alcohol

Alcohol Drinking / therapy

drinking

PMID (1):

37844924

MeSH

Alcoholism* / diagnosis

Alcoholism* / drug therapy

British Columbia

Humans

A Canadian guideline for management of alcohol use disorders. James W. Mold, MD, MPHG

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Background: In Canada, low awareness of evidence-based interventions for the clinical management of alcohol use disorder exists among health care providers and people who could benefit from care. To address this gap, the Canadian Research Initiative in Substance Misuse convened a national committee to develop a guideline for the clinical management of high-risk drinking and alcohol use disorder.

Methods: Development of this guideline followed the ADAPTE process, building upon the 2019 British Columbia provincial guideline for alcohol use disorder. A national guideline committee (consisting of 36 members with diverse expertise, including academics, clinicians, people with lived and living experiences of alcohol use, and people who self-identified as Indigenous or Métis) selected priority topics, reviewed evidence and reached consensus on the recommendations. We used the Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) and the Guidelines International Network’s Principles for Disclosure of Interests and Management of Conflicts to ensure the guideline met international standards for transparency, high quality and methodological rigour. We rated the final recommendations using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool; the recommendations underwent external review by 13 national and international experts and stakeholders.

Recommendations: The guideline includes 15 recommendations that cover screening, diagnosis, withdrawal management and ongoing treatment, including psychosocial treatment interventions, pharmacotherapies and community-based programs. The guideline committee identified a need to emphasize both underused interventions that may be beneficial and common prescribing and other practice patterns that are not evidence based and that may potentially worsen alcohol use outcomes.

Interpretation: The guideline is intended to be a resource for physicians, policymakers and other clinical and nonclinical personnel, as well as individuals, families and communities affected by alcohol use. The recommendations seek to provide a framework for addressing a large burden of unmet treatment and care needs for alcohol use disorder within Canada in an evidence-based manner.

Author/s:

Evan Wood, Jessica Bright, Katrina Hsu, Nirupa Goel, Josey W G Ross

About Moderate Alcohol Use

Alex Haga — Thu, 30 May 2024 22:17:25 +0000

Date Added:

May 30, 2024

Journal/Publication:

CDC

Publication Date:

May 15, 2024

URL:

About Moderate Alcohol Use

Type:

Patient Education Materials

Format:

Article

Keywords

MeSH

Information for patients regarding moderate alcohol use and health. James W. Mold, MPH

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KEY POINTS
Drinking excessively increases your risk of getting sick, injured, or dying sooner.
You can choose not to drink alcohol, drink less, or drink in moderation to lower these risks, compared to drinking excessively.
However, even moderate drinking may increase your risk of death and other alcohol-related harms, compared to not drinking.

Improving behavioral health outcomes in primary care

Alex Haga — Mon, 13 May 2024 21:14:31 +0000

Date Added:

May 13, 2024

Journal/Publication:

Oklahoma Primary Healthcare Improvement Cooperative

Type:

Best Local Practices

Format:

Article

Keywords

MeSH

referral and consultation

An overview of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) initiative being implemented in primary care practices in Oklahoma. James W. Mold, MD, MPH

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Screening, Brief Intervention, and Referral to Treatment in Oklahoma (SBIRT-OK)
is an evidence-based, integrated approach to identify and intervene with patients whose
patterns of tobacco, alcohol, and/or drug use, or depression, put their health at risk.

NIAAA for Middle School

Erin Blanchette — Mon, 19 Feb 2024 16:29:17 +0000

Date Added:

February 19, 2024

Publisher:

National Institute of Health

URL:

NIAAA for Middle School

Type:

Patient Education Materials

Format:

Web Page

Keywords

MeSH

national institute on alcohol abuse and alcoholism (U.S.)

Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder

Parents

caregivers

Guidance for families with middle school children regarding prevention of alcohol use and abuse. James W. Mold, MD, MPH

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Underage drinking is a significant public health problem in the United States.

This webpage contains interactive activities to help parents, caregivers, and teachers introduce and reinforce key messages about peer pressure, resistance skills, and other important topics related to underage drinking.

