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Alcohol Use Disorders in Primary Health Care: What Do We Know and Where Do We Go?

Alcohol Use Disorders in Primary Health Care: What Do We Know and Where Do We Go? AimsTo analyze the current paradigm and clinical practice for dealing with alcohol use disorders (AUD) in primary health care.MethodsAnalyses of guidelines and recommendations, reviews and meta-analyses.ResultsMany recommendations or guidelines for interventions for people with alcohol use problems in primary health care, from hazardous drinking to AUD, can be summarized in the SBIRT principle: screening for alcohol use and alcohol-related problems, brief interventions for hazardous and in some cases harmful drinking, referral to specialized treatment for people with AUD. However, while there is some evidence that these procedures are effective in reducing drinking levels, they are rarely applied in clinical practice in primary health care, and no interventions are initiated, even if the primary care physician had detected problems or AUD. Rather than asking primary health care physicians to conduct interventions which are not typical for medical doctors, we recommend treatment initiation for AUD at the primary health care level. AUD should be treated like hypertension, i.e. with regular checks for alcohol consumption, advice for behavioral interventions in case of consumption exceeding thresholds, and pharmaceutical assistance in case the behavioral interventions were not successful. Minimally, alcohol consumption should be screened for in all situations where there is a co-morbidity with alcohol being a potential cause (such as hypertension, insomnia, depression or anxiety disorders).ConclusionsA paradigm shift is proposed for dealing with problematic alcohol consumption in primary health care, where initiation for treatment for AUD is seen as the central element. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Alcohol and Alcoholism Oxford University Press

Alcohol Use Disorders in Primary Health Care: What Do We Know and Where Do We Go?

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References (75)

Publisher
Oxford University Press
Copyright
© The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved
Subject
Article
ISSN
0735-0414
eISSN
1464-3502
DOI
10.1093/alcalc/agv127
pmid
26574600
Publisher site
See Article on Publisher Site

Abstract

AimsTo analyze the current paradigm and clinical practice for dealing with alcohol use disorders (AUD) in primary health care.MethodsAnalyses of guidelines and recommendations, reviews and meta-analyses.ResultsMany recommendations or guidelines for interventions for people with alcohol use problems in primary health care, from hazardous drinking to AUD, can be summarized in the SBIRT principle: screening for alcohol use and alcohol-related problems, brief interventions for hazardous and in some cases harmful drinking, referral to specialized treatment for people with AUD. However, while there is some evidence that these procedures are effective in reducing drinking levels, they are rarely applied in clinical practice in primary health care, and no interventions are initiated, even if the primary care physician had detected problems or AUD. Rather than asking primary health care physicians to conduct interventions which are not typical for medical doctors, we recommend treatment initiation for AUD at the primary health care level. AUD should be treated like hypertension, i.e. with regular checks for alcohol consumption, advice for behavioral interventions in case of consumption exceeding thresholds, and pharmaceutical assistance in case the behavioral interventions were not successful. Minimally, alcohol consumption should be screened for in all situations where there is a co-morbidity with alcohol being a potential cause (such as hypertension, insomnia, depression or anxiety disorders).ConclusionsA paradigm shift is proposed for dealing with problematic alcohol consumption in primary health care, where initiation for treatment for AUD is seen as the central element.

Journal

Alcohol and Alcoholism – Oxford University Press

Published: Jul 1, 2016

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