Alcohol Matrix Bite 2: Influence of the practitioner on brief interventions

Second part of the fortnightly course on the evidence for alcohol treatment. Selects, explores and explains seminal and key research on the influence of the practitioner on the impacts of brief interventions.

Alcohol treatments medications work in well as Europe as elsewhere

Whether differences between the patients mean impacts of the alcohol treatment medications acamprosate and naltrexone vary between Europe and the USA was the issue which motivated this fresh analysis of randomised trials. It confirmed the medications’ efficacy and found no evidence that this differed in European trials versus those conducted elsewhere.

Latest minimum unit pricing estimates

Whether alcohol tax rises would be an acceptable and effective alternative could determine the legality under EU law of Scotland’s law permitting a minimum unit price for alcohol. This analysis predicts tax rises would curb consumption and save lives, but not without perhaps unacceptably hitting the pockets of non-harmful drinkers.

Alcohol Matrix Bite 1: Screening and Brief Intervention

First instalment of a fortnightly course on the evidence for alcohol treatment selects, explains and discusses seminal and key research on the effectiveness of screening and brief interventions.

‘Inconclusive’ verdict on brief alcohol advice for young emergency patients

“Inconclusive” was the verdict of a review which aimed to assess the effectiveness of brief alcohol interventions among patients aged 11 to 21 attending for emergency care in the USA. Most promising targets seem to have been the more heavily or irresponsibly drinking among patients who were young adults rather than adolescents.

What about evidence-based commissioning?

Though central to implementing policy and embedding evidence in practice, the process of ensuring that the pattern of services in an area efficiently meets local needs is itself relatively unevidenced. Such reports as we have from the UK often graphically portray the shortfalls. Is payment-by-results the answer? Not yet, it seems from early results.

The impact of Scotland’s ambitious alcohol strategy

While some evidence-based interventions from Scotland’s alcohol strategy have been implemented, failure to introduce minimum unit pricing has limited the strategy’s contribution to declines in alcohol consumption and related harm.

It takes multiple sessions to shift risky-drinking of hospital inpatients

A review of studies of interventions for heavy drinkers among general hospital inpatients concluded that multi-session brief interventions could reduce drinking, while no effect was found for single interventions.  “Could” is an important qualifier: it remains unclear why, although they sometimes, brief interventions still often fail to produce significant effects.

Individualising treatment: an obviously ‘good thing’?

Individualising care might seem an obvious and basic prerequisite for any treatment service, but in practice services have often striven for the opposite.

Should we offer prizes for not using drugs or alcohol?

Can we dispense with counselling, therapy, with treatment as we know it, and just punish or deprive people of rewards when they use substances in undesired ways, and reward them when they behave as we and/or they would wish?