AUD: preventing harmful drinking

Citation

(2011), "AUD: preventing harmful drinking", Advances in Dual Diagnosis, Vol. 4 No. 1. https://doi.org/10.1108/add.2011.54104aaa.004

AUD: preventing harmful drinking

Article Type: News From: Advances in Dual Diagnosis, Volume 4, Issue 1

This is public health guidance. It includes recommendations relating to pricing, availability, marketing and licensing as well as alcohol screening and interventions. The guidance recommends that alcohol screening should be an integral part of health and social care practice, with a particular focus on people that may be at increased risk of harm from alcohol. Specific groups identified include those with mental health problems such as anxiety, depression and other mood disorders, people at risk of self-harm, with drug problems, whose children are involved with child safeguarding agencies, who have been assaulted, or are at risk of domestic abuse.

The alcohol use disorders identification test (AUDIT) (Babor et al., 1989) is the recommended screening tool. AUDIT comprises ten questions and the total score provides an indication of whether or not the person is drinking in a harmful way, and, if so, the extent of this. Scores of 8-15 identify the person as a hazardous drinker (alcohol use is increasing the person’s risk of harm), scores of 16-19 indicate harmful use (alcohol use is likely to be causing physical or mental harm), and a score of 20 or above is likely to indicate dependence. NICE note that the terms increasing risk and higher risk are sometimes used as alternatives to hazardous and harmful (e.g. NHS Choices web site www.nhs.uk/Livewell/alcohol/Pages/Effectsofalcohol.aspx).

Interventions are required for people scoring 8 or above. For hazardous and harmful drinkers (scores of 8-15 and 16-19, respectively) structured brief advice (5-15 minutes) should be offered. If people do not respond up to five sessions of extended brief interventions (20-30 minutes) should be made available. The AUD: diagnosis, assessment and management of harmful drinking and alcohol dependence recommends that extended brief interventions should routinely be offered to harmful drinkers (those scoring 16-19).

Resources that will help staff to implement the guidance on alcohol screening and delivering brief and extended brief interventions are available on the alcohol learning and screening and intervention programme for sensible (SIPS) drinking (web sites: www.alcohollearningcentre.org.uk/_library/Structured_Brief_Advice_Tool_Nov_2010.ppt#2, www.alcohollearningcentre.org.uk/Topics/Browse/BriefAdvice/SIPS/BriefAdviceTrainingandTools/?parent=4449&child=4558 and www.sips.iop.kcl.ac.uk/blc.php).

A free e-learning package to support the identification of problem alcohol use and delivery of brief advice is also available at: www.alcohollearningcentre.org.uk/eLearning/IBA/

For people that do not respond to brief interventions but want to receive further help for their alcohol problem NICE recommends considering referral to a specialist alcohol service. Referral should also be made for people that are dependent on alcohol, and/or when the person has a co-morbid alcohol-related mental health problem.

The guidance notes that managers must ensure that staff have the time and resources to carry out screening and brief interventions and that they receive training in equip them for this. Staff should have access to evidence-based packs (such as those available on the Alcohol Learning Centre and SIPS sites) to aid the delivery of these interventions.