For adults, NICE guidance advocates screening, brief advice and motivational support to identify and respond to alcohol misuse. ‘Identification and brief advice’ (IBA) in primary care has been shown to be effective in encouraging people drinking at higher risk levels to cut down, through screening and giving appropriate guidance. 6

Screening and brief advice has also been recommended by NICE as part of an ‘invest to save’ approach for the NHS and local authorities. 7

The brief advice component is a structured conversation, usually lasting no more than ten minutes, aimed at motivating at-risk drinkers to change their drinking behaviour or reinforcing the habits of low risk drinkers. This has very good evidence of efficacy for adolescents and adults (Table 11 of the Evidence and good practice overview section).

IBA-type interventions are useful in identifying non-dependent but risky drinkers, and even a single session can motivate individuals to reduce their drinking. 8 However, IBA must be aligned to context, and delivered sensitively to avoid unintended consequences. 9 It is unlikely to be effective in contexts where the recipient may perceive that their responses will affect the services they receive or where the person delivering IBA lacks credibility, cultural competence, or confidence and legitimacy. Without this, IBA may simply lead to ‘false negatives’, with people being unwilling to disclose risky behaviour. 10

References

  1. Kaner et al, “Effectiveness of brief alcohol interventions in primary care populations,” Cochrane Database of Systemic Review, 2007.
  2. NICE , “PH24, Alcohol use disorders: prevention,” 2010. [Online]. Available: https://www.nice.org.uk/guidance/ph24/chapter/1-Recommendations. [Accessed 15 August 2016].
  3. Mdege, N. D. et al,, “Interventions for reducing alcohol consumption, Drug and Alcohol Dependence,” 2013. [Online]. Available: https://www.researchgate.net/publication/235894775_Interventions_for_reducing_alcohol_consumption_among_general_hospital_inpatient_heavy_alcohol. [Accessed 15 August 2016].
  4. NICE, “QS11 Alcohol Use Disorders: Diagnosis and Management,” 2011. [Online]. Available: https://www.nice.org.uk/guidance/qs11/chapter/Quality-statement-2-Opportunistic-screening-and-brief-interventions. [Accessed 15 August 2016].
  5. Thom et al, “Delivering Alcohol IBA in Housing, Probation, and Social Work Settings, Drug and Alcohol Research Centre, Middlesex University,” 2016. [Online]. Available: http://alcoholresearchuk.org/wp-content/uploads/2014/09/Thom-et-al-IBA-in-housing-probation-and-work-settings. [Accessed 15 August 2016].
  6. Kaner et al, “Effectiveness of brief alcohol interventions in primary care populations,” Cochrane Database of Systemic Review, 2007.
  7. NICE , “PH24, Alcohol use disorders: prevention,” 2010. [Online]. Available: https://www.nice.org.uk/guidance/ph24/chapter/1-Recommendations. [Accessed 15 August 2016].
  8. Mdege, N. D. et al,, “Interventions for reducing alcohol consumption, Drug and Alcohol Dependence,” 2013. [Online]. Available: https://www.researchgate.net/publication/235894775_Interventions_for_reducing_alcohol_consumption_among_general_hospital_inpatient_heavy_alcohol. [Accessed 15 August 2016].
  9. NICE, “QS11 Alcohol Use Disorders: Diagnosis and Management,” 2011. [Online]. Available: https://www.nice.org.uk/guidance/qs11/chapter/Quality-statement-2-Opportunistic-screening-and-brief-interventions. [Accessed 15 August 2016].
  10. Thom et al, “Delivering Alcohol IBA in Housing, Probation, and Social Work Settings, Drug and Alcohol Research Centre, Middlesex University,” 2016. [Online]. Available: http://alcoholresearchuk.org/wp-content/uploads/2014/09/Thom-et-al-IBA-in-housing-probation-and-work-settings. [Accessed 15 August 2016].