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Alcohol Use Disorders in Primary Health Care: What Do We Know and Where Do We Go?

Lookup NU author(s): Professor Peter Anderson


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To analyze the current paradigm and clinical practice for dealing with alcohol use disorders (AUD) in primary health care.Analyses of guidelines and recommendations, reviews and meta-analyses.Many recommendations or guidelines for interventions for people with alcohol use problems in primary health care, from hazardous drinking to AUD, can be summarized in the SBIRT principle: screening for alcohol use and alcohol-related problems, brief interventions for hazardous and in some cases harmful drinking, referral to specialized treatment for people with AUD. However, while there is some evidence that these procedures are effective in reducing drinking levels, they are rarely applied in clinical practice in primary health care, and no interventions are initiated, even if the primary care physician had detected problems or AUD. Rather than asking primary health care physicians to conduct interventions which are not typical for medical doctors, we recommend treatment initiation for AUD at the primary health care level. AUD should be treated like hypertension, i.e. with regular checks for alcohol consumption, advice for behavioral interventions in case of consumption exceeding thresholds, and pharmaceutical assistance in case the behavioral interventions were not successful. Minimally, alcohol consumption should be screened for in all situations where there is a co-morbidity with alcohol being a potential cause (such as hypertension, insomnia, depression or anxiety disorders).A paradigm shift is proposed for dealing with problematic alcohol consumption in primary health care, where initiation for treatment for AUD is seen as the central element.

Publication metadata

Author(s): Rehm J, Anderson P, Manthey J, Shield KD, Struzzo P, Wojnar M, Gual A

Publication type: Article

Publication status: Published

Journal: Alcohol and Alcoholism

Year: 2016

Volume: 51

Issue: 4

Pages: 422-427

Online publication date: 15/11/2015

Acceptance date: 20/10/2015

ISSN (print): 0735-0414

ISSN (electronic): 1464-3502

Publisher: Oxford University Press


DOI: 10.1093/alcalc/agv127

PubMed id: 26574600


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