Paradigm shift: Moving the management of alcohol use disorders from specialized care to primary care.

Almost 20 years ago research indicated that brief interventions1 in primary care settings helped patients with at-risk drinking and milder alcohol use disorder (AUD) reduce heavy drinking.2 More recent meta-analyses have overwhelmingly confirmed this finding.3,4 However, evidence showed that brief interventions were not effective in helping those with more severe AUD reduce or stop drinking.5 As a result, addictions organizations recommended that primary care physicians use the SBIRT (Screening, Brief Intervention and Referral to Treatment) model,1 and that those with more severe AUD should be referred for specialized treatment.