Brief Alcohol Intervention: Prolonged Benefits?

To
examine whether brief intervention (BI) provides benefits beyond
1 year, investigators in Norway reassessed 247 adults who, in 1986,
had been drinking at least 2–3 times per week, had elevated
serum gamma-glutamyltransferase (GGT) levels, and had entered a
randomized trial of BI. During the trial, these participants received
either minimal intervention (a 10-minute discussion of possible
reasons for elevated GGT); more extensive intervention (15 minutes
of counseling regarding decreasing drinking and monthly visits
until GGT levels normalized); or no intervention (though controls
eventually received BI at 1-year follow-up). In this more recent
study, investigators compared these participants with a new control
group of subjects who, in 1986, also had been drinking at least
2–3 times per week but had GGT levels slightly below those
required for inclusion in the original trial.

Nine
years after the original trial (70% follow-up), those who had received
BI, including members of the original control group, had significant
decreases in GGT levels (compared with levels at trial entry).
These decreases significantly differed from the increases seen
in the new control group.

Comments:

These results are
informative, particularly in the absence of a clinical trial of BI
with a decade of follow-up. The better outcomes among drinkers with
high GGT levels than among those with lower levels suggests that the
intervention played a role. This is the third (of 4) controlled studies
in the literature to show long-term benefits. Brief intervention for
risky drinking may be more effective than previously thought.

Richard
Saitz, MD, MPH

Reference:

Nilssen O. Long-term
effect of brief intervention in at-risk alcohol drinkers: a 9-year
follow-up study. Alcohol Alcohol. 2004;39(6):548–551.