What intervention should be provided to adults who screen positive for unhealthy alcohol use?

What intervention should be provided to adults who screen positive for unhealthy alcohol use?

• A. Pharmacotherapy only
• B. Brief behavioral counseling interventions
• C. Inpatient rehabilitation
• D. No intervention

Answer: (B)

After a positive screen, the recommended intervention is brief behavioral counseling interventions. These are short, structured conversations that can be delivered in the primary care visit (often about 5–15 minutes) and may include personalized feedback on how much and how often the person drinks, clear advice to reduce or stop drinking, collaborative goal setting, and plans for follow-up. The goal is to motivate and support modest, realistic changes in drinking behavior, which the evidence shows can lead to meaningful reductions in drinking days, total intake, and related harms over time. This approach is appropriate for a broad range of levels of unhealthy use and does not require specialized treatment to start. Pharmacotherapy alone is not the default intervention for all adults who screen positive, because the initial step is to provide counseling and support to reduce use; pharmacotherapy may be added if there is or develops a higher level of risk or a diagnosed alcohol use disorder. Inpatient rehabilitation is reserved for more severe, complex cases requiring intensive treatment, not routine positive screens. No intervention would miss the opportunity to reduce risk and is not aligned with recommending at least an initial brief counseling contact after screening.

After a positive screen, the recommended intervention is brief behavioral counseling interventions. These are short, structured conversations that can be delivered in the primary care visit (often about 5–15 minutes) and may include personalized feedback on how much and how often the person drinks, clear advice to reduce or stop drinking, collaborative goal setting, and plans for follow-up. The goal is to motivate and support modest, realistic changes in drinking behavior, which the evidence shows can lead to meaningful reductions in drinking days, total intake, and related harms over time. This approach is appropriate for a broad range of levels of unhealthy use and does not require specialized treatment to start.

Pharmacotherapy alone is not the default intervention for all adults who screen positive, because the initial step is to provide counseling and support to reduce use; pharmacotherapy may be added if there is or develops a higher level of risk or a diagnosed alcohol use disorder. Inpatient rehabilitation is reserved for more severe, complex cases requiring intensive treatment, not routine positive screens. No intervention would miss the opportunity to reduce risk and is not aligned with recommending at least an initial brief counseling contact after screening.