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Randomised trials of brief interventions sent by email or letter to moderate 21st birthday drinking by US college students collectively failed to show consequent reductions in amounts drunk at these events, though they may have modestly reduced risks by lowering peak blood alcohol levels.
Computerisation promises to spread the consumption-moderating benefits of alcohol screening and brief advice or treatment across the population, overcoming resource and access limitations to in-person interventions, but small and transient effects may not be enough to mitigate the health and social consequences of drinking.
A rare ‘real world’ trial of whether a routine and feasible brief alcohol intervention can have population-wide public health benefits found that among university students in Sweden, web-based screening had very minor impacts which were not enhanced by feeding back the results.
Findings from this multi-university study in New Zealand seem an example of trials of brief alcohol interventions as they would be implemented in routine practice failing to match more promising findings from trials conducted in less ‘real world’ circumstances.
STUDY 2014 HTM file
Alcohol treatment in England 2013–14
In England a record 114,920 adults were in specialist alcohol treatment in 2013/14 and nearly 4 in 10 left as planned free of dependence. A good record, but probably still most dependent drinkers who might have benefited from treatment did without it, partly because relatively few found their way there via GPs and emergency departments.
Motivational interviewing’s originator has stressed how unexpected findings can force fruitful rethinking. This study may prove an example; designed to forefront the approach’s distinct active ingredients, other than fleetingly and non-significantly, these did not seem active at all among the stable, moderately dependent drinkers recruited to the trial.
DOCUMENT 2014 HTM file
Should dependent drinkers always try for abstinence?
For many alcohol treatment services in the past and now, the only acceptable and feasible drinking goal for alcoholics is abstinence. That mould was decisively cracked when in 1973 researchers showed that even physically dependent drinkers could learn to drink in moderation. Controversy was fierce, reaching to the US Congress, TV networks and the courts.
DOCUMENT 2013 HTM file
Alcohol treatment in England 2012–13
In England nearly 110,000 patients were in specialist alcohol treatment in 2012/13 and over a third left as planned free of dependence. These numbers probably mean most dependent drinkers who could benefit from treatment do without it, perhaps partly because so few find their way to treatment via their GPs and other medical services.
REVIEW 2013 HTM file
Quitting drugs: quantitative and qualitative features
Innovative re-analysis of US national surveys reveals that no matter how long ago someone became dependent on an illegal drug or alcohol, their chances of achieving remission remain the same. The findings challenge models which assume that progressive neural, lifestyle or psychological changes increasingly lock someone in to addiction.
STUDY 2011 HTM file
Probability and predictors of remission from life-time nicotine, alcohol, cannabis or cocaine dependence: results from the National Epidemiologic Survey on Alcohol and Related Conditions
The largest recent US national survey of drink and drug problems shows that outside the addiction treatment clinic, remission is the norm and recovery common. After 14 years half the people at some time dependent on alcohol were in remission, a milestone reached for cannabis after six years, and for cocaine after just five.
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