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Brief interventions against excessive alcohol consumption 

Brief interventions against excessive alcohol consumption

Chapter:
Brief interventions against excessive alcohol consumption
Author(s):

Nick Heather

and Eileen Kaner

DOI:
10.1093/med/9780199204854.003.260702_update_001

July 30, 2015: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

Update:

Recommendations on screening and implementation of brief interventions revised to reflect National Institute for Health and Clinical Excellence (NICE) guidance.

Updated on 30 Nov 2011. The previous version of this content can be found here.
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date: 25 March 2017

Treatment and prevention of alcohol-related harm includes attention to the full range of alcohol problems that occur, including hazardous and harmful drinking as well as alcohol dependence. The prevalence of these problems is high, amounting to about one in four of the adult population of the United Kingdom, which is similar to the numbers who smoke.

Definition and role—screening and brief alcohol interventions are secondary prevention activities involving early identification of alcohol-related risk or harm, followed by advice or counselling to help reduce this risk or harm. Screening and brief interventions delivered opportunistically in medical settings have a crucial role to play in improving public health.

Screening instrument—that of choice is the alcohol use disorders identification test (AUDIT), shorter versions of which are available for use in situations where time for screening is limited.

Aim and efficacy of brief interventions—the usual goal is to reduce drinking to low-risk levels, and there is very good evidence from numerous randomized controlled trials that the alcohol consumption of hazardous and harmful drinkers can be reduced to this target, with the number needed to treat (NNT) for a successful outcome of brief alcohol intervention being about ten, which compares favourably with physicians’ advice to quit smoking.

Delivery of brief intervention—there are two basic methods: (1) simple brief intervention—comprising simple, structured advice that can be delivered by someone without extensive training in 3 to 5 min; and (2) extended brief intervention—brief behavioural counselling that takes from 20 to 30 min, possibly involves repeat consultations, and needs training to deliver.

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