Managing Problem Drinking: Screening Tools and Brief Interventions for Primary Care Physicians

摘要

A high percentage of patients seen in primary care clinics partake in excessive alcohol consumption. It leads to numerous health problems and remains one of the leading risk factors for chronic disease. Despite the health concerns, screening for and intervening in patients’ alcohol misuse has yet to become standard practice in many primary care settings. There is well-established empirical evidence that brief doctor-patient interactions reduce alcohol consumption among excessive drinkers in primary care settings. This article draws on randomized controlled trials and literature on screening techniques, motivational interviewing, the transtheoretical model of behavior change, and medication-assisted treatments to enhance brief intervention methodology. Through this review, evidence-based practical strategies are presented to primary care doctors that reduce alcohol consumption in patients screened as problem drinkers. Referral information for those individuals with severe drinking problems is included. We propose that short, multicomponent interventions are most effective when they include interventions that utilize the lifestyle medicine philosophy, a nonjudgmental therapeutic alliance, and account for patient concerns more directly.