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Alcohol Screening and Brief Intervention

Photo: Woman's faceDrinking too much alcohol can cause many health problems. There are easy ways health professionals can screen all adults, including pregnant women, and counsel those who drink too much to drink less.

At least 38 million adults drink too much although most are not dependent on alcohol. Drinking too much causes about 88,000 deaths in the United States each year, and costs the economy about $224 billion.

Drinking too much includes

  • Binge drinking
  • High weekly use
  • Any alcohol use by pregnant women
  • Any alcohol use by those under age 21

Drinking too much is dangerous for both men and women, and can lead to

  • heart disease
  • breast cancer
  • sexually transmitted diseases
  • unintended pregnancy
  • fetal alcohol spectrum disorders
  • sudden infant death syndrome
  • motor-vehicle crashes
  • violence

Alcohol and Women

  • CDC reports that 1 in 8 women and 1 in 5 high school girls binge drink.1
  • Alcohol affects men and women differently because their bodies work differently. Women tend to
    • absorb more alcohol when they drink, and
    • take longer to break it down and remove it from their bodies.
  • Even when they drink the same amount of alcohol, women tend to have higher levels of alcohol in their blood than men, and the immediate effects of impairment occur more quickly and last longer.
  • Drinking too much, including binge drinking, results in about 26,000 deaths in women and girls each year.

Alcohol Use During Pregnancy

Photo: Doctor consulting with pregnant woman

One in 13 women reports drinking alcohol during pregnancy.2

  • Alcohol use during pregnancy increases the risk of miscarriage, stillbirth, and fetal alcohol spectrum disorders (FASDs).
  • FASDs include
    • physical and intellectual disabilities
    • problems with behavior and learning
    • a mixture of these problems
  • FASDs are a leading known cause of intellectual disability and birth defects.
  • FASDs are completely preventable if a woman does not drink alcohol while she is pregnant or may become pregnant.
  • There is no known safe amount of alcohol use while pregnant. There is also no safe time during pregnancy to drink, and no safe kind of alcohol.
  • Women should not drink alcohol if they are trying to get pregnant or if they are sexually active and do not use effective birth control, because they could become pregnant and not know for several weeks.
  • About half of all pregnancies in the United States are unplanned. If a woman does not recognize that she is pregnant and she continues drinking, she can expose her baby to alcohol without realizing it.
  • Only 17% of pregnant women have talked to a health professional about their drinking.

We Know What Works

Alcohol screening and brief counseling works.

Doctors, nurses, and other health professionals should screen all adult patients and counsel those who drink too much to drink less.

  • It can reduce how much alcohol a person drinks on an occasion by 25%.
  • It improves health and saves money, just like blood pressure screening, flu vaccines, and cholesterol or breast cancer screening.
  • It is recommended for all adults, including pregnant women.

Doctors, nurses, health plans, and insurers can

  • Screen all adult patients for alcohol use as part of their usual services. Use current guidelines to do this effectively. Counsel, refer, and track those patients who need more help.
  • Advise women not to drink at all if there is any chance they could be pregnant.
  • Recruit and train nurses, social workers and health educators in a practice to screen and counsel all patients.
  • Through insurers and employers, provide insurance coverage for alcohol screening and counseling.

States and communities can

  • Reduce excessive alcohol use, including binge and underage drinking, by implementing evidence-based population strategies, such as
    • Increasing alcohol excise taxes
    • Regulating alcohol outlet density
    • Maintaining and enforcing the age 21 years minimum legal drinking age (MLDA)
  • These recommendations and others can be found in the Guide to Community Preventive Services.

Resources for Health Professionals

  • CDC Vital Signs – Alcohol Screening and Counseling
    CDC Vital Signs offers recent data and calls to action for important public health issues. This Vital Signs on alcohol screening and counseling presents findings on how infrequently health professionals talk with adults about their alcohol use. It also highlights key steps that health professionals can take to conduct alcohol screening and counseling and how it can be implemented as a routine part of adult preventive care.
  • Clinician Pocket Guide for Alcohol Screening and Brief Intervention [575 KB]
    This pocket guide, from the National Institute on Alcohol Abuse and Alcoholism, provides step-by-step information about how to screen for heavy drinking, how to assess for alcohol use disorders, and how to conduct a brief intervention. It also contains information on standard drink sizes, drinking patterns, and medications prescribed for alcohol dependence.
  • Women and Alcohol
    This website from the American College of Obstetricians and Gynecologists provides resources for women's healthcare providers that can be used to identify women who drink too much and offer them brief intervention to reduce or eliminate alcohol use. The website also has links to resources and information for the public.
  • Medscape Video - Alcohol and Women: How to Screen and Intervene
    In this CDC Expert Commentary in partnership with Medscape, Dr. Joe Sniezek discusses steps that healthcare providers can take to detect and intervene with women who drink alcohol at risky levels. Advice is based on guidance from the American College of Obstetricians and Gynecologists.
  1. In this report, binge drinking for women is defined as four or more drinks on an occasion. Binge drinking for high school girls is defined as having had five or more drinks of alcohol in a row (within a couple of hours) on at least one day during the 30 days before the survey. Source: Vital Signs: Binge Drinking Among Women and High School Girls – United States, 2011
  2. Defined as at least one drink of any alcoholic beverage during the 30 days before the survey. Source: Alcohol Use and Binge Drinking Among Women of Childbearing Age – United States, 2006–2010
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