These engaging activities are designed for middle schoolers ages 11 to 13. They can be used at home, in classrooms, or in after-school programs.

The content is based on a curriculum for grades 6–8 developed by the University of Michigan. The curriculum was created for the Alcohol Misuse Prevention Study (AMPS), a large-scale project supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

One goal of AMPS was to give students a clearer picture about alcohol use among their peers. Many middle schoolers tend to overestimate how much other students their age really drink. When they learn more accurate information, some of the pressure to drink can subside. Other goals of AMPS were to help students learn skills to resist pressure to drink and to give them reasons not to drink. This site incorporates AMPS goals in these and other features.

This website contains three sections focused on different aspects of alcohol, peer pressure, and resistance skills, followed by a resource list in section 4. The first three sections contain an overview, handouts, and role-playing exercises. The overviews provide background information to help you prepare to discuss alcohol and peer pressure with middle schoolers. The handouts are designed to be given to middle schoolers. The role-playing exercises are designed to be led by an adult and consist of two parts—a guide for the adult leader and a script for the middle schooler to read aloud.

Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder

Rowan Hutchins — Sun, 22 Oct 2023 05:00:00 +0000

Date Added:

October 22, 2023

Journal/Publication:

CMAJ

Publisher:

CMA

Publication Date:

October 16, 2023

Issue:

Volume:

195

Pages:

E1364-E1379

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.230715

Keywords

Practice Guidelines as Topic / standards*

alcohol abuse

PMID (1):

37844924

MeSH

Alcohol use disorder

Canadian Guidelines for management of alcohol use disorder. James W. Mold, MD, MPH

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Author/s:

Evan Wood, Jessica Bright, Katrina Hsu, Nirupa Goel, Josey W.G. Ross, Averill Hanson, Rand Teed, Ginette Poulin, Bryany Denning, Kim Corace, Corrina Chase, Katelyn Halpape, Ronald Lim, Tim Kealey, Jürgen Rehm

Reported Risky Alcohol Use Among US Adults Prescribed 3 Classes of Chronic Alcohol–Interactive Medications

Rowan Hutchins — Tue, 03 Oct 2023 05:00:00 +0000

Date Added:

October 3, 2023

Journal/Publication:

JAMA

Publisher:

AMA

Publication Date:

September 14, 2023

URL:

Reported Risky Alcohol Use Among US Adults Prescribed 3 Classes of Chronic Alcohol–Interactive Medications

Type:

Clinical Research Results

DOI (1):

10.1001/jama.2023.16641

Keywords

drug interaction

PMID (1):

PMC10502693

MeSH

Drug Interactions

Looking Back, Looking Forward: Current Medications and Innovative Potential Medications to Treat Alcohol Use Disorder

ethanol

More than 20% of patients taking opiates, seizure meds, and/or benzodiazepine receptor agonists report binge alcohol drinking while using those medications. Fewer than 3% of primary care visits include screening for alcohol misuse. James W. Mold, MD, MPH

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Alcohol-interactive medications pose increased risk of adverse events and death when used with alcohol.1 To our knowledge, the most recent study of alcohol use and alcohol-interactive medications included data through 2010.1 Mortality rates from alcohol and such medications have since increased.2,3 Therefore, we assessed contemporary patterns of risky alcohol use among adults taking high-risk alcohol-interactive medications.

Author/s:

Bernstein, Eden Y., Baggett, Travis P., Anderson, timothy S.

Looking Back, Looking Forward: Current Medications and Innovative Potential Medications to Treat Alcohol Use Disorder

Aubrey Delammermore — Sun, 06 Nov 2022 05:00:00 +0000

Date Added:

November 6, 2022

Journal/Publication:

Alcohol Research Current Reviews

Publisher:

National Institutes of Health

Publication Date:

October 20, 2022

Issue:

Volume:

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.35946/arcr.v42.1.11

Keywords

National Institute on Alcohol Abuse and Alcoholism (U.S.)

