A New Rx for Problem Drinking: Brief Physician Counseling

Cost-benefit study of a brief intervention treatment for problem drinkers in a primary care setting

From 1996 to 1999, researchers with the University of Wisconsin-Madison Medical School assessed the long-term efficacy and benefit-cost of a brief intervention for problem drinkers.

Brief intervention had been demonstrated to be effective in decreasing problem drinking in randomized controlled trials in the United States and abroad.

This project examined brief intervention in two previously completed clinical trials funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) that were conducted by the principal investigator:

  • Project TrEAT (Trial for Early Alcohol Treatment)
  • And Project GOAL (Guiding Older Adult Lifestyles).

Key Findings

The researchers were able to follow 774 subjects from Project TrEAT for an additional three years (or 48 months total) and 158 problem drinkers from Project GOAL for an additional year (or 24 months total).

The study assessed health care utilization variables, alcohol and substance use, legal events (e.g., traffic and criminal violations), and health status measures. It found:

  • The brief intervention led to significant long-term decreases on several measures of alcohol use among male and female problem drinkers ages 18 to 64 included in Project TrEAT, and among male and female problem drinkers age 65 and older included in Project GOAL.
  • The researchers estimated that brief intervention generated $56,263 in cost savings (in emergency room and hospital use, crime, and motor vehicle accidents) for every $10,000 invested in Project TrEAT, yielding a benefit-to-cost ratio of 5.6 to 1.

Key Results

  • Articles summarizing findings have been published in Medical Care and the Journal of Family Practice. See the Bibliography.
  • The researchers presented findings from the project at several national and international meetings of the American Society of Addiction Medicine and the International Health Economics Association.
  • The researchers also developed and are teaching the "NIAAA Medical Model for the Prevention and Treatment of Alcohol Use Disorders" at medical schools worldwide.

Funding

The Robert Wood Johnson Foundation (RWJF) supported this project with a grant of $421,605 from February 1996 to January 1999.