The DOI matches its Crossref record; 178 of the 201 references it cites were found in a registry or an index.
Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
Open accessAbstract
Importance: Unhealthy alcohol use is common, increasing, and a leading cause of premature mortality. Objective: To review literature on the effectiveness and harms of screening and counseling for unhealthy alcohol use to inform the US Preventive Services Task Force. Data Sources: MEDLINE, PubMed, PsycINFO, and the Cochrane Central Register of Controlled Trials through October 12, 2017; literature surveillance through August 1, 2018. Study Selection: Test accuracy studies and randomized clinical trials of screening and counseling to reduce unhealthy alcohol use. Data Extraction and Synthesis: Independent critical appraisal and data abstraction by 2 reviewers. Counseling trials were pooled using random-effects meta-analyses. Main Outcomes and Measures: Sensitivity, specificity, drinks per week, exceeding recommended limits, heavy use episodes, abstinence (for pregnant women), and other health, family, social, and legal outcomes. Results: One hundred thirteen studies (N = 314 466) were included. No studies examined benefits or harms of screening programs to reduce unhealthy alcohol use. For adolescents (10 studies [n = 171 363]), 1 study (n = 225) reported a sensitivity of 0.73 (95% CI, 0.60 to 0.83) and specificity of 0.81 (95% CI, 0.74 to 0.86) using the AUDIT-C (Alcohol Use Disorders Identification Test-Consumption) to detect the full spectrum of unhealthy alcohol use. For adults (35 studies [n = 114 182]), brief screening instruments commonly reported sensitivity and specificity between 0.70 and 0.85. Two trials of the effects of interventions to reduce unhealthy alcohol use in adolescents (n = 588) found mixed results: one reported a benefit in high-risk but not moderate-risk drinkers, and the other reported a statistically significant reduction in drinking frequency for boys but not girls; neither reported health or related outcomes. Across all populations (68 studies [n = 36 528]), counseling interventions were associated with a decrease in drinks per week (weighted mean difference, -1.6 [95% CI, -2.2 to -1.0]; 32 studies [37 effects; n = 15 974]), the proportion exceeding recommended drinking limits (odds ratio [OR], 0.60 [95% CI, 0.53 to 0.67]; 15 studies [16 effects; n = 9760]), and the proportion reporting a heavy use episode (OR, 0.67 [95% CI, 0.58 to 0.77]; 12 studies [14 effects; n = 8108]), and an increase in the proportion of pregnant women reporting abstinence (OR, 2.26 [95% CI, 1.43 to 3.56]; 5 studies [n = 796]) after 6 to 12 months. Health outcomes were sparsely reported and generally did not demonstrate group differences in effect. There was no evidence that these interventions could be harmful. Conclusions and Relevance: Among adults, screening instruments feasible for use in primary care are available that can effectively identify people with unhealthy alcohol use, and counseling interventions in those who screen positive are associated with reductions in unhealthy alcohol use. There was no evidence that these interventions have unintended harmful effects.
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“there are benefits for alcohol and other substance use problems among adolescents (45) and adults (46, 47)”
From Initial insights from a quality improvement initiative to develop an evidence-informed young adult substance use program (2022) · cites this paper as [46]
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The relationship between different dimensions of alcohol use and the burden of disease—an update
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Research works printed but not linked: 2
- Northrup, 2010, Effective measurement of problematic drinking for college students: reducing differential item functioning across gender and race., Diss Abstr Int B Sci Eng, 70, 4492
- U.S. Preventive Services Task Force, 2015, U.S. Preventive Services Task Force Procedure Manual
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US Preventive Services Task Force, Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., Doubeni, C. A., Epling, J. W., Kemper, A. R., et al. (2018) · JAMA · doi:10.1001/jama.2018.16789 · Cited by 517
Diagnosis and Treatment of Alcohol-Associated Liver Disease: A Review
Singal, A. K., & Mathurin, P. (2021) · JAMA · doi:10.1001/jama.2021.7683 · Cited by 398
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Fetal alcohol spectrum disorders
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ACG Clinical Guideline: Alcohol-Associated Liver Disease
Jophlin, L., Singal, A. K., Bataller, R. A., Wong, R. J., Sauer, B. G., Terrault, N. A., & Shah, V. H. (2023) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002572 · Cited by 319
Metadata
- Authors
- O’Connor, E. A., Perdue, L. A., Senger, C. A., Rushkin, M., Patnode, C. D., Bean, S. I., & Jonas, D. E.
- Affiliations
- Kaiser Permanente (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- O’Connor, Elizabeth A.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2018-11-13
- Volume
- 320
- Issue
- 18
- Pages
- 1910
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC13585200
- OpenAlex
- W2901360762
- Cited by
- 249
- References
- 201
- Citations by year
- 2026: 29 · 2025: 27 · 2024: 30 · 2023: 40 · 2022: 32 · 2021: 34 · 2020: 40 · 2019: 11 · 2018: 6
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Keywords
- unhealthy alcohol use, alcohol screening, behavioral counseling, adolescents, adults, AUDIT-C, screening sensitivity and specificity, brief intervention, abstinence, pregnant women, alcohol-related harm, USPSTF recommendations, sex differences in drinking, high-risk drinkers, alcohol-related violence
- MeSH terms
- Health Risk Behaviors, Adolescent, Adult, Alcohol Drinking, Behavior Therapy, Counseling, Female, Humans, Male, Mass Screening, Patient Education as Topic, Alcohol-Related Disorders
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