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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.
When a patient has screened positive for risky drinking, up pops a computerised prompt to remind the clinician to consider counselling. In one service for US ex-military personnel, this resulted in nearly three quarters of patients being counselled and a hint of consequentially reduced drinking; at another, findings were negative. Why the difference?
STUDY 2008 HTM file
Reducing alcohol harm: health services in England for alcohol misuse
Official audit of work by the Department of Health and NHS to address the health effects of alcohol misuse. Describes a system whose infrastructure is clearly inadequate compared to the size of the task, but one recently taking steps in the right direction.
REVIEW 2006 PDF file 1464Kb
Motivational arm twisting: contradiction in terms?
Part 4 of the Manners Matter series asks whether motivational interviewing can overcome the hostile prison environment and the distrust of youngsters, drink drivers and other offenders pressured into counselling by the criminal justice system.
REVIEW 1999 HTM file
Barriers to implementing effective correctional drug treatment programs
Expertly describes and evaluates the difficulties of mounting drug treatment programmes in prisons, drawing on the pooled knowledge and experience of leading US researchers on why real-world programmes sometimes fail to live up to expectations based on more ideal-world trials. Though focused on prison, much is relevant also to community sentences.
‘A minute makes a difference in primary care consultations’, was the finding of a 1992 study about improving the capacity of general practitioners to screen for problems such as heavy drinking, smoking, and high blood pressure. But is extra time on the clock enough to secure routine (as opposed to more frequent) delivery of health promotion and brief intervention?
STUDY 1970 HTM file
Frontiers of alcoholism
Later to become founding director of the US National Institute on Alcohol Abuse and Alcoholism, in the late 1950s Dr Morris Chafetz of the Massachusetts General Hospital conducted a remarkable series of studies which proved that an alcohol clinic's intake and performance can be transformed by the simple application of empathy and organisation.
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