Alcoholism

Do Brief Alcohol Interventions Work?

Brief alcohol interventions are short educational sessions that doctors and other professionals can use to help people who drink alcohol in unhealthy ways alter their behaviors. Unlike formal treatment programs, these interventions are typically conducted by people who don’t specialize in alcohol-related issues. In a study review published in January 2014 in the journal Alcohol and Alcoholism, a multinational research team analyzed the real-world usefulness of brief alcohol interventions in modifying dangerous drinking patterns. These researchers concluded that such interventions clearly work, at least for certain groups of drinkers.

Background Information

Prior to developing diagnosable symptoms of alcoholism or an impairing level of non-addicted alcohol abuse, drinkers typically adopt a pattern of unhealthy alcohol consumption that sets them up for future problems. For the vast majority of men, the risks for alcohol-related problems arise whenever their alcohol intake exceeds four drinks a day or 14 drinks a week. For the vast majority of women, the risks for these problems arise whenever their alcohol intake exceeds three drinks a day or seven drinks a week. The chances of developing diagnosable alcohol abuse or alcoholism increase along with the frequency of excessive alcohol intake. For example, people who regularly drink excessively once a month have a roughly 20 percent chance of eventually qualifying for a diagnosis. In people who regularly drink excessively twice a week, the chances of eventually qualifying for a diagnosis rise to 50 percent.

Brief Alcohol Intervention Basics

During a brief alcohol intervention, a doctor, doctor’s assistant, nurse or other qualified professional will engage in a face-to-face conversation with a person who consumes alcohol in unhealthy ways. Instead of taking on a formal or confrontational tone, such conversations are typically conducted in a low-key manner specifically intended to avoid alarming an individual or putting him or her on the defensive. After bringing the warning signs of serious alcohol-related harm to the attention of patient/client, the professional conducting the intervention will usually provide supporting information in the form of a brochure, pamphlet or short computer-based presentation. In some cases, a professional may also use motivational techniques designed to reduce a patient’s/client’s resistance to accepting the information provided through the intervention. As a rule, the goal of a brief intervention is not complete cessation of drinking; instead, the approach aims to significantly reduce a person’s risks for experiencing alcohol-related harm.

In many cases, doctors and other professionals identify candidates for brief alcohol intervention during routine screenings for alcohol abuse or alcoholism. Candidates for intervention are also sometimes identified during prenatal visits to an obstetrician/gynecologist, during emergency room visits, while speaking with a counselor or peer counselor on a college campus, after coming into contact with the criminal justice system or while undergoing advanced testing for certain physical ailments. Although the professionals who conduct brief alcohol interventions are not usually specialists in treating alcohol abuse or alcoholism, they do receive training in the proper ways to conduct an intervention session.

Do Interventions Work?

In the study review published in Alcohol and Alcoholism, researchers from Great Britain, the Netherlands and Germany analyzed the results of 24 previous reviews that assessed the effectiveness of brief alcohol interventions. All told, these 24 prior reviews included the results of 56 separate projects. Essentially all of the reviewed projects showed that brief alcohol interventions work for white, middle-aged men involved in dangerous patterns of alcohol consumption. The authors of the current review confirmed this finding after completing their large-scale analysis.

The authors of the current review note that the 56 analyzed research projects did not produce definitive information regarding the effectiveness of brief alcohol interventions for a number of important groups. Prominent examples of these groups include women, teen and young adult drinkers, elderly drinkers, members of various ethnic or racial minorities, drinkers already affected by alcoholism, drinkers affected by other substance-related problems and drinkers living in non-industrialized countries. The authors also note that the results of their review did not conclusively indicate how long brief alcohol interventions should last or how often problem drinkers should receive brief intervention refreshers in order to remain free from diagnosable alcohol abuse or alcoholism. 

Considerations

Despite their track record for effectiveness, brief alcohol interventions are typically underutilized by primary care physicians across the U.S., the National Institute on Alcohol Abuse and Alcoholism reports. Current evidence indicates that the majority of non-specialist doctors never even discuss alcohol use patterns with their patients.