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At over 50%, this US study's main achievement may have been to show that emergency department nurses can screen a high proportion of patients for risky drinking. After that point it suffered from a low intervention implementation rate, and no statistically significant benefits were found.
Addressing the substance use promoting tendencies of the personality traits of London secondary school pupils at particular risk of substance misuse led to fewer drinking and, among the drinkers, fewer drinking heavily. The study showed that school staff could effectively conduct the focus group interventions.
STUDY 2010 HTM file
Effect of motivational interviewing on reduction of alcohol use
At Californian methadone clinics, group education sessions led by a nurse and focused on the risks of aggravating hepatitis infection led to the same substantial reductions in drinking as one-to-one or group motivational interviewing conducted by highly trained counsellors, offering a cost-effective means to reduce alcohol-related risks.
Uniquely among modern heroin prescribing trials, the trial in Germany was not confined to heroin-addicted patients who had done poorly on methadone, offering the opportunity to assess whether heroin should be reserved for these patients. The conclusion was that other patients too benefit more from injectable heroin than oral methadone.
The first European trial of an emergency department brief alcohol intervention being implemented nationally in the USA found no significant impacts either short term or a year later, but in Britain and elsewhere, different types of interventions have worked.
In Brazil adding home visits to a three-month alcohol detoxification and treatment programme cost-effectively increased the abstinence rate at the end of treatment.
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.
Studies published in the mid-2000s confirm that counselling based on motivational interviewing helps heavy drinking US college students control their drinking and reduce related problems.
Dutch general practice patients at risk of cardiovascular disease did not further reduce their risks (including drinking and smoking) in response to motivational counselling from the practice nurse. Why did a well worked out, multi-session intervention fail to better usual care? The probable answer is among the common factors which transcend therapies.
Is being caught and disciplined all it takes to get heavy drinkers who violate university drinking rules to cut back? According to this US study, the discipline process does work, but adding brief motivational-style advice makes a worthwhile extra impact.
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