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Brief physician advice to problem drinkers reduced alcohol intake and societal costs

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 QUESTION: In patients with drinking problems, is brief advice given by a physician cost effective?


Cost benefit analysis of a randomised controlled trial with 12 months of follow up.


17 community clinics in Wisconsin, United States, comprising practices of 64 family physicians and general internists.


774 patients who were 18–65 years of age (62% men) and drank >14 alcoholic drinks/week (>168 g alcohol/wk) (>11 drinks/wk for women [>132 g alcohol/wk]). Exclusion criteria were pregnancy, attendance at an alcohol treatment programme or symptoms of alcohol withdrawal in the previous year, physician advice to change alcohol use in the previous 3 months, consumption of >50 drinks/week (>600 g alcohol/wk), or symptoms of suicide.


Patients were allocated to a brief physician advice intervention (n=392) or a control group (n=382). The intervention consisted of printed feedback on health behaviours and previous problem drinking, adverse effects of alcohol, drinking cues, and diary cards. Intervention group patients had two 15 minute physician visits 1 …

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  • Sources of funding: Robert Wood Johnson Foundation; National Institute on Drug Abuse; National Institute on Alcohol Abuse and Alcoholism.

  • For correspondence: Dr M F Fleming, Center for Addiction Research and Education, University of Wisconsin-Madison, 777 South Mills Street, Madison, WI 53715, USA. Fax +1 608 263 5813.

  • Abstract and commentary also appear in Evidence-Based Mental Health.