Search tips
Search criteria 


Logo of canfamphysLink to Publisher's site
Can Fam Physician. 1997 November; 43: 1959-62, 1965-7.
PMCID: PMC2255191

Reducing alcohol consumption. Comparing three brief methods in family practice.


OBJECTIVE: To compare the effects of three brief methods of reducing alcohol consumption among family practice patients. DESIGN: Patients randomly assigned to one of three interventions were assessed initially and at 3-, 6-, and 12-month follow-up appointments. SETTING: Family practice clinic composed of 12 primary care physicians seeing approximately 6000 adults monthly in a small urban community, population 40,000. PARTICIPANTS: Through a screening questionnaire, 134 men and 131 women were identified as hazardous drinkers (five or more drinks at least once monthly) during an 11-month screening of 1420 patients. Of 265 patients approached, 180 agreed to participate and 159 (83 men and 76 women) actually participated in the study. INTERVENTIONS: Three interventions were studied: brief physician advice (5 minutes), two 30-minute sessions with a physician using cognitive behavioural strategies or two 30-minute sessions with a nurse practitioner using identical strategies. MAIN OUTCOME MEASURES: Quantity and frequency (QF) of drinking were used to assess reduction in hazardous drinking and problems related to drinking over 12 months of follow up. RESULTS: No statistical difference between groups was found. The QF of monthly drinking was reduced overall by 66% (among men) and 74% (among women) for those reporting at least one hazardous drinking day weekly at assessment (N = 96). Men reported drinking significantly more than women. CONCLUSIONS: These results indicated that offering brief, specific advice can motivate patients to reduce their alcohol intake. There was no difference in effect between brief advice from their own physician or brief intervention by a physician or a nurse.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Rush BR. The use of family medical practices by patients with drinking problems. CMAJ. 1989 Jan 1;140(1):35–39. [PMC free article] [PubMed]
  • Rush B, Brennan M. Is the health profile of problem drinkers different from that of other patients? J Fam Pract. 1990 Jul;31(1):42–46. [PubMed]
  • Holder HD, Blose JO. Alcoholism treatment and total health care utilization and costs. A four-year longitudinal analysis of federal employees. JAMA. 1986 Sep 19;256(11):1456–1460. [PubMed]
  • Reiff S, Griffiths B, Forsythe AB, Sherman RM. Utilization of medical services by alcoholics participating in a health maintenance organization outpatient treatment program: three-year follow-up. Alcohol Clin Exp Res. 1981 Fall;5(4):559–562. [PubMed]
  • Buchsbaum DG, Buchanan RG, Centor RM, Schnoll SH, Lawton MJ. Screening for alcohol abuse using CAGE scores and likelihood ratios. Ann Intern Med. 1991 Nov 15;115(10):774–777. [PubMed]
  • Cleary PD, Miller M, Bush BT, Warburg MM, Delbanco TL, Aronson MD. Prevalence and recognition of alcohol abuse in a primary care population. Am J Med. 1988 Oct;85(4):466–471. [PubMed]
  • Coulehan JL, Zettler-Segal M, Block M, McClelland M, Schulberg HC. Recognition of alcoholism and substance abuse in primary care patients. Arch Intern Med. 1987 Feb;147(2):349–352. [PubMed]
  • Skinner HA, Holt S, Schuller R, Roy J, Israel Y. Identification of alcohol abuse using laboratory tests and a history of trauma. Ann Intern Med. 1984 Dec;101(6):847–851. [PubMed]
  • Puddey IB, Beilin LJ, Vandongen R. Regular alcohol use raises blood pressure in treated hypertensive subjects. A randomised controlled trial. Lancet. 1987 Mar 21;1(8534):647–651. [PubMed]
