JavaScript has to be enabled to view this site. Learn how to enable JavaScript.

ICSI Icon

Level I – Alcohol Misuse

Level I Services: Preventive services for which clinicians and health systems must assess the need.  These services must be recommended to each patient, as they have the highest value and are worthy of attention at every opportunity.

The USPSTF recommendations are fully endorsed by the ICSI Preventive Services work group. Grade of Recommendation and Level of Certainty as Evaluated by USPSTF
  1. “Clinicians screen adults ages 18 years or older for alcohol misuse and provide persons engages in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse.”
  2. “The current evidence is insufficient to assess the balance of benefits and harms of screening and behavioral counseling interventions in primary care settings to reduce alcohol misuse in adolescents.”
(USPSTF Last Revised 2013)
Grade of Recommendation:
  1. B
  2. I Statement

Level of Certainty:

  1. Moderate
  2. Undetermined
“Benefits:
The USPSTF found adequate evidence that brief behavioral counseling interventions are effective in reducing heavy drinking episodes in adults engaging in risky or hazardous drinking. These interventions also reduce weekly alcohol consumption rates and increase adherence to recommended drinking limits. Direct evidence about the effectiveness of brief behavioral counseling interventions in pregnant women engaging in alcohol use is more limited. However, studies in the general adult population show that such interventions reduce alcohol consumption and increase adherence to recommended drinking limits among women of childbearing age.
The USPSTF found insufficient evidence of the effect of screening for alcohol misuse and brief behavioral counseling interventions on outcomes in adolescents.
Harms:
There are minimal data to assess the magnitude of harms of screening for alcohol misuse or of consequent brief behavioral counseling interventions in any population. However, no studies have identified direct evidence of harms. Thus, given the non-invasive nature of the screening process and behavioral counseling interventions, the related harms are probably small to none.
Benefits-Harms Assessment:
The USPSTF concludes with moderate certainty that there is a moderate net benefit to screening for alcohol misuse and brief behavioral counseling interventions in the primary care setting for adults ages 18 years or older.
The evidence on screening for alcohol misuse and brief behavioral counseling interventions in the primary care setting for adolescents is insufficient, and the balance of benefits and harms cannot be determined.”
Relevant Resources:
http://www.uspreventiveservicestaskforce.org/uspstf12/alcmisuse/alcmisusefinalrs.htm
Implementation Tools and Strategies:
Screening and Behavioral Counseling Interventions to Reduce Alcohol Misuse