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At three London hospitals 4% of inpatients completed a brief alcohol intervention after being screened for hazardous drinking by ward staff. Staff were positive and on one ward nearly half the patients were screened and one in ten counselled, but the overall results are unlikely to dent the public health burden imposed by risky drinking.
Applying a systematic and comprehensive framework to map the strategies trialled in attempts to implement screening and counselling for risky drinking primary care patients gives some clues to what it has taken to achieve a high screening rate, the essential first step in the process.
STUDY 2010 HTM file
Offender alcohol interventions: minding the policy gap
Based on exhaustive consultations in the south west of England, this report diagnoses the blockages to providing adequate alcohol-related services to offenders and makes recommendations to improve commissioning, coordination and practice.
No matter which dissemination strategy was tried, just 4 in 10 GPs in Germany logged in to a government funded online alcohol intervention education and support system. Even among the few practices who joined the study, training was poorly attended.
Offering valuable clues to how best to do motivational interviewing, this London study of cannabis-using students found they were most likely to stop using after brief interventions which embodied the spirit of the approach and featured responses from the counsellor reflecting back and elaborating on the student's comments.
The perennial problem of excessive student drinking may have a modern-day remedy in the form of web-based programs comparing the site visitor with other students. This UK trial is not altogether convincing, but the US evidence is on balance positive.
Addressing the substance use promoting tendencies of the personality traits of London secondary school pupils at particular risk of substance misuse led to less intensive drinking six months later, and there was some support for the psychological mechanisms thought to underpin the intervention.
REVIEW 2010 HTM file
Computer-delivered interventions for alcohol and tobacco use: a meta-analysis
Computer-based and in particular internet-based therapies open doors to treatment for drinkers who cannot get or do not want face-to-face-help. This review finds they do curb drinking, but its sub-finding that they are as effective as alternative therapies should not be taken to mean computers can replace therapists.
Does it help to add a structured internet-based therapeutic programme to web access to a mutual aid network also geared to moderate drinking? Sustained extra moderation in the form of fewer days drinking was the clearest positive effect; less clear was whether it led to greater reductions in drink-related problems.
In Norway, long-term continuity of care by the same adults in a family-like setting outside the home (a specially funded foster home or residential centre) was the key to a better later life for severely troubled young teenage substance users.
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