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24-10-2012 | Psychology | Article

Behavioral counseling can impact risky drinking habits

Abstract

Free abstract

medwireNews: Counseling about alcohol misuse can reduce the number of drinks consumed weekly among adults with risky drinking habits, according to a review of the evidence.

In addition, behavioral counseling can reduce the number of adults who engage in heavy drinking episodes, as well as reduce the amount of drinking above the currently recommended quantities, report investigators in the Annals of Internal Medicine.

"The evidence for effectiveness in adults is strongest for brief multicontact interventions," says lead researcher Daniel Jonas (University of North Carolina, Chapel Hill, USA) and colleagues. These brief interventions are typically 10 to 15 minutes long.

The researchers note that other published accounts have suggested that the benefit of multicontact interventions are durable, often remaining for several years.

The strength of evidence supporting the improvement in intermediate outcomes is moderate, and there is some evidence, albeit weaker, that behavioral counseling might reduce the number of hospital days for risky or hazardous drinking.

The systematic review, conducted for the US Preventive Services Task Force, included 23 trials with at least 6 months' duration. The analysis included individuals with alcohol misuse identified through screening in primary care settings. Risky or hazardous drinking was defined as the consumption of alcohol above recommended daily, weekly, or per occasion amounts, but most trials excluded patients with alcohol dependence.

Among the adults receiving treatment with behavioral counseling there was a significant reduction in the number of drinks consumed per week. Relative to baseline, those enrolled in behavioral counseling drank 3.6 fewer drinks per week as measured in 10 trials with 4332 adults.

In seven trials with 2737 individuals, 12% fewer adults given counseling reported heavy drinking episodes, compared with those not given counseling, while in nine trials with 5973 adults, counseling resulted in an 11% increase in adults drinking within the recommended limits.

Among studies that included young adults or college students, the analysis also found that counseling reduced consumption and the number of heavy-drinking episodes.

In an analysis of older adults, there was a moderate level of evidence to show a reduction of 1.7 drinks per week for those who underwent behavioral counseling.

For health outcomes, the evidence showed no difference between the control arm and behavioral counseling with regard to mortality. The evidence was also insufficient to draw conclusions about the effect of counseling on alcohol-related liver problems.

The researchers caution that it is unclear if these findings apply to individuals with comorbid conditions, particularly psychiatric conditions such as anxiety or depression.

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