The CDC urges doctors to talk to patients about their drinking habits, even if they’re not alcoholics.

Most heavy drinkers, including those who aren’t considered alcoholics, don’t talk to their doctors about their drinking habits.

A new report from the U.S. Centers for Disease Control and Prevention (CDC) has found that just one in six adults—and only one in four binge drinkers—have discussed their drinking habits with their doctors. Moreover, those same people report that their doctors don’t warn them about the dangers of drinking too much.

“The bottom line is that drinking too much is a problem in American society,” Dr. Thomas Frieden, director of the CDC, told reporters Tuesday. “It shouldn’t get a free pass in screening by health providers.”

While most people who drink do so without adverse health problems, the level of drinking in America has remained steady since the 1990s, according to the survey from 2011, which included data from 44 states and Washington, D.C.

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Excessive drinking is problematic, and intervention strategies exist, but they’re not being used, Frieden said.

“For every alcoholic, there are six people who drink too much to the point where it adversely affects their lives,” he said.

Only one in three of the heaviest binge drinkers—women who consume four or more and men who consume five or more drinks within a few hours, 10 or more times a month—have discussed their alcohol use with their doctors.

A simple conversation could improve the health of the estimated 38 million Americans who drink too much, but who don’t meet the qualifications for alcoholism.

Alcoholism is when a person continues to drink despite serious social, physical, or psychological problems; when they need to drink more to get the same effect; and when they suffer withdrawal symptoms if they don’t drink, Frieden said.

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Excessive drinking is linked to about 88,000 deaths in the U.S. each year, and it cost the American economy about $224 billion in 2006, the CDC says.

Health problems related to excessive drinking include heart disease, breast cancer, fetal alcohol spectrum disorders, motor-vehicle crashes, and interpersonal violence.

Alcohol screening and brief counseling at the doctor’s office can reduce the amount of alcohol the average adult consumes in a single sitting by up to 25 percent, Frieden said.

“We’re not saying people shouldn’t drink at all,” he said. “People should drink in moderation, if they choose to drink, or not at all if they have a health issue associated with it.”

Screenings can be as simple as a questionnaire or a discussion with a health worker, be it a doctor or a nurse. They should focus on people’s drinking habits, any problems they experience, and what realistic plans they have for the future.

The problem, Frieden said, is that doctors aren’t having these important conversations.

Besides social or professional problems, screenings can help identify whether a person’s drinking habits are making a chronic condition like Crohn’s disease or a heart problem worse.

“It sounds very simple, but it works for many patients,” Frieden said. “Most people who have problem drinking patterns don’t know they’re drinking problems.”