Alcohol Policy UK

Findings bulletins: brief interventions under the microscope, cycle of change & treatment

Recent bulletins from the Findings drug and alcohol bank:

‘My GP says I drink too much’: screening and brief intervention

In the absence of greater obstacles to availability, widespread screening to identify and then briefly advise risky drinkers has been the great hope for improved alcohol-related public health. This major hot topic update guides you through the studies which exposed questionable effectiveness and patchy implementation, leading to today’s less ambitious plans.

GP-delivered brief interventions an ‘important piece of the alcohol policy jigsaw’

Doctors working in Scotland share their thoughts on what helps and hinders the delivery of brief alcohol interventions in general practice. Stifled by short consultation times and faced by a lack of awareness among patients of what constitutes harmful/hazardous drinking, doctors face numerous challenges to embedding these interventions in routine practice despite or regardless of their enthusiasm.

'Health Matters': PHE resources on brief intervention CQUIN

Public Health England (PHE) have released a new 'Health Matters: preventing ill health from alcohol and tobacco use' resource calling on practitioners and commissioners to 'play their part' in reducing alcohol harms through Identification and Brief Advice. A case study of an IBA CQUIN in mental health settings in South London also provides insight into local implementation efforts.

In 2016 it was announced mental health and hospital trusts in England would be incentivised to deliver brief interventions for alcohol and smoking as part of the NHS Commissioning for Quality and Innovation (CQUINs). PHE says CQUIN No.9 Preventing Ill Health by Risky Behaviours is 'an important opportunity to improve patient health across England' via the opportunity to 'identify and support inpatients who are increasing or higher risk drinkers and to identify and support inpatients who smoke, and importantly to embed these interventions into routine care for patients.'

Findings bulletins: 2003 Licensing Act review, drink-driving, binge drinking ABI, interventions & treatment

Recent bulletins from the Findings drug and alcohol bank:  

Realising the potential of the 2003 UK alcohol licensing act 

Seen as excluding health concerns and requiring an individualistic and ‘premises by premises’ approach, interviews with stakeholders and a revisiting of the 2003 Licensing Act for England and Wales suggest it could nevertheless be used to address public health and to implement licensing policies and decisions based on likely overall local impact.

Armed forces deploy brief interventions: will it work?

The Ministry of Defence (MoD) have released figures on an initiative to deliver alcohol brief interventions across the armed forces via dental check ups, identifying 61% of military personnel drinking at a risky or harmful levels.

The MoD has previously come under fire over a lack of action to address high levels of alcohol misuse amongst the armed forces. In 2015 Professor Neil Greenberg, lead on military health at the Royal College of Psychiatrists and a former Navy Commander, said an approach based education alone was not effective. Subsequently an MoD alcohol working group was instigated to "review policy and data to identify what more we can do to tackle alcohol misuse in the armed forces".

Brief intervention reports highlight role of GPs but delivery still questionable

Two new reports on alcohol brief interventions (ABIs) in Scotland have been released, highlighting the importance of GP settings and key factors influencing delivery.

The reports, published by Scottish Health Action on Alcohol Problems (SHAAP), are:

• 'Practice and attitudes of General Practitioners in the delivery of Alcohol Brief Interventions in Scotland' [pdf]

• 'Financial incentives for Alcohol Brief Interventions in Primary Care in Scotland' [pdf]

Alcohol Research UK studies: drinking cultures, A&E, hospital and local projects & more

Findings from a range of alcohol-related projects funded by Alcohol Research UK are available to access below. 

• A new approach to measuring drinking cultures in Britain
• The 3rd National Emergency Department survey of Alcohol Identification and Intervention activity
• Frequent attenders to accident and emergency departments: a qualitative study of individuals who repeatedly present with alcohol-related health conditions
• An exploration of the role of alcohol in the life experiences of the homeless population in Merseyside, UK
• The Time of My Life Project: A Realist Evaluation

Findings bulletins: assessing England's treatment, AA effectiveness, recovery, women's day & more

Recent bulletins from the Findings drug and alcohol bank: 

How do treatment systems in England measure up?

English treatment systems perform at least as well as other countries on a number of measures, but have a considerably higher rate of drug-related deaths than elsewhere in Europe. As well as pursuing harm reduction and recovery, this Public Health England report stresses the importance of social integration as an objective.

Does AA really help drinkers stop?

For Britain 12-step fellowships offer a way to reconcile shrunken resources with the desire to get more patients safely out of treatment. Accounting for the self-selection bias which has obscured AA’s impacts, this synthesis of US trials finds that attending more meetings after treatment boosts abstinence. Why then is research equivocal on whether promoting attendance significantly improves drink-related outcomes?

Findings bulletins: naltrexone Vs acamprosate, treatment pathways, IBA history, drugs & doctors

Recent bulletins from the drug and alcohol bank:

Naltrexone and acamprosate best suited to different alcohol treatment goals

Naltrexone and acamprosate both modestly curtail drinking among alcohol-dependent patients, but which is best in which circumstances and for which treatment goals? To find out, this review compared the medications’ performance when separately benchmarked against a placebo, bringing to bear much more data than is available from the few trials which directly compared the two.

Alcohol treatment pathways can be confusing and unpredictable, say patients

Hospitals and mental health services to see IBA 'CQUIN' contracts

Certain secondary healthcare providers will be incentivised to carry out alcohol 'Identification and Brief Advice' (IBA), also known as brief intervention, as part of the NHS Commissioning for Quality and Innovation (CQUINs) payments framework from 2017-2019.

IBA has been a central component of alcohol prevention strategies in the UK and in other countries, but whilst there may be good evidence from research trials, the extent of effective routine implementation remains questionable. By introducing smoking intervention and IBA targets as part of the CQUIN, it is hoped that further progress will be made in delivering the NHS Five Year Forward View for achieving a healthier population.

'Reducing alcohol consumption: guidelines, local government and digital technologies' event presentations

Presentations from a recent NIHR School for Public Health Research and UCL Centre for Behaviour Change event on the 12th October 2016, 'Reducing alcohol consumption: guidelines, local government and digital technologies', are available to download.

Presentations included:

• What is the Alcohol Toolkit Study and future research opportunities - Dr Emma Beard [PDF]

• Comparison of brief interventions on smoking and alcohol consumption - DrJamieBrown [PDF]