Prevention and Treatment of Alcohol Problems Research Opportunities (1990) / Chapter Skim
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10 Early Identification and Treatment
10 Early Identification and Treatment
Pages 215-230
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From page 215... ...
Part of the impetus for these programs comes from a broader public health concern with the relationship between life-style-related behavioral risk factors and disease prevalence (IOM, 1982~. Because life-style risk factors such as heavy or intensive drinking are often amenable to behavioral interventions, a number of innovative clinical trials, demonstration projects, and early intervention programs have been initiated.
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From page 216... ...
BRIEF INTERVENTIONS AND TREATMENT RESEARCH Current data indicate that brief interventions are superior to no treatment or to waiting list status. lithe assumption is made that some proportion of those on a waiting list would respond favorably to a brief intervention and not require treatment.
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From page 217... ...
. The following questions represent opportunities for research on brief interventions: · What brief intervention procedures effectively reduce the probability and severity of future alcohol abuse?
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From page 218... ...
The following questions represent opportunities for research on intervention to prevent fetal~alcohol effects: women? · What interventions are effective in suppressing drinking behavior among pregnant · Do drinking-focused interventions with pregnant women yield significant reductions in risk for their infants?
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From page 219... ...
, for example, evaluated 5- to 7-year outcomes among alcoholics who received unspecified treatment at medical and psychiatric facilities. They reported that 15 percent were totally abstinent for at least the 3 years prior to the interview, 1.6 percent sustained moderate drinking for that period, 4.2 percent were mostly abstinent with occasional moderate alcohol consumption, 12 percent were drinking heavily but without evidence of problems, and 66 percent continued heavy drinking with alcohol-related problems.
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From page 220... ...
Miller and Caddy, 1977~. The following questions represent opportunities for research on abstinence outcomes and goals: · What are the characteristics of individuals who sustain moderate and problem-free drinking over extended spans of time after treatment?
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From page 221... ...
Because verbal report methods such as the MAST and CAGE can be falsified easily by defensive individuals, there has been strong interest in the development of biological markers that reflect recent heavy drinking or the early onset of physical consequences. Measures of GOT and MCV have been used for both screening and confirmatory diagnosis, but their values are affected by substances other than alcohol, as well as by physical conditions that are not related to drinking; furthermore, they are not invariably elevated in heavy drinkers.
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From page 222... ...
Such dimensions include quantity and frequency of consumption, severity of alcohol dependence, number and intensity of alcohol-related social and health problems, and extent of family history and childhood risk factors for alcohol problems (Babor, Kranzler, and Lauerman, 1989~. The following questions represent opportunities for research questions on screening: · Which of the many available biochemical, clinical, and self-report screening procedures are best suited to the identification of alcohol problems in primary care clinics, through community surveys, or in employment and criminal justice settings?
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From page 223... ...
reported modest decreases in alcohol use and increased helpseeking among a population of problem drinkers given a "drinker's checkup" that involved feedback regarding personal impairment related to alcohol use. The following questions represent opportunities for research on recruitment: · What kinds of recruitment approaches (e.g., voluntary versus coercive; media solicitation versus initiation by a health worker)
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From page 224... ...
The Kristenson study indicated that early intervention may have significant long-term effects on morbidity and mortality, which would suggest that remuneration for such services could be highly cost-effective in health care delivery systems. The following questions represent opportunities for research on program implementation: · What are the principal barriers to implementation of effective screening, recruitment, and intervention strategies once they have been identified?
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From page 225... ...
Early detection of harmful alcohol consumption: A comparison of clinical, laboratory and self-report screening procedures. Addictive Behavior 14(2)
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Broad-spectrum behavioral treatment for chronic alcoholics: Effects of training controlled drinking skills.
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~ Baca. Two-year follow-up of bibliotherapy and therapist-directed controlled drinking training for problem drinkers.
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From page 228... ...
Ogborne, ~ C A note on the characteristics of alcohol abusers with controlled drinking aspirations.
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From page 229... ...
Clinical versus laboratory detection of alcohol abuse: The Alcohol Clinical Index Br.
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