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Article
As the burden of alcohol misuse — in terms of disease, trauma and social problems — grows in Canada, increased access to brief interventions is recommended. Such access forms part of a comprehensive two-tiered response involving population-level changes, such as regulating the marketing, pricing and availability of alcohol, and more focused practices, such as education and intervention.1 In 2007, recommendations from Canada’s National Alcohol Strategy Working Group identified screening, brief intervention and referral to specialist treatment as an important strategy for reducing the negative health effects of excessive alcohol consumption, particularly injury and chronic disease.2 Here, we discuss a practical approach to the delivery of brief interventions based on evidence supporting their effectiveness (Box 1). This approach is intended for use by health care providers who determine, during the provision of primary, specialty or hospital care, that an individual is engaging in unhealthy drinking. Box 1: Evidence used in this review We searched PubMed and MEDLINE databases using combinations of the terms “brief,” “intervention,” “alcohol” and “review” along with the “related articles” function. These searches yielded citations numbering in the hundreds; we focused our attention on the most recently published research, particularly state-of-the-art systematic reviews and a recent systematic review of reviews. We selected the examples of brief interventions featured here to illustrate differing salient aspects of their content and delivery (intensiveness and intensity, type of practitioner) with a focus on high-quality research (i.e., randomized controlled trials) and evidence related to the Canadian context.
Article
Introduction: At present, the substances acamprosate, naltrexone and disulfiram are available for pharmacotherapy in alcohol dependence, but clinical studies found only modest effect sizes of these treatment options. Areas covered: This article focuses on current pharmacological treatment approaches for alcohol dependence, which have been evaluated in randomized, placebo-controlled trials (RCTs). Expert opinion: Besides the opioid system modulator nalmefene, which has recently been approved as a medication for the reduction of alcohol consumption, several compounds have been investigated in patients with alcohol dependence using a randomized, placebo-controlled design. In these studies, the antiepileptic drugs topiramate and gabapentin were found to be effective in improving several drinking-related outcomes, whereas levetiracetam failed to show efficacy in the treatment of alcohol dependence. Clinical studies using (low-dose) baclofen, a selective GABA-B receptor agonist, produced conflicting results, so that results of further trials are needed. Varenicline has also shown mixed results in two RCTs, but might possibly be useful in patients with comorbid nicotine dependence. The α1 adrenergic antagonist prazosin is currently under investigation in alcohol dependence with and without comorbid posttraumatic stress disorder (PTSD). Finally, first clinical evidence suggests that the 5-HT3 antagonist ondansetron might possibly be used in future within a pharmacogenetic treatment approach in alcohol dependence.
Brief interventionf for hazardous and harmful drinking a manual for use in primary care
  • T Babor
  • J Higgins-Biddle
Babor T, Higgins-Biddle J: Brief interventionf for hazardous and harmful drinking a manual for use in primary care. http://apps. who.int/iris/bitstream/10665/67210/1/WHO_MSD_MSB_01.6b. pdf Letzter Zugriff: 03.03.2016.
Kurzinterventionen bei Patienten mit risikoreichem Alkoholkonsum: ein Leitfaden für Ärzte und Fachleute in der Grundversorgung
  • P Loeb
  • B Stoll
  • B Weil
Loeb P, Stoll B, Weil B: Kurzinterventionen bei Patienten mit risikoreichem Alkoholkonsum: ein Leitfaden für Ärzte und Fachleute in der Grundversorgung. EMH-Media, 2014. http:// praxis-suchtmedizin.ch/fosumos/index.php/de/kurzintervention. Letzter Zugriff: 03.03.2016.