National Institutes of Health (U.S.)

naltrexone

PMID (1):

36320345

MeSH

Alcohol Deterrents* / therapeutic use

Alcoholism* / diagnosis

Naltrexone / therapeutic use

Alcohol-Related Disorders*

A review of current and potential new medications for treatment of patients with alcohol use disorders. James W. Mold, MD, MPH

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This article is part of a Festschrift commemorating the 50th anniversary of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Established in 1970, first as part of the National Institute of Mental Health and later as an independent institute of the National Institutes of Health, NIAAA today is the world's largest funding agency for alcohol research. In addition to its own intramural research program, NIAAA supports the entire spectrum of innovative basic, translational, and clinical research to advance the diagnosis, prevention, and treatment of alcohol use disorder and alcohol-related problems. To celebrate the anniversary, NIAAA hosted a 2-day symposium, "Alcohol Across the Lifespan: 50 Years of Evidence-Based Diagnosis, Prevention, and Treatment Research," devoted to key topics within the field of alcohol research. This article is based on Dr. Mason's presentation at the event. NIAAA Director George F. Koob, Ph.D., serves as editor of the Festschrift.

Author/s:

Mason, B. J.

Alcohol Abstinence in Drinkers with Atrial Fibrillation

Brian Desmarais — Fri, 03 Jan 2020 22:27:35 +0000

Date Added:

January 3, 2020

Journal/Publication:

New England Journal of Medicine

Publication Date:

January 2, 2020

Issue:

Volume:

382

Pages:

20-28

URL:

Alcohol Abstinence in Drinkers with Atrial Fibrillation

Type:

Clinical Research Results

Format:

Article

DOI (1):

https://doi.org/10.1093/ntr/ntz234

Keywords

MeSH

Not surprisingly, reducing alcohol intake reduces the frequency of atrial fibrillation in patients known to have had episodes of atrial fibrillation.

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BACKGROUND:

Excessive alcohol consumption is associated with incident atrial fibrillation and adverse atrial remodeling; however, the effect of abstinence from alcohol on secondary prevention of atrial fibrillation is unclear.

METHODS:

We conducted a multicenter, prospective, open-label, randomized, controlled trial at six hospitals in Australia. Adults who consumed 10 or more standard drinks (with 1 standard drink containing approximately 12 g of pure alcohol) per week and who had paroxysmal or persistent atrial fibrillation in sinus rhythm at baseline were randomly assigned in a 1:1 ratio to either abstain from alcohol or continue their usual alcohol consumption. The two primary end points were freedom from recurrence of atrial fibrillation (after a 2-week "blanking period") and total atrial fibrillation burden (proportion of time in atrial fibrillation) during 6 months of follow-up.

RESULTS:

Of 140 patients who underwent randomization (85% men; mean [±SD] age, 62±9 years), 70 were assigned to the abstinence group and 70 to the control group. Patients in the abstinence group reduced their alcohol intake from 16.8±7.7 to 2.1±3.7 standard drinks per week (a reduction of 87.5%), and patients in the control group reduced their alcohol intake from 16.4±6.9 to 13.2±6.5 drinks per week (a reduction of 19.5%). After a 2-week blanking period, atrial fibrillation recurred in 37 of 70 patients (53%) in the abstinence group and in 51 of 70 patients (73%) in the control group. The abstinence group had a longer period before recurrence of atrial fibrillation than the control group (hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.84; P = 0.005). The atrial fibrillation burden over 6 months of follow-up was significantly lower in the abstinence group than in the control group (median percentage of time in atrial fibrillation, 0.5% [interquartile range, 0.0 to 3.0] vs. 1.2% [interquartile range, 0.0 to 10.3]; P = 0.01).

CONCLUSIONS:

Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation. (Funded by the Government of Victoria Operational Infrastructure Support Program and others; Australian New Zealand Clinical Trials Registry number, ACTRN12616000256471.).

