Screening isn't enough: Study finds few adults who drink heavily receive interventions

RESEARCH TRIANGLE PARK, N.C. — Most U.S. adults who visit a health care provider are screened for alcohol use, but relatively few receive interventions to reduce heavy drinking or treatment referrals, according to a new study led by researchers at RTI International, an independent scientific research institute.

Published in the journal Addiction, the study found that while nearly 69% of adults who received health care reported being screened for alcohol use, only 3.5% of those reporting heavy drinking received advice from a health care provider to reduce their alcohol consumption.

The findings reveal where screening, brief intervention and referral to treatment (SBIRT), an evidence-based approach for identifying unhealthy drinking and connecting people to care, breaks down. Most patients are asked about their drinking, but few who drink heavily get the follow-up that could help, and women are the most likely to be missed. For health systems, that gap is also an opportunity to build on routine visits patients are already making.

"Alcohol screening is an important first step, but screening alone is not enough," said Katherine Karriker-Jaffe, Ph.D., a behavioral health expert at RTI. "Our findings show that many people who could benefit from early intervention are not receiving it, particularly those who drink heavily but have not developed alcohol use disorder."

The study also found that just 7.5% of adults with alcohol use disorder reported receiving alcohol treatment in the previous year. In addition, women were approximately 48% less likely than men to receive a brief intervention and 38% less likely to receive a treatment referral.

Researchers examined nationally representative data from more than 139,000 U.S. adults who participated in the National Survey on Drug Use and Health (NSDUH), a survey conducted by RTI on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA). The study assessed whether individuals received health care, alcohol screening, brief interventions, treatment referrals, and alcohol treatment. Researchers also examined differences based on alcohol consumption, demographic characteristics and insurance coverage.

The researchers noted that individuals who drink heavily but do not meet the criteria for alcohol use disorder represent an important opportunity for prevention. They also identified a need to expand alcohol-related services beyond traditional health care settings, particularly for individuals who face barriers to accessing care.

“Three out of four people who drink heavily are already being asked about their drinking when they see a health care provider, but fewer than one in 20 are advised to cut back. That’s a missed chance to act before an alcohol use disorder develops, which is when a conversation about drinking less works best,” said Carolina Barbosa, Ph.D., a health economist at RTI. “Prevention means reaching people who drink heavily before they develop a disorder, both in the doctor’s office and in the communities where people who struggle to get care live and work.”

The study was supported by the National Institutes of Health under award number R01AA029812.

Read the full study (via Addiction)

Learn more about RTI's behavioral health expertise

Learn more about RTI’s role in NSDUH