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REVIEW 2018 HTM file
Effectiveness of brief alcohol interventions in primary care populations
Update of a key document forming the basis of claims that brief interventions work in ‘real-world’ settings. Combined findings from randomised trials confirm that brief advice in primary care can reduce drinking, but will those reductions be realised in contemporary routine 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.
Combining a randomised trial with a 'real-world' test, studies of the Dutch Drinking Less programme have gone further than any others to establish the beneficial impacts of web-based alcohol self-help interventions.
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.
From the Netherlands, the first randomised controlled trial to evaluate internet-based therapy for problem drinking via text-chat conversations with a real therapist found this improved on an automated self-help option; on average alcohol intake was cut by nearly two-thirds.
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.
STUDY 2012 HTM file
Screening for alcohol use in criminal justice settings: an exploratory study
At English prisons, police stations and probation offices, offenders and arrestees in this study usually scored as at least hazardous drinkers and over half as problematic on a drink problem survey; nearly all would have been identified by a much briefer screening method usually requiring just a single question.
The policy emphasis on systematic screening to identify risky drinkers seems justified by this review, which found that without this GPs and other non-specialist doctors and nurses missed about half the risky drinkers they saw. However, that is better than in many screening programmes, prompting the reviewers to query whether these really do improve on clinical judgement.
A US study of young people in rural primary care settings finds that alcohol use disorders can be identified with a single question about frequency of drinking.
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