Author/s:

Voskoboinik, A., Kalman, J.M., De Silva, A., Nicholls, T., Costello, B., Nanayakkara, S., Prabhu, S., Stub, D., Azzopardi, S., Vizi, D., Wong, G., Nalliah, C., Sugumar, H., Wong, M., Kotschet, E., Kaye D., Taylor, A.J., Kistler, P.M.

Naltrexone for the treatment of alcoholism: A meta-analysis of randomized controlled trials

Jeffrey Wilson — Wed, 02 Jan 2019 14:38:22 +0000

Date Added:

January 2, 2019

Journal/Publication:

International Journal of Neuropsychopharmacology

Publisher:

Oxford University Press

Publication Date:

June 1, 2005

Issue:

Volume:

Pages:

267-280

URL:

Naltrexone for the treatment of alcoholism: A meta-analysis of randomized controlled trials

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1017/S1461145704004997

Keywords

naltrexone

PMID (1):

15850502

MeSH

Brief physician advice for problem alcohol drinkers. A randomized controlled trial in community-based primary care practices

naltrexone

This Meta-analysis involving 2861 subjects in 24 RCTs found that, in short-term treatment, naltrexone significantly decreased relapses [relative risk (RR) 0.64, 95% confidence interval (CI) 0.51-0.82], but not return to drinking (RR 0.91, 95% CI 0.81-1.02). Short-term treatment of naltrexone significantly increased nausea, dizziness, and fatigue in comparison to placebo [RRs (95% CIs) 2.14 (1.61-2.83), 2.09 (1.28-3.39), and 1.35 (1.04-1.75)].

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Many trials of naltrexone have been carried out in alcohol-dependent patients. This paper is aimed to systematically review its benefits, adverse effects, and discontinuation of treatment. We assessed and extracted the data of double-blind, randomized controlled trials (RCTs) comparing naltrexone with placebo or other treatment in people with alcoholism. Two primary outcomes were subjects who relapsed (including heavy drinking) and those who returned to drinking. Secondary outcomes were time to first drink, drinking days, number of standard drinks for a defined period, and craving. All outcomes were reported for the short, medium, and long term. Five common adverse effects and dropout rates in short-term treatment were also examined. A total of 2861 subjects in 24 RCTs presented in 32 papers were included. For short-term treatment, naltrexone significantly decreased relapses [relative risk (RR) 0.64, 95% confidence interval (CI) 0.51-0.82], but not return to drinking (RR 0.91, 95% CI 0.81-1.02). Short-term treatment of naltrexone significantly increased nausea, dizziness, and fatigue in comparison to placebo [RRs (95% CIs) 2.14 (1.61-2.83), 2.09 (1.28-3.39), and 1.35 (1.04-1.75)]. Naltrexone administration did not significantly diminish short-term discontinuation of treatment (RR 0.85, 95% CI 0.70-1.01). Naltrexone should be accepted as a short-term treatment for alcoholism. As yet, we do not know the appropriate duration of treatment continuation in an alcohol-dependent patient who responds to short-term naltrexone administration. To ensure that the real-world treatment is as effective as the research findings, a form of psychosocial therapy should be concomitantly given to all alcohol-dependent patients receiving naltrexone administration.

Author/s:

Srisurapanont, Manit, Jarusuraisin, Ngamwong

Brief physician advice for problem alcohol drinkers. A randomized controlled trial in community-based primary care practices

Jeffrey Wilson — Wed, 02 Jan 2019 14:31:45 +0000

Date Added:

January 2, 2019

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

April 1, 1997

Issue:

Volume:

277

Pages:

1039-1045

URL:

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1001/jama.1997.03540370029032

Keywords

PMID (1):

9091691

MeSH

In this RCT conducted in primary care settings, two 10- to 15-minute counseling visits delivered by physicians using a scripted workbook that included advice, education, and contracting information was sufficient to reduce 7-day alcohol use from 19.1 to 11.5 at 12 months in the experimental group vs 18.9 at baseline to 15.5 at 12 months in controls (P<.001); episodes of binge drinking from 5.7 at baseline to 3.1 at 12 months in the experimental group vs 5.3 at baseline to 4.2 at 12 months in controls (P<.001), and percentage drinking excessively in previous 7 days from 47.5% at baseline to 17.8% at 12 months in the experimental group vs 48.1% at baseline to 32.5% at 12 months in controls (P<.001) at one year.

