Patients meeting thresholds for possible misuse were flagged. Clinical notes were reviewed to determine whether flagged patients had alcohol use discussed by their orthopaedic team.
RESULTS: Among 99,269 patients screened, 67.9% reported some alcohol use, and 2.5% reported a personal history of AUD. Of 1040 patients completing the AUDIT-C, 29.2% screened positive for potential misuse; 11.1% of bone health patients also met criteria for at-risk drinking. Only 80 of 718 flagged patients (11.1%) had a documented alcohol-related discussion, with higher rates in bone health registries and among older patients.
CONCLUSION: Alcohol use and misuse are common among orthopaedic patients, yet systematic screening and discussion are infrequent. Integrating validated screeners such as AUDIT-C into routine intake and supporting clinicians with training and referral pathways represent critical opportunities to improve patient safety and orthopaedic outcomes.
PMID:42554739 | DOI:10.5435/JAAOSGlobal-D-25-00483
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