Teachable Moments in Alcohol-Related Diseases: A Practical Framework for Promoting Abstinence in General Internal Medicine.

Alcohol consumption remains a leading preventable cause of morbidity and mortality; however, abstinence counseling is not routinely implemented in general internal medicine. This review proposes a Japan-oriented framework for translating the diagnosis of alcohol-related diseases into behavioral change interventions. Central to this framework is the concept of the "teachable moment," in which a new diagnosis increases patient motivation and creates opportunities for timely clinical intervention. We reviewed common alcohol-related conditions, including liver disease, alcohol-related cancers, acute pancreatitis, atrial fibrillation, hypertension, hypertriglyceridemia, gout, sleep disorders, and pneumonia, and summarized the evidence that abstinence or reduced alcohol consumption can improve outcomes. We also present an integrated approach that combines brief intervention, liver function-guided pharmacotherapy, nutritional rehabilitation, and specialist collaboration. ALDH2 and ADH1B polymorphisms, common in East Asians, may aid in risk stratification and treatment selection.