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OBJECTIVE:

Project TrEAT (Trial for Early Alcohol Treatment) was designed to test the efficacy of brief physician advice in reducing alcohol use and health care utilization in problem drinkers.

DESIGN:

Randomized controlled clinical trial with 12-month follow-up.

SETTING:

A total of 17 community-based primary care practices (64 physicians) located in 10 Wisconsin counties.

PARTICIPANTS:

Of the 17695 patients screened for problem drinking, 482 men and 292 women met inclusion criteria and were randomized into a control (n=382) or an experimental (n=392) group. A total of 723 subjects (93%) participated in the 12-month follow-up procedures.

INTERVENTION:

The intervention consisted of two 10- to 15-minute counseling visits delivered by physicians using a scripted workbook that included advice, education, and contracting information.

MAIN OUTCOME MEASURES:

Alcohol use measures, emergency department visits, and hospital days.

RESULTS:

There were no significant differences between groups at baseline on alcohol use, age, socioeconomic status, smoking status, rates of depression or anxiety, frequency of conduct disorders, lifetime drug use, or health care utilization. At the time of the 12-month follow-up, there were significant reductions in 7-day alcohol use (mean number of drinks in previous 7 days decreased from 19.1 at baseline to 11.5 at 12 months for the experimental group vs 18.9 at baseline to 15.5 at 12 months for controls; t=4.33; P<.001), episodes of binge drinking (mean number of binge drinking episodes during previous 30 days decreased from 5.7 at baseline to 3.1 at 12 months for the experimental group vs 5.3 at baseline to 4.2 at 12 months for controls; t=2.81; P<.001), and frequency of excessive drinking (percentage drinking excessively in previous 7 days decreased from 47.5% at baseline to 17.8% at 12 months for the experimental group vs 48.1% at baseline to 32.5% at 12 months for controls; t=4.53; P<.001). The chi2 test of independence revealed a significant relationship between group status and length of hospitalization over the study period for men (P<.01).

CONCLUSIONS:

This study provides the first direct evidence that physician intervention with problem drinkers decreases alcohol use and health resource utilization in the US health care system.

Author/s:

Fleming, Michael F., Barry, Kristen L., Manwell, Linda B., Johnson, Kristen, London, Richard

Brief physician and nurse practitioner-delivered counseling for high-risk drinking. Results at 12-month follow-up

Jeffrey Wilson — Wed, 02 Jan 2019 14:26:10 +0000

Date Added:

January 2, 2019

Journal/Publication:

Journal of General Internal Medicine

Publisher:

Society of General Internal Medicine

Publication Date:

January 1, 2005

Issue:

Volume:

Pages:

7-13

URL:

Brief physician and nurse practitioner-delivered counseling for high-risk drinking. Results at 12-month follow-up

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1111/j.1525-1497.2005.21240.x

Keywords

Adapting Screening, Brief Intervention, and Referral to Treatment for Alcohol and Drugs to Culturally Diverse Clinical Populations

PMID (1):

15693921

MeSH

In this RCT conducted in academic primary care practices, brief (5–10 minute) patient-centered counseling plus an office system that cued providers to intervene and provided patient educational materials was sufficient to reduce weekly alcohol intake in patients with unhealthy alcohol intake one year post-intervention.

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BACKGROUND:

The objective of this study was to determine the effects of a brief primary care provider-delivered counseling intervention on the reduction of alcohol consumption by high-risk drinkers. The intervention was implemented as part of routine primary care medical practice.

METHODS:

We performed a controlled clinical trial with 6- and 12-month follow-up. Three primary care practices affiliated with an academic medical center were randomly assigned to special intervention (SI) or usual care (UC). A total of 9,772 primary care patients were screened for high-risk drinking. A fourth site was added later. From the group that was screened, 530 high-risk drinkers entered into the study, with 447 providing follow-up at 12 months. The intervention consisted of brief (5-10 minute) patient-centered counseling plus an office system that cued providers to intervene and provided patient educational materials.

