Assessment of drinking, even without a subsequent intervention, may induce drinking changes. To examine this possibility, researchers studied data from 293 students in New Zealand who had participated in a randomized trial of screening and brief intervention for unhealthy alcohol use.
These students—all with an AUDIT* score of >8 and a heavy drinking episode (>6 drinks for men, >4 for women) in the last 4 weeks—had been randomized to receive either of the following: a leaflet describing drinking risks and safe limits, or a leaflet and then a 10-minute web-based drinking assessment 4 weeks later. The assessment included a drinking diary, alcohol and academic problems scales, and questions on perceived drinking norms.
- At 6 months (84% follow-up rate), most drinking outcomes were better, though nonsignificantly, in the assessment group than in the leaflet-only group.
- At 12 months (86% follow-up rate), however, the assessment group had significantly
- less consumption in the past 2 weeks (25 drinks for the assessment group versus 30 drinks for the leaflet-only group);
- fewer episodes of drinking >9 drinks (>6 for women) in the past 2 weeks (0 versus 1) and alcohol-related problems (2 versus 3);
- lower AUDIT scores (13 versus 14).
Although many primary care clinicians lack confidence in their ability to intervene with unhealthy drinking, most have the skills to ask about current consumption and possible consequences. This study suggests that screening for unhealthy alcohol use, delivery of written materials (such as the National Institute on Alcohol Abuse and Alcoholism’s How to Cut Down on Your Drinking), and follow-up assessment at future visits may help to reduce drinking and its adverse consequences.
Peter D. Friedmann, MD, MPH
Kypri K, Langley JD, Saunders JB, et al. Assessment may conceal therapeutic benefit: findings from a randomized controlled trial for hazardous drinking. Addiction. 2006;102(1):62–70.