According to the National Institute for Alcohol Abuse and Alcoholism (NIAAA), about 3 in 10 adults in the United States drink at levels that increase their risk for physical, social and mental health problems. Clinical trials have shown that brief interventions can promote significant and lasting reductions in drinking levels in at-risk drinkers. Even patients with alcohol dependence who will not accept referral to addiction treatment programs can achieve improvement with repeated alcohol-focused visits with a health provider. If you have not already done so, NIAAA encourages all health providers to incorporate alcohol screening, brief intervention, and treatment referral into their practice. After asking questions about alcohol use and resulting impacts, NIAAA offers the following steps for intervening for those with alcohol use disorders:

Advise and Assist

• State your conclusion and recommendations clearly. “I believe that you have an alcohol use disorder and I strongly recommend that you quit drinking.”
• Gauge readiness to change drinking pattern. “Are you willing to consider making changes in your drinking?”
• Negotiate a goal to abstain for a period of time.
• Agree on a plan including strategies for managing high-risk situations and identifying sober loved ones and/or friends who can be a support.
• Consider referral to an addiction specialist, especially if the patient is alcohol dependent
• Consider recommending a mutual help group.
• Consider medication to support abstinence.
• Schedule follow-up appointments.

Follow-up

• Document alcohol use and review goals at each scheduled follow-up visit.
• If patient has met goals, reinforce and support continued adherence to recommendations.
• If not, acknowledge that change is difficult and encourage continued effort.
• Relate drinking to problems (medical, social, and psychological) as appropriate.
• Continue to recommend referral to an addiction specialist, mutual help groups, and consider appropriate medication.
• Address coexisting medical and psychiatric disorders as needed. More information, screening tools, and other resources are available at: www.NIAAA.nih.gov or Cigna.com.

To refer a patient to an addiction specialist, call the number on back of the member’s ID card.