Brief interventions for risky drinkers

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Background

Alcohol is the third leading risk factor for disease and disability all over the world, and one of the leading causes of premature mortality in western societies. The harmful use of alcohol is the leading risk factor for death in men aged 15–59, and heavy drinking accounts for about two thirds of the burden of disease attributable to alcohol. Quite often alcohol problems remain unnoticed and no action is taken at early stages, when the drinker may drink large amounts but experience few or no problems.
In the early eighties screening and brief interventions (SBI) in primary health care settings were proposed as effective strategies to identify risky drinkers and help them reduce their drinking before severe impairment takes place. Since then, a growing body of evidence, including several meta-analysis and Cochrane reviews, has shown the efficacy and effectiveness of SBI in primary health settings.
But the effectiveness of SBI has not been enough to facilitate its general implementation in the routines of general practitioners, and in fact the dissemination of SBI has proven to be a difficult business. Qualitative and quantitative research has identified most of the facilitators and barriers for its implementation, and publicly funded research has been earmarked to address the dissemination problems worldwide. Some example are the EU funded projects (Phepa, Amphora, Odhin, Bistairs), the UK SIPS trials and the SBIRT developments sponsored by the Substance Abuse & Mental Health Services Administration (SAMHSA) in the US.
The efficacy and effectiveness of SBI in primary health seems now well established, but there are still quite a few questions that remain unsolved. Which practitioners should deliver them, what length should they have, the need for booster sessions, the added value of a motivational approach and some other relevant aspects of SBI still need further research.
In recent years SBIs have been tested in settings other than primary health, including hospitals, Accident and Emergency rooms, criminal justice, colleges and universities, social services and pharmacies. In some of those areas the evidence is scarce (ie: pharmacies) while in others it is very promising (ie: students, hospitals). New technologies have also offered the possibility of online tools, and in the last few years different web based applications have been tested successfully as new ways to deliver effective SBIs to larger amounts of people. Brief interventions have also spread to other topics, mostly other drugs of abuse like cannabis and tobacco.
In summary, this is an emerging field which is now incorporated in the alcohol strategies of most of the western countries. There is also an international network of researchers (INEBRIA) devoted to this topic, and the use of new technologies has opened the field to new research and dissemination opportunities.
The editors (Gual & Anderson) have a long experience of co-leading EU projects on SBI, have been deeply involved in the development of Inebria, and are in an excellent position to engage the most relevant people in the field in the publication process.

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