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DOCUMENT 2015 HTM file
Online flowcharts from the UK National Institute for Health and Clinical Excellence guide planners and practitioners dealing with alcohol use disorders through choices of strategies and interventions on prevention, brief interventions, alcohol treatment, and treatment of associated medical conditions.
STUDY 1999 PDF file 224Kb
Stepped care for drinkers yet to prove itself
The first evaluation of 'stepped care' for heavy drinkers found no added benefit from offering further treatment to those who did not respond to initial therapy, but the study was not a definitive refutation of this cost-saving approach.
STUDY 2010 HTM file
A brief image-based prevention intervention for adolescents
Across the sample, a brief face-to-face consultation highlighting how substance use might stop them becoming the sort of young adults they wanted to be generally did not prevent substance use among US high school pupils, but those already using substances were significantly more responsive, suggesting a selective if not a universal prevention role.
Binge drinkers among young Swiss men being conscripted in to the army responded to around 16 minutes of alcohol advice by on average cutting their intake 20% more than recruits whose drinking was simply assessed, a rare demonstration of the impact of a brief intervention in an unselected population.
Compared to basic drug education, it should at least have moderated current use, but this attempt to deploy motivational interviewing as an across-the-board prevention strategy among college students in London neither did that, nor did it prevent non-users starting to use, negative findings which raise interesting questions.
STUDY 1999 PDF file 209Kb
Advice and referral curb drinking in alcohol dependent hospital patients
In New York the serendipitous misapplication of a brief intervention to alcohol-dependent general hospital patients raised the possibility that they benefit as much from this as from referral to full-blown treatment.
STUDY 2003 PDF file 188Kb
Nurses help prevent hazardous drinking while caring for injured drinkers
This British study found that young men injured after binge drinking respond well to a brief intervention mounted in a hospital clinic dealing with injuries of the kind often related to drinking.
STUDY 2003 PDF file 180Kb
Alcohol counselling: try brief therapy first
This Australian study of a drug and alcohol counselling service extended work on brief alcohol interventions to a non-medical setting, confirming their potential as a first-line response to less severely affected treatment-seeking clients.
Just a few minutes with specially hired screening and intervention staff can make a difference to emergency patients' drinking, but in the real world the hospital's own staff will usually do this work. A US study tested this real-world scenario and still found (modest) drinking reductions.
Brief interventions based on motivational interviewing typically incorporate feedback on the individual's risk and use level compared to the norm, but does this really help? A US college study found it did, the combination leading to greater drinking reductions than either on its own.
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