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Planning and implementing screening and brief intervention for risky alcohol use : a step-by-step guide for primary care practices
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    Introduction: Alcohol Screening and Brief Intervention: A Critical Clinical Preventive Service; Purpose of the Guide; The Process -- I. Laying the Groundwork: Step 1: Understand the Need for Alcohol SBI; Step 2: Get Organizational Commitment -- II. Adapting Alcohol SBI to Your Practice: Step 3: Plan for Screening; Step 4: Plan for Brief Intervention; 15 Step 5: Establish Referral Procedures -- III. Implementing Alcohol SBI in Your Practice: Step 6 Orientation and Training; Step 7: Plan a Pilot Test; Step 8: Support a Strong Start-Up -- IV. Refining and Promoting: Step 9: Monitor and Update Your Plan; Step 10: Share Your Success -- V. APPENDICES: -- Appendix A: Our Alcohol SBI Service; Appendix B: Alcohol SBI Fact Sheet; Appendix C: What’s a Standard Drink?;Appendix D: Fetal Alcohol Spectrum Disorders; Appendix E: Negative Effects of Risky and Binge Drinking; Appendix F: Single Question Alcohol Screen; Appendix G: AUDIT 1-3 (US); Appendix H: AUDIT (US)—Alcohol Use Disorders Identification Test; Appendix I: Other Screening Instruments; Appendix J: Screening for Drug Misuse; Appendix K: Orienting Staff to Alcohol SBI; Appendix L: How Do Patients React to Alcohol Screening? The Cutting Back Study; Appendix M: Training for Screening Staff; Appendix N: Brief Intervention Guidance; Appendix O: Training to Deliver Brief Interventions; Appendix P: Follow-Up System; Appendix Q: Billing; Appendix R: Tips for Communicating about Your Alcohol SBI Services -- References.

    Like hypertension or tobacco screening, alcohol screening and brief intervention (alcohol SBI) is a clinical preventive service. It identifies and helps patients who may be drinking too much. It involves:

    • A validated set of screening questions to identify patients’ drinking patterns,

    • A short conversation with patients who are drinking too much, and for patients with severe risk, a referral to specialized treatment as warranted.

    The entire service takes only a few minutes, is inexpensive, and may be reimbursable. Thirty years of research has shown that alcohol SBI is effective at reducing the amount of alcohol consumed by those who are drinking too much. Based on this evidence, the U.S. Preventive Services Task Force5 and many other organizations have recommended that alcohol SBI be implemented for all adults in primary health care settings.

    Risky drinking can have many negative health effects including increasing the risk of hypertension, stroke, type 2 diabetes, cancers (breast, upper gastrointestinal tract, and colon), cirrhosis of the liver, injury, and violence. Risky drinking is also associated with increased body weight and can impair short- and long­ term cognitive function. Binge drinking is associated with a wide range of other health and social problems, including sexually transmitted diseases, unintended pregnancy, and violent crime.

    Suggested citation: Centers for Disease Control and Prevention. Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use: A Step-by-Step Guide for Primary Care Practices. Atlanta, Georgia: Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, 2014.


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