RESULTS:

At 12-month follow-up, after controlling for baseline differences in alcohol consumption, SI participants had significantly larger changes (P=.03) in weekly alcohol intake compared to UC (SI=-5.7 drinks per week; UC=-3.1 drinks per week), and of those who changed to safe drinking at 6 months more SI participants maintained that change at 12 months than UC.

CONCLUSIONS:

Project Health provides evidence that screening and very brief (5-10 minute) advice and counseling delivered by a patient's personal physician or nurse practitioner as a routine part of a primary care visit can reduce alcohol consumption by high-risk drinkers.

Author/s:

Reiff-Hekking, Sarah, Ockene, Judith K., Hurley, Thomas G.

Adapting Screening, Brief Intervention, and Referral to Treatment for Alcohol and Drugs to Culturally Diverse Clinical Populations

Jeffrey Wilson — Wed, 02 Jan 2019 14:20:26 +0000

Date Added:

January 2, 2019

Journal/Publication:

Journal of Addiction Medicine

Publisher:

American Society of Addiction Medicine

Publication Date:

September 1, 2015

Issue:

Volume:

Pages:

343-351

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1097/ADM.0000000000000150

Keywords

community health services

SBIRT

PMID (1):

26428359

MeSH

substance-related disorders

motivational interviewing

This is a systematic review that provides guidance regarding use of the SBIRT process in culturally diverse patient populations.

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OBJECTIVES:

To review the literature on the screening, brief intervention, and referral to treatment (SBIRT) approach to alcohol and drug use with racial and ethnic subgroups in the United States and to develop recommendations for culturally competent SBIRT practice.

METHODS:

Articles reporting on the use of SBIRT components (screening, brief intervention, referral to treatment) for alcohol and drug use were identified through a comprehensive literature search of PubMed from 1995 to 2015.

RESULTS:

A synthesis of the published literature on racial and ethnic considerations regarding SBIRT components (including motivational interviewing techniques) was created using evidence-based findings. Recommendations on culturally competent use of SBIRT with specific ethnic groups are also described.

CONCLUSIONS:

On the basis of the literature reviewed, SBIRT offers a useful set of tools to help reduce risky or problematic substance use. Special attention to validated screeners, appropriate use of language/literacy, trust building, and incorporation of patient and community health care preferences may enhance SBIRT acceptability and effectiveness.

PRACTICE IMPLICATIONS:

Providers should consider the implications of previous research when adapting SBIRT for diverse populations, and use validated screening and brief intervention methods. The accompanying case illustration provides additional information relevant to clinical practice.

Author/s:

Manuel, Jennifer K., Satre, Derek D., Tsoh, Janice, Moreno-John, Gina, Ramos, Jacqueline S., McCance-Katz, Elinore F., Satterfield, Jason M.

Primary care intervention to reduce alcohol misuse ranking its health impact and cost effectiveness

Jeffrey Wilson — Wed, 02 Jan 2019 14:14:52 +0000

Date Added:

January 2, 2019

Journal/Publication:

American Journal of Preventative Medicine

Publisher:

American College of Preventative Medicine and Association for Prevention Teaching and Research

Publication Date:

February 1, 2008

Issue:

Volume:

Pages:

143-152

URL:

Primary care intervention to reduce alcohol misuse ranking its health impact and cost effectiveness

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.amepre.2007.09.035

Keywords

Helping Patients Who Drink Too Much: A Clinician's Guide

alcohol abuse

PMID (1):

18201645

MeSH

This systematic review concluded that screening, brief interventions, and treatment of alcohol use disorders was one of the highest-ranking preventive services among the 25 effective services evaluated.

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BACKGROUND:

The U.S. Preventive Services Task Force (USPSTF) has recommended screening and behavioral counseling interventions in primary care to reduce alcohol misuse. This study was designed to develop a standardized rating for the clinically preventable burden and cost effectiveness of complying with that recommendation that would allow comparisons across many recommended services.

