Delivery of a brief motivational intervention to patients with alcohol-related facial injuries: role for a specialist nurse.
In this paper we focus on providing an alcohol screening and intervention service within maxillofacial surgery.
Two trained nurses screened patients with alcohol-related facial injuries who attended maxillofacial outpatient clinics, and gave brief motivational interventions to those who had been drinking to a hazardous level.
Patients were followed up at 3 and 12 months after the intervention. 195/249 patients (78%) drank to a hazardous level.
One hundred and ninety-five patients received an intervention. Duration of intervention was between 5 and 65 minutes. Reasons for refusal to participate included lack of interest or time, and the main reason for exclusion was length of time since injury.
The follow up rate was 103 (53%) at 3 months and 134 (69%) at 12 months.
CONCLUSIONS: The high level of hazardous drinking among people with facial trauma suggests a clear need for alcohol screening and intervention. It is feasible for nursing staff to deliver brief interventions in a busy maxillofacial trauma clinic.
Oakey F, Ayoub AF, Goodall CA, Crawford A, Smith I, Russell A, Holland IS. Delivery of a brief motivational intervention to patients with alcohol-related facial injuries: role for a specialist nurse. Br J Oral Maxillofac Surg. 2008 Mar;46(2):102-6. Epub 2007 Dec 21.
Are Brief Alcohol Interventions Likely to be Effective in Routine Primary Care Practice?
A number of meta-analyses have demonstrated the modest efficacy of brief interventions (BI) for nondependent unhealthy alcohol use in primary care settings.
Whether this level of efficacy can be expected when BIs are delivered outside of research studies in not known.
This systematic review identified 22 randomized trials including over 5800 patients. Investigators classified the trials on a spectrum from tightly controlled (efficacy design) to real world (effectiveness design) studies.
The scale considered whether patients presented to health care with a range of conditions, whether practices delivered a full range of medical services, whether practitioners routinely worked in the service rather than being funded by the trial, and whether the intervention could be delivered within standard visit times.
Participants who received BI drank approximately 3 standard drinks per week less than those who did not.
Longer duration of intervention was not significantly associated with a larger effect.
The effect of BI on drinking was similar in studies regardless of whether they were tightly controlled or had more real world characteristics.
Comments by Michael Levy, PhD
This meta-analytic study showed the benefit of BI in reducing alcohol consumption in both controlled and real world primary care settings.
It seems logical to assume similar results could be achieved in community treatment programs.
Since BI in the studies reviewed was designed to achieve a reduction in alcohol consumption, treatment programs could consider implementing BI for patients who are not interested in achieving abstinence but who want to reduce their intake.
Reference: Kaner EF, Dickinson HO, Beyer F, et al. The effectiveness of brief alcohol intervention in primary care settings: a systematic review. Drug Alcohol Rev. 2009;28(3):301–323.
Medical students’ knowledge about alcohol and drug problems: results of the medical council of Canada examination.
PURPOSE: To determine knowledge of a national sample of medical students about substance withdrawal, screening and early intervention, medical and psychiatric complications of addiction, and treatment options.
METHODS: Based on learning objectives developed by medical faculty, twenty-two questions on addictions were included in the 1998 Canadian licensing examination.
RESULTS: The exam was written by 858 medical students. The average score on the addiction questions was 64%.
Students showed strong knowledge of the clinical features of medical complications.
Specific knowledge gaps were identified for
withdrawal treatment protocols,
low-risk drinking guidelines,
taking an alcohol history,
substance-induced psychiatric disorders, and
Alcoholics Anonymous.
CONCLUSION: Medical students are knowledge-deficient around key learning objectives in addictions. The deficiencies were in areas of basic knowledge that could be learnt with little difficulty.
Research report; Kahan M, Midmer D, Wilson L, Borsoi D. Medical students’ knowledge about alcohol and drug problems: results of the medical council of Canada examination. Subst Abus. 2006 Dec;27(4):1-7.
Professional Interventions That Facilitate 12-Step Self-Help Group Involvement.
Facilitating patients’ involvement with 12-step self-help organizations, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), is often a goal of substance abuse treatment.
Twelve-step-facilitation (TSF) interventions have been found to be more effective than comparison treatments in increasing patients’ 12-step group involvement and in promoting abstinence.
Future TSF evaluation research should address the effectiveness of incorporating TSF interventions with cognitive-behavioral treatment methods, the relative impact of brief versus extended TSF interventions, and the cost-effectiveness and health care cost-offset of TSF interventions within managed health care systems.
Although the United States has developed an extensive array of professional alcohol treatment services over the past 30 years, the peer-led, voluntary fellowship known as Alcoholics Anonymous (AA) continues to be the most widely accessed resource for people with alcohol problems (McCrady and Miller 1993).
This article discusses the rationale for interventions that facilitate alcohol-dependent patients’ affiliations with AA and related mutual-help organizations (e.g., Narcotics Anonymous [NA]).
The article also reviews recent research comparing those interventions with other treatment methods.
Research; Professional Interventions That Facilitate 12-Step Self-Help Group Involvement. Journal article by Keith Humphreys; Alcohol Research & Health, Vol. 23, 1999
See also;
Twelve Step Facilitation is designed to support people returning to their community
Delivery of a brief motivational intervention to patients with alcohol-related facial injuries: role for a specialist nurse.
Facilitating patients’ involvement with 12-step self-help organizations, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), is often a goal of substance abuse treatment. 
