Babor and colleagues from the California Endowment, the University of Washington, and the University of Kentucky, Lexington, evaluated the effectiveness of alcohol treatment programs. According to the researchers, simple approaches have yielded great results, yet seldom are implemented. For example, nearly half of the internists in the United States do not ask patients how much they drink. Many controlled trials, however, show that five minutes of physician-delivered advice effectively reduces the quantity and frequency of patient drinking. In one study, following a brief physician intervention, alcohol consumption by males who drank heavily declined 35 percent over nine months, compared with a 14 percent decline among patients who were not cautioned.
Brief interventions appeal economically too.
The researchers found that some types of individual treatments, including 12-step programs and pharmacological agents, have become increasingly available and effective. Insurance coverage limitations, provider shortages, and perceived stigma of treatment act as barriers. The researchers cite several approaches that work better, including raising the drinking age, higher taxes on liquor and beer, fewer hours of sale, advertising restrictions, and societal disapproval of drunk drivers. In one study involving 17 industrialized nations, an evaluation from 1970 to 1983 showed a 16 percent higher rate of alcohol consumption in countries where broadcast ads for alcohol were permitted. Those countries suffered a 10 percent higher rate of auto fatalities.