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Approaches to alcohol policy differ widely across the UK. Scottish policy appears to be most closely aligned with evidence-based recommendations, framing alcohol as a whole population issue, in contrast with UK government policy which is influenced to a greater extent by prevailing beliefs about personal responsibility for alcohol issues.
Swiss study of brief alcohol interventions with a representative sample of heavy drinking young men exposed the determining influence on later drinking of the practitioner’s competence in motivational interviewing and how they behave in the session.
Evaluated across an entire region, a determined effort to implement alcohol screening and brief intervention in the US health system for ex-military personnel led to no significant reductions in drinking – results seen as a prime example of the disappointing impacts of alcohol brief interventions in real-world conditions.
REVIEW 2015 HTM file
Prevention of addictive behaviours
Based largely on existing reviews, this report for the German Federal Centre for Health Education comprehensively assesses substance use prevention approaches. Among its many conclusions are that approaches based solely on information provision are ineffective, in contrast to the more positive evidence for lifeskills and multi-component community programmes.
From Brazilian primary care clinics a rare confirmation that a positive organisational climate featuring commitment to staff professional development and good links with the local community is associated with overcoming barriers to widely implementing screening and brief intervention programmes.
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?
Based on research findings, a practical US government guide for trauma centres dealing with serious injuries on how to plan, implement and monitor a programme to identify risky drinking among their patients and to offer appropriate advice and referral.
The primary care 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.
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.
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