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Alcohol:
Researchers: The Importance of Addressing Alcohol Moderation and Primary Alcohol Abuse Prevention
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Although 60-70% of the American adult population drinks alcoholic beverages, the vast majority drink in moderation with little ill effect. Most research on alcohol has focused on people who are dependent on alcohol, but who make up only 5 to 10% of the drinking population. Another group deserves greater attention from researchers. Approximately 25% of the people who drink are not alcoholics, but consume alcohol at levels that can pose risks to their health, and to their work and social lives. Alcohol counseling and education usually focuses on total abstinence. This sole focus on abstinence, plus the stigma associated with alcoholism, creates special challenges for engaging and educating this majority of risky drinkers. This group may wish to continue drinking and may not be aware of lower-risk guidelines.
Our demonstration-evaluation research has focused on 1) the impact of moderation counseling on alcohol consumption and on 2) the effectiveness of cardiovascular or general wellness counseling as a strategy for identifying potentially problematic drinkers and providing education that results in behavior change.
Issues addressed in this research include
- Cardiovascular health concerns as a route of access for alcohol education
- Study design issues
- Reliability of alcohol assessment methods
- Methods of counseling about alcohol moderation
- Outcome measures, including
- Changes in alcohol consumption
- Changes in medical utilization
- Changes in costs for medical care
- The cost/benefit ratio for proactive outreach and general wellness counseling that includes alcohol education
Worker Health Program research has documented that general health promotion or ongoing wellness programs offered in the workplace provide a useful place to present information about alcohol1. Health risk factors such as high blood pressure, lack of exercise and high cholesterol can all be partly a function of excessive alcohol use. Alcohol moderation can also be an important component of stress management. Health screenings can assess alcohol consumption patterns as part of general health assessment. In themselves assessments produce little change in alcohol behavior but they provide an opportunity to establish rapport and to gain permission to follow-up proactively with employees with health risks. Thereafter, ongoing, one-to-one outreach to participants provides opportunities to present alcohol information in the context of counseling about other health risks. All general health promotion counselors should have alcohol messages as part of their services, including information that can be used when counseling about stress, blood pressure, cholesterol, and weight management. Wellness Counseling Protocols can address these issues.
Notes:
- The research has been funded by the National Institute of Drug Abuse (NIDA) and the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) through its Center for Substance Abuse Prevention (CSAP).
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