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Brief Chat With ER Docs Can Curb Problem Drinking

In study, 10 minutes of counseling helped people cut down on excessive alcohol use

FRIDAY, Jan. 4 (HealthDay News) -- Even a little counseling on the dangers of alcohol abuse by an emergency room doctor or nurse can help problem drinkers cut back by at least three drinks a week, new research shows.

Researchers trained emergency room staff in a standard alcohol-use screening and counseling tool, then applied it to almost 7,800 emergency patients in 14 university-based emergency centers around the United States.

They found that more than one in four men reported drinking more than four drinks per day, and the same number of women reported consuming three or more drinks per day. That's the standard below which people are considered low-risk drinkers, as defined by the U.S. National Institute on Alcohol Abuse and Alcoholism.

Of those patients who drank more than those limits, more than 1,100 agreed to participate in the study. They were then randomly assigned to receive either a one-on-one interview, following the Brief Negotiated Interview (BNI) protocol, with an emergency room doctor or nurse about alcohol use and abuse, or a pamphlet explaining low-risk drinking and listing local alcohol treatment providers. Those patients who received one-on-one counseling were also given the pamphlet.

"The BNI, a conversation between emergency-care providers and patients that involves listening rather than telling, and guiding rather than directing, is designed to review the patient's current drinking patterns, assess their readiness to change, offer advice about the low-risk guidelines and the next steps to pursue, and negotiate a written prescription for change or a drinking agreement with the patient," study co-author Dr. Edward Bernstein, professor and vice chair for academic affairs in the department of emergency medicine at Boston University School of Medicine, said in a prepared statement. The interview typically takes less than 10 minutes.

The research team followed up with the participants after three months to find out whether they had changed their drinking habits. Those who went through the 10-minute interview reported drinking three fewer drinks per week than those who merely received a pamphlet; more than one in three people who were counseled one-on-one reported drinking at low-risk levels, compared with one in five of the participants who were given an informational pamphlet.

The results are published in the December edition of the Annals of Emergency Medicine.

"These new findings underscore the importance of using the American Medical Association health-care codes for substance abuse screening and brief intervention," study co-author Terry Cline, administrator of Substance Abuse and Mental Health Services Administration, said in a prepared statement.

The American Medical Association develops codes for health services which are used to report procedures to public and private health insurance programs. In January, new codes will allow physicians to report services they provide to screen patients for alcohol problems and to provide a behavioral intervention for high-risk drinking.

"Using these new codes will increase the likelihood that an estimated 18.8 million Americans with serious alcohol abuse problems will receive effective intervention services that could possibly save their lives and promote well-being," said Cline.

More information

To learn more about alcohol abuse visit the U.S. National Institute on Alcohol Abuse and Alcoholism.

-- Madeline Vann

SOURCE: U.S. National Institute on Alcohol Abuse and Alcoholism, news release, Dec. 26, 2007

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