Primary care has been promoted for decades as a preferred setting for clinicians to offer brief interventions to address patients’ heavy consumption of alcohol. But those efforts produce ambiguous results, fail to tackle the complexities of addiction problems, and often are disconnected from patients’ other health conditions and risk behaviors, according to an analysis in the BMJ co-authored by a Boston University School of Public Health (BUSPH) researcher.
Dr. Richard Saitz, professor of community health sciences at BUSPH, and Dr. Jim McCambridge, professor of addictive behaviors and public health at the University of York in the UK, say that the evidence supporting brief counseling for alcohol use in primary care settings is weak, and that new strategic approaches are needed.
“It makes little sense to consider screening and other preventive activities for alcohol in isolation from other risky health behaviors and probably also mental health problems,” they write. “We need to think strategically about alcohol within broad-based prevention approaches, and consider separately how to manage and care for those with severe problems.”
They cite positive results from brief interventions in “well-controlled clinical trials,” but note that other large studies have shown no benefit, or rely on self-reported alcohol consumption to draw conclusions.
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