Guideline Recommends Primary Care Physicians Screen All Adults for Alcohol Misuse

In an update to its 2004 guidelines on screening adults to reduce alcohol misuse, the U.S. Preventive Services Task Force (USPSTF) has recommended that primary care physicians screen patients age 18 years and older for “risky” or “hazardous” drinking and offer brief counseling interventions to reduce these practices.

The new recommendation includes "the full spectrum of unhealthy drinking behaviors, from risky drinking to alcohol dependence," in its definition of “alcohol misuse”, rather than the 2004 definition of “risky, hazardous, or harmful drinking.”

Recommended screening methods range from 1 to 10 questions and take anywhere from 1 minute to 5 minutes to complete.   For behavioral counseling, the USPSTF defined 4 categories: very brief single contact, brief single contact, brief multicontact, and extended multicontact. 

"Brief multicontact behavioral counseling seems to have the best evidence of effectiveness," they wrote. 

“Alcohol misuse is a common issue across U.S. primary care populations; approximately 21% of adults report engaging in risky or hazardous drinking,” they concluded. 

“The USPSTF concludes with moderate certainty that there is a moderate net benefit to screening for alcohol misuse and brief behavioral counseling interventions in the primary care setting for adults aged 18 years or older.”

–Michael Potts

Reference

US Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse [Published online ahead of print May 14, 2013].  Ann Intern Med. doi:10.7326/0003-4819-159-3-201308060-00652