METHODS:

A systematic review of the literature from 1992 through 2004 to identify relevant randomized controlled trials and cost-effectiveness studies was completed in 2005. Clinically preventable burden (CPB) was calculated as the product of effectiveness times the alcohol-attributable fraction of both mortality and morbidity (measured in quality-adjusted life years or QALYs), for all relevant conditions. Cost effectiveness from both the societal perspective and the health-system perspective was estimated. These analyses were completed in 2006.

RESULTS:

The calculated CPB was 176,000 QALYs saved over the lifetime of a birth cohort of 4,000,000, with a range in sensitivity analysis from -43% to +94% (primarily due to variation in estimates of effectiveness). Screening and brief counseling was cost-saving from the societal perspective and had a cost-effectiveness ratio of $1755/QALY saved from the health-system perspective. Sensitivity analysis indicates that from both perspectives the service is very cost effective and may be cost saving.

CONCLUSIONS:

These results make alcohol screening and counseling one of the highest-ranking preventive services among the 25 effective services evaluated using standardized methods. Since current levels of delivery are the lowest of comparably ranked services, this service deserves special attention by clinicians and care delivery systems.

Author/s:

Solberg, Leif I., Maciosek, Michael V., Edwards, Nichol M.

Helping Patients Who Drink Too Much: A Clinician's Guide

Jeffrey Wilson — Wed, 02 Jan 2019 13:58:54 +0000

Date Added:

January 2, 2019

Journal/Publication:

National Institutes of Health

Publisher:

U.S. Department of Health and Human Services

Publication Date:

July 1, 2016

Issue:

07-3769

URL:

Type:

Clinical Decision Aids

Format:

Article

Keywords

MeSH

referral and consultation

primary health care

A meta-analysis of alcohol consumption and the risk of 15 diseases

This is a guidebook produced by the National Institute on Alcohol Abuse and Alcoholism for physicians who want to help patients reduce their alcohol consumption.

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Why screen for heavy drinking?

At-risk drinking and alcohol problems are common. About 3 in 10 U.S. adults drink at levels that elevate their risk for physical, mental health, and social problems. Of these heavy drinkers, about 1 in 4 currently has alcohol abuse or dependence.All heavy drinkers have a greater risk of hypertension, gastro - intestinal bleeding, sleep disorders, major depression, hemorrhagic stroke, cirrhosis of the liver, and several cancers.
Heavy drinking often goes undetected. In a recent study of primary care practices, for example, patients with alcohol dependence received the recommended quality of care, including assessment and referral to treatment, only about 10 percent of the time.
Patients are likely to be more receptive, open, and ready to change than you expect. Most patients don’t object to being screened for alcohol use by clinicians and are open to hearing advice afterward. In addition, most primary care patients who screen positive for heavy drinking or alcohol use disorders show some motivational readiness to change, with those who have the most severe symptoms being the most ready.
You’re in a prime position to make a difference. Clinical trials have demonstrated that brief interventions can promote significant, lasting reductions in drinking levels in at-risk drinkers who aren’t alcohol dependent.8 Some drinkers who are dependent will accept referral to addiction treatment programs. Even for patients who don’t accept a referral, repeated alcohol-focused visits with a health care provider can lead to significant improvement.
If you’re not already doing so, we encourage you to incorporate alcohol screening and intervention into your practice. With this Guide, you have what you need to begin.

Author/s:

National Institute on Alcohol Abuse and Alcoholism

A meta-analysis of alcohol consumption and the risk of 15 diseases

Jeffrey Wilson — Wed, 02 Jan 2019 13:40:25 +0000

Date Added:

January 2, 2019

Journal/Publication:

Preventative Medicine

Publisher:

Elsevier

Publication Date:

May 1, 2004

Issue:

Volume:

Pages:

613-619

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.ypmed.2003.11.027

Keywords

alcohol abuse

PMID (1):

15066364

MeSH