Brief intervention
From Drug Rehab Wiki
The National Institute on Alcohol Abuse and Alcoholism, a division of the National Institutes of Health, recommends brief alcohol interventions as a way to treat alcohol abuse in certain segments of the population. Although this type of treatment will almost certainly not work for the majority of those with characteristics of full-blown alcoholism, it could be beneficial for those who are in the infancy stages of alcohol abuse.
What is Brief Intervention?
Brief alcohol interventions are short, individual counseling sessions that typically do not reoccur over a long period of time. Brief interventions are used to moderate a person’s alcohol use to acceptable levels or to address harmful habits, such as binge drinking or drinking and driving. Supporters of brief interventions feel that even a small change in harmful drinking patters can help reduce the risk of alcohol-related health issues, injuries, domestic violence, car accidents and fetal alcohol syndrome. In direct contrast with traditional, long-term, alcohol treatment, brief intervention does not seek to completely stop a person from ingesting alcohol and, thus, should not be used for people with severe alcoholism or for those who have co-occurring mental disorders.
Brief interventions can be tailored to meet the needs of the individual client. A “brief intervention” usually has up to four brief counseling sessions led by a medical professional. Brief interventions can be particularly effective for people who cannot afford to enter long-term, residential treatment either due to financial constraints or family issues. Some proponents even believe that simply pointing out risky or harmful alcohol-related behavior is enough to get people to change their drinking habits.
Brief Intervention in the Doctor's Office
Most people who participate in brief interventions do so after an interaction with primary care or emergency room doctors. Patients with alcohol issues are identified during the normal course of treatment, as a result of routine lab testing, after a drinking-related injury, or during a pre-natal care visit. The brief intervention can be as simple as the person’s doctor offering advice about why they should reduce their drinking and how to go about doing so.
One of the benefits of doctor-implemented intervention is that the patient is already comfortable with the interventionist and likely trusts and respects him. As denial is a hallmark of alcoholism, it is much harder to discount the opinion of a respected physician than an interventionist, who is previously unknown to the patient.
Project Treat (Trial for Early Alcohol Treatment) was a clinical trial designed to examine the effectiveness of brief interventions in the primary care office setting. For each patient, two brief face-to-face counseling sessions were administrated thirty days apart, with a follow up phone call two weeks after each of the sessions. Patients who participated reported reduced alcohol use and fewer days in the hospital or emergency room than a control group. Although a patient is not likely to readily admit to her doctor that she hasn’t changed her drinking habits (and, thus, results should be taken with a grain of salt), it was discovered that patients were still benefiting from the brief interventions up to four years later.
Brief Intervention in Emergency Rooms
While many alcoholics may never come to the attention of primary care doctors, medical professionals who man the emergency room are in a key position to perform brief interventions. Since these patients typically reveal themselves after an alcohol-related incident and thus, by definition, are exhibiting severe alcohol issues, the brief intervention usually takes the form of a referral to a bona fide addiction specialist.
Roughly one-third of all patients treated in the emergency room test positive for alcohol problems, as well as one-half of all seriously injured trauma patients. Those under twenty-five years of age are the largest group of alcohol patients seen in the emergency department, as they are more likely to be uninsured and use the ER in lieu of regular medical care. They also engage in high-risk binge drinking more often that older adults; this behavior puts them at risk for serious injury, typically related to driving a car.
Emergency room doctors consider treatment for alcohol-related injury to be a prime opportunity to reach those patients who might otherwise discount advice related to their alcohol intake. Brief interventions during trauma treatment can reduce the risk that the patient will be involved in another alcohol-related incident. An additional session once the trauma is over can be even more effective. During one study, patients who received a brief intervention during trauma treatment plus one follow-up session reported fewer alcohol-related injuries compared to patients who are only counseled during the trauma itself.
Whether or not a brief intervention can be enough to reduce harmful drinking behavior in a patient, doctors should certainly screen their patients for evidence of alcohol abuse and refer to competent addiction professionals for early intervention.
