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Brief interventions for patients with at-risk drinking

Helping patients reduce alcohol use and related harms

Brief advice from a primary care provider is effective in reducing alcohol consumption, as well as injuries, emergency room visits, hospital days and health care costs in people with alcohol use problems (Bertholet et al., 2005).

Primary care providers can use various strategies to help patients change their alcohol use and prevent problem use from developing into an alcohol use disorder (O'Donell et al., 2014):

  • Inform patients about Canada's low-risk drinking guidelines.
  • Mention non-specific effects of drinking, such as fatigue, insomnia and low mood.
  • Give patients information about the effects of alcohol use.
  • Link patients' current health condition to their alcohol consumption.
  • Ask about the effects of alcohol on family and work.
  • Ask patients whether their partner has expressed any concerns about their drinking.
  • Advise patients to change their drinking patterns.
  • Ask patients if they would be willing to reduce their drinking.
  • Ask patients to commit to a drinking goal: when, where and with whom they will drink.
  • Suggest that patients keep a daily record of the number of drinks they consume, using a Goal Setting and Drinking Diary
  •  Monitor gamma-glutamyl transferase (GGT) and mean cell volume (MCV) every couple of months.
  • Arrange at least one follow-up visit to discuss alcohol consumption.
  • Give patients tips for reducing alcohol consumption (e.g., avoiding, substituting, setting limits).

The most important components of brief interventions appear to be providing feedback and advice, and setting goals.

Tips to help patients reduce alcohol use

Give patients the following advice to help them cut down on alcohol consumption:

  • Have no more than one drink per hour.
  • Sip drinks – don't gulp.
  • Alternate non-alcoholic drinks with alcoholic drinks.
  • Have a 20-minute "time out" between drinks.
  • Eat a full meal before drinking.
  • Avoid people and places where you tend to drink heavily.
  • Switch to a non-favourite drink (e.g., if you prefer wine, drink beer).

Tools to help patients monitor and reduce drinking

Goal Setting and Drinking Diary

Patients can use the Goal Setting and Drinking Diary to record weekly goals for drinking and to keep track of how much they actually drank. The form also asks patients to track when, where and with whom they drink. Raising patients' awareness of their drinking behaviour can help them to see what changes they can make that will help to reduce their drinking.

Goal Setting and Drinking Diary – Example

Week of: February 9

Drinking goal: "I will have three beers on Thursday, Friday and Saturday, but only at home – not at the bar."

Thinking about Drinking

"Thinking about Drinking," a brochure developed by the Centre for Addiction and Mental Health, contains  a simple test that shows people how their drinking compares to that of other Canadians. It also presents the choices they might want to make about their drinking based on that comparison.

Check Your Drinking

The Check Your Drinking online survey allows people to look at their drinking in various ways, such as how many drinks they had in the past year, how much it cost and how their drinking compares to other Canadians of their age and sex. The survey also provides research-based information about the physical and psychosocial effects of alcohol, and how to reduce the risk of alcohol-related problems.