![\"Doctor](\"http://www.cdc.gov/features/alcohol-alaska/alcohol-alaska_456px.jpg\")
Talk to a health professional about drinking too much alcohol.
About 38 million U.S. adults drink too much alcohol. Excessive or risky alcohol consumption includes binge drinking, high weekly or daily use, and any use by pregnant women or those under age 21.*
\nDrinking too much alcohol contributes to a wide range of negative health and social consequences, including motor vehicle crashes, violence, fetal alcohol spectrum disorders (FASDs), and, over time, can result in serious medical conditions, such as high blood pressure, gastritis (inflamed lining of the stomach), liver disease, and various cancers. Despite the adverse health effects, only 1 in 6 adults has talked about their alcohol use with a health professional. Learn about one state\u2019s effort to reduce risky drinking.
\nAlcohol Screening and Brief Intervention
\nInitially, Alaska\u2019s public health nurses described alcohol screening and brief intervention (SBI) as \u201cawkward\u201d and \u201cchallenging.\u201d Now, however, they routinely perform this preventive service to improve their patients\u2019 overall health.
\nAlaska has one of the highest reported rates of binge drinking in the nation, so public health nurses were interested in approaches that might address this problem. For example, in 2010, about 1 in 5 adults in Alaska reported binge drinking during the last 30 days.*
\nIn 2012, as part of an initiative funded by CDC, the Arctic FASD Regional Training Center (RTC), based at the University of Alaska Anchorage, began working with three public health nursing clinics in Fairbanks, Ketchikan, and Mat-Su/Wasilla to address this problem. This CDC initiative was designed to pilot implementation of alcohol SBI in primary care settings.
\n![\"Infographic:](\"http://www.cdc.gov/features/alcohol-alaska/alcohol-alaska_a600px.gif\")
\n Despite the adverse health effects, only 1 in 6 adults has talked about their alcohol use with a health professional.
\nResearch shows that alcohol SBI is effective at reducing the amount of alcohol consumed by those who are drinking too much. Alcohol SBI is a clinical preventive service recommended by the US Preventive Services Task Force. It consists of:
\n- \n
- A validated set of screening questions to identify patients\u2019 drinking patterns and \n
- A short conversation with patients who are drinking too much and, for patients with severe risk, a referral to specialized treatment. \n
Screening is a routine part of the work public health nurses do, whether in Alaska or other parts of the country. For example, public health nurses screen for high blood pressure, high cholesterol, obesity, recommended immunizations, depression, and domestic violence. Asking the nurses to screen for alcohol as a part of their routine services was initially met with some resistance and hesitancy. \u201cIt\u2019s so private, and there\u2019s so much stigma around it,\u201d was one nurse\u2019s reaction. Also, it added yet another screening to their already packed schedules. Screening patients\u2019 alcohol use and conducting brief interventions with those who were drinking too much required both buy-in from the nurses and training to improve their skills and confidence.
\n\u201cI think it (alcohol SBI) definitely fits because of the fact we know alcohol is a problem. We are public health nurses. Our job is to try and help out the community as a whole, and alcohol is a big issue for the community that we live in.\u201d \u2013 Public Health Nurse, State of Alaska
\nThe Arctic FASD RTC and the Alaska Section of Public Health Nursing (PHN) collaborated to find the best way to get this done. They developed and refined alcohol SBI by using a planning team that included administrators, front line nurses, and those knowledgeable about SBI. They had to:
\n- \n
- Choose screening tools, \n
- Decide on appropriate frequency and visit types, and \n
- Identify documentation procedures. \n
The team tested the process to understand the challenges and determine what really worked before officially launching alcohol SBI.
\n![\"Colleen](\"http://www.cdc.gov/features/alcohol-alaska/alcohol-alaska_b250px.jpg\")
\n Colleen McNulty, Nurse Consultant, State of Alaska
\nAlaska\u2019s public health nurses have reported successes in patient interactions and in developing their own unique styles to conduct alcohol SBI. \u201cWe should be asking these questions. I think it\u2019s right in there with our usual screenings or questions that we ask people regarding their well-being and health habits,\u201d shared a nurse. Alcohol SBI is now done during family planning, sexually transmitted infection, and tuberculosis clinical visits. The involvement of a team with different roles and perspectives helped to make this a successful effort. Building on this success, Alaska PHN expanded their efforts to integrate alcohol SBI in all 22 Public Health Centers and over 240 villages across the state.
\nTraining and practice change to incorporate alcohol SBI into clinical practice for over 180 staff members, including 120 nurses, took 15 months. Beginning July 2014, alcohol SBI became an integral prevention screen in Alaska\u2019s public health nursing practice. \u201cI think it definitely fits because of the fact we know alcohol is a problem. We are public health nurses. Our job is to try and help out the community as a whole, and alcohol is a big issue for the community that we live in,\u201d concludes a nurse.
\nWe Know What Works
\nAlcohol screening and brief counseling works.
\nDoctors, nurses, and other health professionals should screen all adult patients and counsel those who drink too much to drink less.
\nResources for Health Professionals
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- Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use: A Step-by-Step Guide for Primary Care Practices [2.10 MB]
This guide provides steps and resources to help primary care practices plan and implement alcohol SBI. \n - Alcohol Screening, Brief Intervention, and Referral to Treatment: Demonstration Videos
Oregon Health and Science University\u2019s family medicine program offers videos with hands on examples of conducting alcohol SBI. \n - QuantiaMD
This website provides free continuing education opportunity for physicians based on a
presentation highlighting key aspects of alcohol SBI and findings from the CDC 2014 Vital Signs report . \n - Women and Alcohol
The American College of Obstetricians and Gynecologists provides resources for women\u2019s healthcare providers. \n - American College of Nurse-Midwives: Alcohol & Pregnancy
This webpage targets patients and includes risks of drinking alcohol during pregnancy and a chart showing when birth defects are most likely to occur. \n
States and communities can reduce excessive alcohol use, including binge and underage drinking, by implementing evidence-based population strategies that are documented in the Guide to Community Preventive Services.
\n* Binge drinking is defined as drinking five or more drinks on an occasion for men and four or more drinks on an occasion for women.
\nMore Information
\nMore Information
\n- \n
- Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse \u2013 U.S. Preventive Services Task Force \n
- CDC Fetal Alcohol Spectrum Disorders \n
- CDC Alcohol and Public Health \n
- National Organization on Fetal Alcohol Syndrome \n
- Substance Abuse and Mental Health Services Administration \n
- National Institute on Alcohol Abuse and Alcoholism \n