Good practice principles low rik drinking EU RARHA

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13Babor T et al. (2001) AUDIT. The Alcohol Use Disorders Identification Test. Guidelines for Use in Primary Care.Second Edition. Geneva: WHO.14Knight J et al. (2002) Validity of the CRAFFT substance abuse screening test among adolescent clinic patients.Archives of Pediatrics and Adolescent Medicine, 156(6), 607-14.15O’Brien C. (2008) The CAGE Questionnaire for Detection of Alcoholism. The Journal of American MedicalAssociation, 300(17), 2054-2056.16De Paepe N. (2011) De SEM-J: een screeningsinstrument voor Jongeren. Verslaving, 7(2), 51-61.17Kuttler H and Lang S. (2010) HaLT. Präventiv gegen riskanten Alkoholkonsum. SuchtMagazin, 1/2010.18Kadiri H. (2014) Alcohol Purchase Age Limits in Europe. Brussels: Eurocare.52Good practice principles for low risk drinking guidelines
Chapter 5Guidelines to support early identificationand brief intervention for alcohol usedisorders in EuropeEmanuele Scafato a , Claudia Gandin a , Silvia Ghirini a , Lucia Galluzzo a and Sonia Martire aNearly 74% of Europeans aged ≥15 years drink alcoholic beverages. It has been estimated that 58million Europeans (15%) are hazardous drinkers, and 23 million are alcohol dependent (5% of men, 1%of women) [ 1 ]. Hazardous drinkers in particular are often unaware of being at risk of health and socialharm. They are the prime target group for an intervention termed "brief", defined by the World HealthOrganization (WHO) as a practice aimed at early identification of hazardous alcohol consumptionhabits and alcohol-related problems and at motivating the individual towards change [ 2 ].Brief interventions are short educational sessions and counselling (varying from 5 to 30/40minutes and from a single session to multiple sessions). While inspired by the principles ofmotivational interviewing, “brief intervention” is actually a general term for a wide range ofinterventions, which have basically two common characteristics: they are interventions at thecommunity level, 1. provided by non-specialist professionals (general practitioners and otherprimary health care professionals such as hospital doctors, nurses, social workers, criminal justiceofficers and others); and 2. targeted to persons with hazardous or harmful alcohol consumption,who nevertheless do not seek treatment for alcohol use disorders. Brief intervention aims tomotivate the person to change their behavior, exploring with the health professional theunderlying reasons for alcohol consumption and identifying concrete reasons for change. Theintervention is a way to make the patient aware of possible conflicts and ambiguity, and tofacilitate a clearer view, enabling them to decide autonomously that it is time to solve thedilemma.There is substantial evidence that Early Identification and Brief Interventions (EIBI) for Hazardous andHarmful Alcohol Consumption (HHAC) by health professionals in Primary Health Care (PHC) areeffective in preventing future alcohol related diseases. The WHO encourages in the global alcoholstrategy the widespread implementation of EIBI for HHAC and their integration in the routine practiceof primary health care professionals [ 3 ].It is extremely important that the individuals who have not yet developed an alcohol dependencecan reduce or stop drinking receive adequate care and suitable support to prevent the onset of seriousalcohol use disorders. Once the addiction has been established, change in alcohol consumption habitsis more difficult and may require specialist treatment [ 2 ].The term Alcohol Use Disorders (AUDs) refers to the varying consequences and complicationscaused by and related to episodic or prolonged alcohol consumption, being a broader concept thanalcohol dependence. The conceptual model of AUDs has evolved over the years, passing from thedichotomy normality-alcoholism to a spectrum of alcohol-related problems ranging from low-riskconsumption, to hazardous and harmful consumption and finally to alcohol dependence. Thethree main categories relevant for response in health services are hazardous drinking, harmfuldrinking and alcohol dependence. Hazardous drinking is an important concept for EIBI, althoughnot included in WHO’s International Classification of Diseases (ICD-10). [ 4 ]aIstituto Superiore di Sanità (ISS), Rome, Italy53Good practice principles for low risk drinking guidelines
Page 1: Good practice principlesfor low ris
Page 5 and 6: Table of contentsExecutive summary
Page 7 and 8: Executive summaryThe present public
Page 9 and 10: The Standard Drink concept and cons
Page 11 and 12: ForewordA recent flagship report by
Page 13 and 14: IntroductionThe present publication
Page 15 and 16: Chapter 1Joint Action on Reducing A
Page 17 and 18: Chapter 2Towards a common approach
Page 19 and 20: Graph 2. RARHA survey on low risk d
Page 21 and 22: replaced by daily guidelines in 199
Page 23 and 24: informed the UK 2016 review of drin
Page 25 and 26: Variability across population group
Page 27 and 28: the interpretation of low risk drin
Page 29 and 30: individual and public health, the r
Page 31 and 32: • Low risk drinking guidelines sh
Page 33 and 34: 35OECD (2015), Tackling Harmful Alc
Page 35 and 36: • A literature review into practi
Page 37 and 38: Graph 1. Uses of the Standard Drink
Page 39 and 40: link health messages to EU or natio
Page 41 and 42: warning in relation to consuming al
Page 43 and 44: in order to rduce risk of harm, the
Page 45 and 46: Chapter 4Guidance to reduce alcohol
Page 47 and 48: available in websites were mentione
Page 49 and 50: Restricting hours of sale and densi
Page 51: level of compliance with age limits
Page 55 and 56: There is convincing evidence across
Page 57 and 58: standard routine health assessments
Page 59 and 60: Graph 3. Presence of multidisciplin
Page 61 and 62: 8Heather N. (2006) WHO Collaborativ
Page 63 and 64: ES Ministry of Health, Social Servi
Page 65 and 66: Annex 3Positive health effects of a
Page 67 and 68: Table 1. Changes in alcohol intake
Page 69 and 70: A quarter of a century of alcohol c
Page 71 and 72: The percentages vary depending on t
Page 73 and 74: Review of adult drinking guidelines
Page 75 and 76: the addendum to the expert group re
Page 77 and 78: Guidance on alcohol consumption in
Page 79 and 80: Development of drinking guidelines
Page 81 and 82: 7Maa- ja metsätalousministeriö. (
Page 83 and 84: 83Title Report

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