FAC T SHEET FOR PROVIDERS

A Health Campaign of Uniformed Services University, www.usuhs.edu, and theCenter for the Study of Traumatic Stress, Bethesda, Maryland, www.CSTSonline.org

Addressing Alcohol Misuse through
Brief Screening and Counseling
top five most cost-effective preventive
Problem drinking is a persistentIn our current climate of multiple
services doctors can offer.
health issue in the military. The DoD
Patients may engage in risky
spends more than $600 million annuallydeployments, family separations,drinking (levels associated within medical care and lost work time due
single parenting, and reintegration
risk for social, legal, economic, andto alcohol abuse. Another $132 million achallenges, it is reasonable to screen
health problems) or harmful drinking
year is spent to care for babies with fetal(having already experienced adverse
alcohol syndrome, demonstrating thefor problem drinking in theconsequences due to drinking). The
impact of problem drinking on military
military community.
entire spectrum, from risky drinking
families and children. In our current
to alcohol use disorders, is referredclimate of multiple deployments, family
to as alcohol misuse (U.S. Preventive Services Task Force,
separations, single parenting, and reintegration challenges,
it is reasonable to screen for problem drinking in the2004). Patients with the most harmful drinking habits
meet diagnostic criteria for alcohol dependence (American
military community.
Psychiatric Association 1994). This Courage to Care fact
The American Journal of Preventive Medicine reports
sheet addresses the need for brief alcohol screening andthat addressing alcohol use in primary care settings may
alcohol counseling in primary care settings as a preventivehelp reduce drinking patterns in at least one of six problem
approach to foster the health of our military community.
drinkers. Screening for problem drinking, combined with aThe companion fact sheet, Alcohol and Your Health, can be
doctor’s advice, reduced problem drinking by 17.4 percent
downloaded and distributed to your patients. It lists DoD
over a period of six months to two years. Physicians andapproved resources for additional information and help
healthcare professionals can make a difference. Briefwith alcohol problems.
alcohol screening and counseling may rank among theWhy Screen?
■ At risk drinking is common

3 in 10 drinkers are at risk for physical,psychological, or social problems❏ 1 in 4 meet criteria for abuse or dependence❏❏■ Only 10% of patients with an alcohol problem arereferred for treatment■ Brief interventions by physicians can make a realdifference in promoting healthy behavior changes❏ Changes may occur soon after the first session❏ The amount of time spent on the interview
is not a major determinant of change (briefinterventions work well)

The style of the physician’s intervention is a major
determinant of success

Brief Screen■ Do you drink?

35% of patients seen in primary care settings donot drink❏ 45% are low risk drinkers❏ 20% are moderate to high risk drinkers❏ 5% are alcohol dependent❏■ How many drinks do you have during the week? Howmany drinks do you usually have in a day?

Continued•

Men younger than 65—2 drinks/day or 14
drinks/week• Women and men age 65 or older—1 drink/dayor 7 drinks/week❏ At risk drinking• Men younger than 65: > 14/week or > 		4/occasion• Women > 7-11/week or >3/occasion• Men or women age 65 or older: >7/week or>1/occasion
If you have concerns about your health and associatedalcohol risk level please talk with your healthcare provider.
■ Simple advice on alcohol health risks and when not todrink❏ Pregnant or trying to become pregnant❏ Taking prescription or over-the-counter
medications that may cause harmful reactions whenmixed with alcohol❏ Under the age of 21❏ Recovering from alcoholism or are unable tocontrol the amount you drink❏ Affected by a medical condition that may
be worsened by alcohol

You Can Make A Difference
Studies have found that most patients with alcohol
misuse were not counseled about their drinking. Embracing
a broader, preventive focus that includes brief screening
and counseling of every patient can help identify those
who need help. This small and timely intervention canguide toward change and reduce the impact of problem
drinking on individuals and families.
Alcohol Counseling
Alcohol counseling involves 1) educating patients about
safe and at risk drinking levels, and 2) providing ‘simple
advice’ about the risks on drinking for their health history
or medical condition.
■ Definitions of moderate and binge drinking (NIAAA)

Moderate drinking is up to 1 drink per day for
women and up to 2 drinks per day for men❏ Binge drinking is 4 drinks for women in two hours
and 5 drinks for men in two hours❏

https://www.niaaa.nih.gov/alcohol-health/overviewalcohol-consumption/moderate-binge-drinking

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org