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Supplement sponsor: American Academy of Family Physicians. Funding provided by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, cooperative agreement number NU84DD000010.

Fam Pract Manag. 2020;27(6):41-44


Risky alcohol use, defined as any level of alcohol consumption which increases the risk of harm to oneself or others, is both a substance use disorder and a medical issue.1 Recognized as one of the leading preventable causes of death, risky alcohol use leads to more than 95,000 deaths each year in the United States.2Family physicians and other primary care clinicians are in an ideal position to facilitate the prevention of morbidity and mortality associated with risky alcohol use.3 Many professional organizations recognize the importance of screening and behavioral counseling interventions to reduce alcohol misuse, including the American Academy of Family Physicians (AAFP), the American College of Obstetricians and Gynecologists (ACOG), and the U.S. Preventive Services Task Force (USPSTF).

The following are the USPSTF recommendations for alcohol screening and brief intervention (SBI) for adults and adolescents:

PopulationAdults, Including Individuals Who Are PregnantAdolescents
RecommendationScreen for unhealthy alcohol use and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions.
Grade: B
No recommendation
Grade: I (insufficient evidence)

Brief screening instruments can detect unhealthy alcohol use with acceptable sensitivity and specificity in primary care.

Screening testsOne- to three-item screening instruments are accurate for assessing unhealthy alcohol use in adults 18 years or older. These instruments include the Single-Item Alcohol Screening Questionnaire (SASQ) and the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C).
Treatments and interventionsBrief behavioral counseling interventions were found to reduce unhealthy alcohol use in adults 18 years or older, including individuals who are pregnant. Effective behavioral counseling interventions vary in their specific components, administration, length, and number of interactions. The USPSTF was unable to identify specific intervention characteristics or components that were clearly associated with improved outcomes.

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