Wondering how much beer is too much? Contemplating whether your glass-of-wine-a-day habit is good or bad? Don’t count on your doctor to ask about your alcohol use.

An estimated 38 million Americans consume excessive amounts of alcohol, and every year, about 88,000 people die from drinking too much. And excessive alcohol consumption comes at a price: It cost the U.S. economy about $223 billion dollars in 2006 due to losses in work productivity, health care expenses, criminal justice costs and property damage. Despite the high rate of alcohol abuse in the United States, physicians rarely ask patients about alcohol use.

A study conducted by the Centers for Disease Control and Prevention shows that only one in six adults and only one in four binge drinkers had ever discussed their drinking habits with a doctor. The study was based on interviews with 166,000 people.

Just a little counseling from a doctor can go a long way toward helping correct the problem. Counseling might include advice on how to cut back or referring the most serious cases to treatment programs. Excessive drinking can increase the chances of heart disease, liver problems and breast cancer, as well as other health problems.

Moderate drinking, on the other hand, may reduce the risk of heart attack and strokes in certain populations, but the jury is still out. Moderate drinking means up to one drink a day for women and two drinks a day for men. A “drink” is defined as 12 fluid ounces of beer, 5 fluid ounces of wine or 1.5 fluid ounces of distilled spirits. Many times people drink more than this amount without realizing it.

If you have questions about your drinking habits, you might want to bring up the subject with your doctor. And if you are reluctant to discuss your drinking habits with your physician, you might want to ask yourself why.