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The long and winding road to widespread implementation of screening and brief intervention for alcohol problems: A historical overview with special attention to the WHO initiatives
University of Oslo, Norway.
Norwegian Institute for Alcohol and Drug Research, Oslo, Norway.
Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
2008 (English)In: Nordic Studies on Alcohol and Drugs, ISSN 1458-6126, Vol. 25, no 6, 469-476 p.Article in journal (Refereed) Published
Abstract [en]

Before 1970, special institutions, often prison-like, were built for the severely dependent. The effect of this type of treatment, often lasting for months or even years, was hard to document scientifically. During the 1970s several steps were taken towards a more preventive strategy that involved delivery of alcohol interventions in general health care settings, particularly within primary health care. The World Health Organization's (WHO) introduction of the concepts of hazardous and harmful drinking represented a shift from the traditional dichotomous view of individuals being alcoholic-or-not to a continuum where, in line with Rose's "prevention paradox", a large number of people with low risk may give rise to more cases of disease than the small number with high risk. The need for efficient methods to detect persons with various degrees of alcohol risk was evident, and a WHO multinational project that resulted in the publication of AUDIT (Alcohol Use Disorders identification Test) was carried out in the mid 1980s. The usefulness of this principle of case finding was then investigated in a subsequent multinational WHO project of brief intervention, as well as in several other similar projects. Many of these projects have proven quite efficient, but screening and brief intervention for alcohol problems is still not standard procedure in primary health care. The paper discusses some of the reasons why.

Place, publisher, year, edition, pages
2008. Vol. 25, no 6, 469-476 p.
Keyword [en]
Alcohol, screening, brief, intervention, primary health, care, history, WHO, AUDIT
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-77901OAI: diva2:529780
Available from: 2012-05-31 Created: 2012-05-31 Last updated: 2012-06-07

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Nilsen, Per
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Division of Preventive and Social Medicine and Public Health ScienceFaculty of Health Sciences
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