Implementing alcohol screening and brief intervention in primary care: identifying barriers, proposing solutions

Background Alcohol screening and brief intervention (SBI) can reduce heavy and harmful alcohol use [1-5]. The strongest evidence for SBI effectiveness is in primary care settings where meta-analyses studies show 10–30 percent reductions in alcohol consumption at 12 months [4,5]. Over the past decade, there have been significant efforts to support the adoption and implementation of SBI in general health-care settings, including $305 million in SBI service and training grants from the Substance Abuse and Mental Health Services Administration (SAMHSA), and approximately $17 million per year from the National Institute on Alcohol Abuse and Alcoholism for more than 40 SBI studies. In addition, numerous individual state initiatives have focused on SBI dissemination. Nonetheless, a recent Centers for Disease Control and Prevention survey found alcohol SBI is rarely performed [6]. Only 1 in 6 adults reported they had talked with a health professional about their alcohol use in the past year [6]. The present study uses data from two SAMHSA-funded projects to identify barriers to widespread implementation of SBI and propose potential solutions.