Summary

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  • Brief interventions are a useful approach for reaching primary care patients with alcohol use disorder.
    • The goal of brief interventions is to decrease or eliminate unhealthy alcohol use.
    • Effective brief interventions involve a combination of feedback/advice from the health provider and agreement and cooperation from the patient regarding drinking behaviors.
    • Patient resistance and ambivalence are the most common barriers to a successful brief intervention.
  • The CSAT and FRAMES approaches are two common, effective brief intervention strategies.
  • Motivational Interviewing is a patient-centered part of the treatment process and centers on the idea that motivation to change comes from a patient's desire to do so.
  • Patients begin the stages of change before they recognize that they have a problem and reach the final stage when they are able to maintain the changes they wish to make.
  • Treatment for alcohol use disorder is available in several settings, each of which is appropriate for different patients based on their stage of recovery and severity of the disorder.
    • Monitor the treatment of alcohol use disorder as you would other chronic conditions.
    • Substance use treatment specialists include addiction psychiatrists, addiction counselors, and PCPs who are specially certified in addiction medicine.
    • Major forms of psychosocial treatment include: cognitive-behavioral therapy, motivational enhancement therapy, and 12-step programs.
    • Self-help groups are peer-led and often complement professional treatment.
    • View relapse as a natural part of the recovery process rather than a treatment failure.