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Alcohol screening and brief intervention in workplace settings and social services: a comparison of literature

Employee alcohol and other drug use can negatively impact the workplace, resulting in absenteeism, reduced productivity, high turnover, and worksite safety issues. As the workplace can influence employee substance use through environmental and cultural factors, it also presents a key opportunity to deliver interventions, particularly to employees who may not otherwise seek help. This is a systematic review of workplace-based interventions for the prevention and treatment of problematic substance use. Five databases were searched for efficacy, effectiveness and/or cost-effectiveness studies and reviews published since 2010 that measured use of psychoactive substances (i.e., alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, and stimulants) as a primary or secondary outcome, in employees aged over 18. Thirty-nine articles were identified, 28 describing primary research and 11 reviews, most of which focused solely on alcohol use. Heterogeneity between studies with respect to intervention and evaluation design limited the degree to which findings could be synthesized, however, there is some promising evidence for workplace-based universal health promotion interventions, targeted brief interventions, and universal substance use screening. The few studies that examined implementation in the workplace revealed specific barriers including lack of engagement with e-health interventions, heavy use and reluctance to seek help amongst male employees, and confidentiality concerns. Tailoring interventions to each workplace, and ease of implementation and employee engagement emerged as facilitators. Further high-quality research is needed to examine the effectiveness of workplace substance use testing, Employee Assistance Programs, and strategies targeting the use of substances other than alcohol in the workplace.

Pregnant woman and social worker alcohol brief intervention

This video demonstrates a brief alcohol intervention delivered by a social worker to a pregnant woman following an anonymous concern about drinking during pregnancy. At the first meeting, the patient feels shocked and angry about the referral and initially does not believe her drinking (one to two drinks, up to three times per week, occasionally more at social events) is problematic. Using a calm, non-judgmental approach, the social worker acknowledges the patient’s feelings, explains the purpose of the visit, and asks permission to discuss alcohol use. The conversation explores drinking patterns, social norms, and mixed messages from friends, online sources, and healthcare professionals. The clinician validates confusion while clearly communicating current evidence: no amount of alcohol is considered safe during pregnancy, as alcohol exposure can affect fetal development and may lead to miscarriage, low birth weight, premature birth, or later neurodevelopmental difficulties. When the patient compares her situation to friends whose babies appear “fine,” the social worker gently explains that some effects may not be immediately visible and can emerge later in childhood. The session emphasizes information-sharing rather than confrontation, provides written educational materials, and allows time for reflection. Although the patient is not ready to commit to immediate change, she expresses a desire to protect her baby. The social worker proposes follow-up and offers referral to a specialist drug and alcohol liaison midwifery service for additional support. The video models how brief intervention in maternity and social care settings can address defensiveness, misinformation, and social normalization of alcohol use while maintaining empathy, reinforcing autonomy, and keeping the focus on protecting maternal and fetal health.

Community and municipal action on alcohol

Europe is a major producer and consumer of alcohol, and alcohol-related problems make a major impact on health, social welfare and the economy. Despite these costs, many communities continue to regard alcohol problems solely as a medical or even a narrowly psychiatric issue. Community programmes and local action of all kinds are one important way of supporting healthier lifestyles, as well as of securing public and political support for modifying the sale and use of alcohol. In addition to the development of local policy, local action can exert a powerful influence on national and even international policy. Every community has the potential for preventive action. Homes, schools, workplaces and health care establishments offer opportunities to encourage healthy behaviour, improve social support and strengthen attitudes that favour lighter drinking. These guidelines are essentially practical and contain approaches that can be adapted to different settings. They can serve as a template around which to build the methods and experiences that are unique to particular communities. They are designed to stimulate local interest and the creation of a detailed local action plan. The book comprises chapters that address specific areas of community life where there are good prospects for developing effective alcohol policies.

The ASSIST-linked brief intervention for hazardous and harmful substance use Manual for use in primary care

This manual is a companion to ‘The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): manual for use in primary care’ 1 and is based on ‘Brief Intervention for Substance Use: Guidelines for Use in Primary Care. Draft Version 1.1 for Field Testing’2 . The purpose of this manual is to explain the theoretical basis and evidence for the effectiveness of brief interventions and to assist primary health care workers in conducting a simple brief intervention for clients whose substance use is putting them at risk. Together with the companion manual 1, this manual presents a comprehensive approach to screening and brief intervention which is tailored to the specific circumstances of primary care and is designed to improve the health of populations and client groups as well as of individuals. This manual describes: ❙❙ the rationale for brief intervention in primary care; ❙❙ a model of behaviour change; ❙❙ the components of brief interventions that work principles of motivational interviewing and essential skills; ❙❙ how to link the ASSIST screening procedure with a brief intervention; ❙❙ how to give feedback to clients; ❙❙ how to conduct brief intervention for people at moderate risk; ❙❙ examples of ASSIST-linked brief interventions; ❙❙ how to help clients who inject drugs; ❙❙ how to address multiple substance use; ❙❙ how to give longer or recurrent interventions. Although the manual is particularly aimed at primary health care workers, it may also be useful for others who work with high-risk clients or clients who are more likely to engage in drug use such as hospital physicians and nurses, midwives and obstetricians, social workers, prison workers and community correction workers.

Social Services