Rethinking alcohol interventions in health care: a thematic meeting of the International Network on Brief Interventions for Alcohol & Other Drugs (INEBRIA)

Abstract

In 2016, the International Network on Brief Interventions for Alcohol & Other Drugs convened a meeting titled “Rethinking alcohol interventions in health care”. The aims of the meeting were to synthesize recent evidence about screening and brief intervention and to set directions for research, practice, and policy in light of this evidence. Screening and brief intervention is efficacious in reducing self-reported alcohol consumption for some with unhealthy alcohol use, but there are gaps in evidence for its effectiveness. Because screening and brief intervention is not known to be efficacious for individuals with more severe unhealthy alcohol use, recent data showing the lack of evidence for referral to treatment as part of screening and brief intervention are alarming. While screening and brief intervention was designed to be a population-based approach, its reach is limited. Implementation in real world care also remains a challenge. This report summarizes practice, research, and policy recommendations and key research developments from our meeting. In order to move the field forward, a research agenda was proposed to (1) address evidence gaps in screening, brief intervention, and referral to treatment, (2) develop innovations to address severe unhealthy alcohol use within primary care, (3) describe the stigma of unhealthy alcohol use, which obstructs progress in prevention and treatment, (4) reconsider existing conceptualizations of unhealthy alcohol use that may influence health care, and (5) identify efforts needed to improve the capacity for addressing unhealthy alcohol consumption in all world regions.

The Drug and Alcohol Clinical Advisory Service: A model of telephone‐delivered addiction specialist support

“…Despite the significant barriers to screening patients for AOD problems (e.g. time constraints, attitudes toward substance use, uncertainty about how to assist, concerns about offending patients and disrupting rapport) , the patient consultation can provide a critical opportunity to intervene—if only to assertively link to AOD treatment services—with potential to reduce problem substance use, re‐presentation and health‐care costs.…”

Evaluation of training on brief interventions for teachers: health contributions

“…The findings show the potential impact of training on screening and brief interventions on attitudes of professionals outside the health area, since this universal tool can be used in different contexts (28) , cooperate with the understanding of how and in what contexts these strategies can work and what their real effectiveness is, which is a gap raised in the scientific literature (39) . In a previous study, actions to prevent the use of substances were mentioned as more effective when implemented by teachers than those offered by specialists (15) .…”

Factors Influencing the Implementation of Screening and Brief Interventions for Alcohol Use in Primary Care Practices: A Systematic Review Protocol

“…[4][5][6][7][8][9][10][11] However, there has been recent debate concerning the validity of this effectiveness evidence. 12,13 Most trials use self-reported alcohol consumption as their primary outcome measure rather than alcohol-related morbidity or mortality problems, and such self-reported outcomes may be subject to social desirability bias or other research participation effects. 14,15 Furthermore, the active ingredients of SBI have yet to be determined.…”