  • Buchan IC, Buckley EG, Deacon GL, Irvine R, Ryan MP. Problem drinkers and their problems. J R Coll Gen Pract. 1981 Mar;31(224):151–153. [PMC free article] [PubMed]
  • Gill JS, Zezulka AV, Shipley MJ, Gill SK, Beevers DG. Stroke and alcohol consumption. N Engl J Med. 1986 Oct 23;315(17):1041–1046. [PubMed]
  • Putnam SL. Alcoholism, morbidity and care-seeking. The inpatient and ambulatory service utilization and associated illness experience of alcoholics and matched controls in a health maintenance organization. Med Care. 1982 Jan;20(1):97–121. [PubMed]
  • Roghmann KJ, Roberts JS, Smith TS, Wells SM, Wersinger RP. Alcoholics' versus nonalcoholics' use of services of a health maintenance organization. J Stud Alcohol. 1981 Mar;42(3):312–322. [PubMed]
  • Malla A, Merskey H. Screening for alcoholism in family practice. Fam Pract Res J. 1987 Spring;6(3):138–147. [PubMed]
  • McIntosh MC, Sanchez-Craig M. Moderate drinking: an alternative treatment goal for early-stage problem drinking. Can Med Assoc J. 1984 Oct 15;131(8):873–876. [PMC free article] [PubMed]
  • Rush B, Ellis K, Crowe T, Powell L. How general practitioners view alcohol use. Clearing up the confusion. Can Fam Physician. 1994 Sep;40:1570–1579. [PMC free article] [PubMed]
  • Sanchez-Craig M, Annis HM, Bornet AR, MacDonald KR. Random assignment to abstinence and controlled drinking: evaluation of a cognitive-behavioral program for problem drinkers. J Consult Clin Psychol. 1984 Jun;52(3):390–403. [PubMed]
  • Sanchez-Craig M, Leigh G, Spivak K, Lei H. Superior outcome of females over males after brief treatment for the reduction of heavy drinking. Br J Addict. 1989 Apr;84(4):395–404. [PubMed]
  • Sanchez-Craig M, Spivak K, Davila R. Superior outcome of females over males after brief treatment for the reduction of heavy drinking: replication and report of therapist effects. Br J Addict. 1991 Jul;86(7):867–876. [PubMed]
  • Sanchez-Craig M, Davila R, Cooper G. A self-help approach for high-risk drinking: effect of an initial assessment. J Consult Clin Psychol. 1996 Aug;64(4):694–700. [PubMed]
  • Mayfield D, McLeod G, Hall P. The CAGE questionnaire: validation of a new alcoholism screening instrument. Am J Psychiatry. 1974 Oct;131(10):1121–1123. [PubMed]
  • McIntosh MC, Leigh G, Baldwin NJ. Screening for hazardous drinking. Using the CAGE and measures of alcohol consumption in family practice. Can Fam Physician. 1994 Sep;40:1546–1553. [PMC free article] [PubMed]
  • Anderson P, Scott E. The effect of general practitioners' advice to heavy drinking men. Br J Addict. 1992 Jun;87(6):891–900. [PubMed]
  • Wallace P, Cutler S, Haines A. Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption. BMJ. 1988 Sep 10;297(6649):663–668. [PMC free article] [PubMed]
  • Treadwell TL, Keeffe EB, Lake J, Read A, Friedman LS, Goldman IS, Howell CD, DeMedina M, Schiff ER, Jensen DM, et al. Immunogenicity of two recombinant hepatitis B vaccines in older individuals. Am J Med. 1993 Dec;95(6):584–588. [PubMed]
  • Dahl-Hansen E, Siebke JC, Frøland SS, Degré M. Immunogenicity of yeast-derived hepatitis B vaccine from two different producers. Epidemiol Infect. 1990 Feb;104(1):143–149. [PMC free article] [PubMed]
  • Greenberg DP, Vadheim CM, Wong VK, Marcy SM, Partridge S, Greene T, Chiu CY, Margolis HS, Ward JI. Comparative safety and immunogenicity of two recombinant hepatitis B vaccines given to infants at two, four and six months of age. Pediatr Infect Dis J. 1996 Jul;15(7):590–596. [PubMed]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada