“Alcohol dependence” means the person is physically dependent on alcohol. Diagnosis generally requires three or more of these symptoms within a 12-month period: • A great deal of time spent in obtaining, using, or recovering from use of alcohol • Difficulty controlling drinking, i.e. persistent desire to drink or unsuccessful attempts to cut down on drinking • Physical withdrawal symptoms when alcohol use is stopped or decreased, or drinking to relieve withdrawal symptoms • Tolerance: increased amounts of alcohol are required to achieve the same effects Giving up or reducing important activities because of alcohol use • Drinking more or longer than intended
• Continued use despite recurrent psychological or physical problems.8 Your role in a brief intervention is to: 25
1) Provide information and feedback empathetically about screening results, the link between drinking and the problems it can cause, guidelines for lower-risk alcohol use, and ways to reduce or stop drinking. 2) Understand the client’s view of drinking and increase his or her motivation to change. This approach encourages clients to think about and discuss what they like and dislike about their drinking, how drinking may have contributed to their current problems, and how they might want to change their drinking behavior and risks. Engage clients in a discussion that helps them come to their own decisions about drinking. 3) Provide clear and respectful advice, without judgment or blame, about the need to decrease risk by cutting down or quitting drinking and avoiding high-risk situations. Explore different options by listening to the person’s concerns and clarifying his or her strengths, resources, and past successes. The best result is for clients to develop their own goals and a realistic plan of action to achieve them based on how ready they are to change. The plan may involve reducing drinking somewhat or quitting altogether. Resistance to change is a common response. In...
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2. NIAAA Alcohol Education Project. (2004). Standardized SBIRT Curriculum. Retrieved May 15, 2008 from http://www.ed.bmc.org/sbirt/scope.php
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7. U.S. Department of Transportation, National Highway Transportation Safety Administration. (2007, July). Traffic safety facts: 2006 traffic safety annual assessment—A preview. Retrieved May 26, 2008 from http://www-nrd.nhtsa.dot.gov/Pubs/810791.PDF
9. SAMHSA Bulletin. (2008, March 5). SAMHSA to provide $3.75 million to train medical residents in SBIRT techniques. Retrieved May 15, 2008 from http://www-nrd.nhtsa.dot.gov/Pubs/810791.PDF http://www.samhsa.gov/newsroom/advisories/0803041505.aspx
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17. U.S. Preventive Services Task Force. (2004). Screening and behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: Recommendation statement. Annals of Internal Medicine 140(7), 554-556.
18. Ballesteros, J., González-Pinto, A., Querejeta, I., & Arino, J. (2004). Brief interventions for hazardous drinkers delivered in primary care are equally effective in men and women. Addiction 99(1), 103-108.
19. D’Onofrio, G, & Degutis, L. C. (2002, June) Preventive care in the emergency department: Screening and brief intervention for alcohol problems in the emergency department: A systematic review. Academic Emergency Medicine 9(6), 627-638.
20. SAMHSA News (2008, March/April). Screening works: Update from the field. Retrieved May 26, 2008 from http://www.samhsa.gov/ SAMHSA_News/VolumeXVI_2/article1.htm
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