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Excessive alcohol consumption:
brief interventions can reduce consumption

General practitioners are well placed to identify people whose alcohol consumption is excessive, or who are at risk, and to intervene to help them reduce their alcohol consumption.

According to the World Health Organization (WHO), alcohol consumption is dangerous when it is regular (at least 5 days a week) and exceeds 3 "standard glasses" per day for men and 2 "standard glasses" per day for women; or occasional drinking, for both sexes, of more than 40g of pure spirits, i.e. 4 "standard glasses".

It is important to identify subjects who are not alcohol-dependent, but for whom the prolonged consumption of alcohol is likely to have harmful consequences ("risky use"), or who already display alcohol-related problems ("harmful use").

Several clinical trials have evaluated the effectiveness of medical intervention in such cases through a brief one-off conversation giving patients information on alcohol-related risks and advising them to reduce alcohol consumption to levels considered to be safe, with no drugs being prescribed. These trials report a measure of success.

Even if it can sometimes be difficult to broach the subject of alcohol with patients who have not come for a consultation on this issue, general practitioners are the best placed to adopt a routine strategy of identifying the problem and giving succinct advice when appropriate.

©Prescrire June 2005

Source: "Alcoolisation excessive : des interventions brèves pour modérer la consommation. Pour les sujets dont l'usage d'alcool est associé à un dommage médical, psychique ou social" Rev Prescrire 2005 ; 25 (262) : 450-457.

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