Syphilis:
All adults should be screened for syphilis infection if at an increased risk. which include men who have sex with men and engage in high-risk sexual behavior, commercial sex workers, persons who exchange sex for drugs, and those in adult correctional facilities. Per the USPSTF, prevalence is higher in communities of the southern U.S., within cities, and in African American and Hispanic ethnicities. Routine screening of person with no related symptoms (asymptomatic) who are not at increased risk for syphilis infection is recommended against by the USPSTF. (24)
Alcohol use:
Primary care physicians are recommended by the U.S. Preventive Services Task Force (USPSTF) to screen all adult patients for the misuse of alcohol (39). The most widely used screening tool for alcoholism may be found here: CAGE questionaire. The primary goal for alcoholics is complete abstinence. Interventions options include behavioral therapy, therapy with health professionals which specialize in abuse, and medications which can either reduce the craving, or medication which causes an adverse physical reaction if alcohol is combined with it. Alcoholism medications to curb craving include nalmefene, also known as Revex, which has been found to be effective for the prevention of relapse (12). Another anti-craving agent is naltrexone which showed a significantly greater rate of abstinence than placebo (13). Agents which cause aversion reactions after drinking alcohol include disulfiram and calcium carbimide. These agents were also found to produce an abstinence rate in outpatient alcoholics of over 50% in a 9 year period and were tolerated well long term (14). An abrupt discontinuation of alcohol may not only lead to a life-threatening withdrawal syndrome, it may place patients at higher risk of stroke. Please see the section on Ischemic Stroke in Preventive Health Advisor. Alcohol use in moderation is best consumed in the form of red wine which may help non-alcoholics achieve several long term health benefits. See also the section on Red Wine and the section on Alcohol Consumption Risks and Benefits in Preventive Health Advisor.