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Clinical Summary

Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Clinical Summary of U.S. Preventive Services Task Force Recommendation

Population Adults aged 18 years or older Adolescents
Recommendation Screen for alcohol misuse and provide brief behavioral counseling interventions to persons engaged in risky or hazardous drinking.
Grade: B
No recommendation.
Grade: I statement
Screening Tests Numerous screening instruments can detect alcohol misuse in adults with acceptable sensitivity and specificity. The USPSTF prefers the following tools for alcohol misuse screening in the primary care setting:
  1. AUDIT
  2. Abbreviated AUDIT-C
  3. Single-question screening, such as asking, “How many times in the past year have you had 5 (for men) or 4 (for women and all adults older than 65 years) or more drinks in a day?”
Behavioral Counseling Interventions Counseling interventions in the primary care setting can improve unhealthy alcohol consumption behaviors in adults engaging in risky or hazardous drinking. Behavioral counseling interventions for alcohol misuse vary in their specific components, administration, length, and number of interactions. Brief multicontact behavioral counseling seems to have the best evidence of effectiveness; very brief behavioral counseling has limited effect.
Balance of Benefits and Harms There is a moderate net benefit to alcohol misuse screening and brief behavioral counseling interventions in the primary care setting for adults aged 18 years or older. The evidence on alcohol misuse screening and brief behavioral counseling interventions in the primary care setting for adolescents is insufficient, and the balance of benefits and harms cannot be determined.
Other Relevant USPSTF Recommendations The USPSTF has made recommendations on screening for illicit drug use and counseling and interventions to prevent tobacco use. These recommendations are available at http://www.uspreventiveservicestaskforce.org.

For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org/.

Current as of: May 2013

Internet Citation: Clinical Summary: Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care. U.S. Preventive Services Task Force. October 2014.
https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/alcohol-misuse-screening-and-behavioral-counseling-interventions-in-primary-care

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