Despite benefit, physicians slow to offer brief advice on harmful alcohol use.

A QUARTER-CENTURY AGO, THE World Health Organization (WHO) launched an international effort to develop validated screening and brief intervention protocols for excessive alcohol use in primary care. Since then, an extensive body of literature has grown in support of clinicians screening patients for harmful alcohol use and offering structured advice to those identified.Yetphysicians havebeen slow to adopt these effective and costsaving 5to 10-minute interventions. As this 25-year anniversary milestone passes, experts hope recent studies and analyses may help overcome this reluctance by demonstrating that such brief interventions are both feasible and successful in a variety of real-life settings. A Cochrane Collaboration review of 21 randomized controlled trials published in April 2007 found that primary care patients who receive brief interventions for excessive alcohol use substantially reduce their alcohol intake compared with controls. The WHO also completed the fourth and final phase of its Collaborative Project on Detection and Management of Alcohol-Related Problems in Primary Health Care. Efforts to make it easier for physicians to bill for these services may help as well.