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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.
Simulation exercise estimates that had either the main anti-relapse medications or brief interventions on hospital wards reached 40% of the heaviest and dependent drinkers, in 2004 they would have prevented nearly 12,000 deaths across the European Union.
When an addiction psychiatrist modelled good alcohol assessment practice while accompanying doctors once a week during their ward rounds, the result was steeply increased rates of correct diagnosis of drink problems and of referral to treatment, offering an alternative to possibly unwelcome training or direction of clinical staff.
‘Do just the minimum’ seems the message of the emergency department arm of the largest alcohol screening and brief intervention study yet conducted in Britain; the proportion of risky drinkers fell no less after a brief warning than after more sophisticated and longer interventions.
STUDY 2012 HTM file
Alcohol screening and brief intervention in emergency departments
The emergency department arm of the largest alcohol screening and brief intervention study yet conducted in Britain found that the proportion of risky drinkers fell just as much after the most minimal of screening and intervention methods as after more sophisticated and longer (but still brief) alternatives.
Heavy drinking by mothers-to-be threatens their unborn child – but for that very reason, stigma may mean women shy away from admitting their problem. This review found several brief screening questionnaires showed promise in identifying mothers who might need to cut back, while others seemed unsuitable for the antenatal care context.
Screening for risky drinking and offering brief advice slightly reduces later emergency department visits was the main finding of this review, suggesting these programmes can help ease pressure on overloaded departments. Adding to their attraction, some of the evidence comes from studies in the services set to benefit.
Even dependent drinkers among Taiwanese hospital patients substantially cut back their drinking after being identified and offered brief advice, findings from a study which provides one of the most convincing demonstrations yet that brief intervention can work in this setting.
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.
For the first time this US study tried mobile phone text messaging as a way to moderate the hazardous drinking of young adults screened at emergency departments. Compared to merely monitoring, text-based advice did cut drinking – but why did the monitoring-only patients actually start to drink more?
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