What's the Same, What's New in This Update
Same approach to screening and intervention
The approach to alcohol screening and intervention presented in the original 2005
Guide remains unchanged. That edition established a number of new
directions compared with earlier versions, including a simplified, single-question
screening question; more guidance for managing alcohol-dependent patients;
and an expanded target audience that includes mental health practitioners,
since their patients are more likely to have alcohol problems than patients
in the general population.11,12
In the “how-to” section, two small revisions are noteworthy.
Feedback from Guide users told us that some patients do not consider
beer to be an alcoholic beverage, so the prescreening question on page 4
now reads,
“Do you sometimes drink beer, wine, or other alcoholic beverages?”
And on page 5, the assessment criteria remain the same, but the sequence
now better reflects a likely progression of symptoms in alcohol use disorders.
Updated and new supporting materials
- Updated medications section. The section on prescribing
medications (pages 13–16) contains added information about treatment
strategies and options. It describes a newly approved, extended-release
injectable drug to treat alcohol dependence that joins three previously
approved oral medications.
- Medication management support. Patients taking medications
for alcohol dependence require some behavioral support, but this doesn’t
need to be specialized alcohol counseling. For clinicians in general medicine
and mental health settings, the Guide now outlines a brief, effective
program of behavioral support that was developed for patients who received
pharmacotherapy in a recent clinical trial (pages 17–22).
- Specialized alcohol counseling resource. For mental
health clinicians who wish to provide specialized counseling for alcohol
dependence, we’ve added information about a state-of-the-art behavioral
intervention also developed for a recent clinical trial (page 31).
- Online resources. A new page on the NIAAA Web site is
devoted to the Guide and related resources (www.niaaa.nih.gov/guide).
See page 27 for a sampling of available forms, publications, and training
resources.
- New patient education handout. “Strategies for
Cutting Down” provides concise guidance for patients who are ready
to cut back or quit. The handout may be photocopied from page 26 or downloaded
from www.niaaa.nih.gov/guide,
where it is also available in Spanish.
- Transferred sections. Two appendix resources from the
preceding edition (the sample questions for assessment and the preformatted
progress notes for baseline and followup visits) are now available online
at www.niaaa.nih.gov/guide.
The previous “Materials from NIAAA” section is now part of
the “Online Materials for Clinicians and Patients” on page
27.
