New Tools for Primary Care Providers: First-line Treatment of Alcohol Misuse

Drinking glasses on a bar
U.S. Air Force photo by Samuel King Jr.
By Army Maj. Demietrice Pittman, Chief of Implementation, Deployment Health Clinical Center
February 21, 2017

It’s another Monday morning at the clinic. As you turn in the black swivel chair to welcome your first patient of the day, you catch a faint whiff of alcohol. You start by asking what brought him in and go through the standard questions about his health. When you get to the alcohol questions, he responds that he usually has “a couple of drinks on the weekend but nothing major.” You look to see that your technician asked about consumption and the patient’s response was about two times a month. So the information is not lining up. Now you have to have the potentially awkward conversation about his alcohol use.

To make this easier, Deployment Health Clinical Center (DHCC) created clinical support tools that you can use to help service members who may be drinking too much.

The Substance Abuse and Mental Health Services Administration (SAMHSA) developed the evidence-based process of Screening, Brief Intervention and Referral to Treatment (SBIRT) for use in the civilian sector.

DHCC sponsored an implementation pilot to test if SBIRT is a feasible approach to address alcohol misuse in the Military Health System (MHS). The pilot found that SBIRT gives military primary care providers an opportunity to reach service members who may not recognize they have an issue with alcohol misuse. It also reduces stigma associated with seeking behavioral health services for alcohol misuse and supports the delivery of evidence-based behavioral health practices.

Back to the potentially awkward conversation about alcohol. You can use the following resources, which DHCC designed for the pilot to increase patients’ psychological health literacy and promote help-seeking and engagement in care. The resources are free of charge and can be downloaded or ordered in bulk quantities.

Information on preventing risky drinking, indicators and impact of risky drinking and where to seek help

  • Standard Drink Calculator: Guide for the number of standard drinks per each common drink container and mixed drink type
  • Daily Drink Tracker: Tracker to record daily drink consumption, type of drink, situation and contributing factors
  • My Plan for Change: Worksheet to record a plan for how to handle specific situations that challenge drinking goals
  • Preparing for Change: Worksheet to record advantages and drawbacks to drinking and reasons for wanting to change drinking habits

You can also share the following resources with patients for support between sessions.

These resources provide the latest guidance and standards on early intervention for alcohol use in the MHS:

The views expressed in Clinician's Corner blogs are solely those of the author and do not necessarily reflect the opinion of the Psychological Health Center of Excellence or Department of Defense.


  • Love MAJ Pittman's style

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