Patient-Reported Offers of Alcohol Treatment for Primary Care Patients at High-Risk for an Alcohol Use Disorder

Published in: Journal of the American Board of Family Medicine, v. 29, no. 6, Nov.-Dec. 2016, p. 682-687

by Sean Grant, Katherine E. Watkins, Andy Bogart, Susan M. Paddock, Kimberly A. Hepner

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Research Questions

  1. What proportion of patients at high risk for an alcohol use disorder were offered formal treatment for alcohol use during routine annual screening in primary care?
  2. What types of formal treatment were offered, and what factors were associated with offer of treatment?


This study assessed patient-reported alcohol treatment offers by health care providers following routine annual screening for alcohol use in primary care.


A telephone interview within 30 days of the annual screen assessed demographics, alcohol and other drug use, mental health symptoms, and offers of formal treatment for alcohol by a Veterans Affairs health care provider. We included male patients (n = 349) at high risk for an alcohol use disorder (AUD) who had not received alcohol treatment in the past 3 months. We assessed self-reported receipt of any offers of formal treatment for alcohol use and associations of offers of formal treatment for alcohol with demographic and clinical variables.


A total of 145 patients (41.5%) reported an offer of at least 1 type of formal treatment for alcohol use. More severe alcohol misuse (odds ratio, 1.07; 95% confidence interval, 1.03–1.11) and younger age (odds ratio, 0.97, 95% confidence interval, 0.95–0.99) were associated with reporting an offer of formal treatment.


Most primary care patients at high risk for an AUD were not offered treatment following annual screening. Our results highlight the importance of training primary care providers in what constitutes appropriate medical treatment for this population and the most effective ways of offering treatment.

Key Findings

  • In a sample of patients at high risk for alcohol use disorder, more than half reported not being offered formal treatment for alcohol use.
  • Therapy or counseling was the most frequently offered form of treatment; medication and referral to intensive outpatient treatment or a residential program were rarely offered.
  • Greater severity of alcohol misuse was associated with offers of treatment.
  • Older patients were less likely to be offered treatment.

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