The Article in Brief

Readiness to Change in Primary Care Patients Who Screen Positive for Alcohol Misuse

Emily C. Williams, MPH, and colleagues

Background Alcohol misuse is widespread, and one of the most costly public health problems in the United States. This study of more than 6,000 male patients who reported alcohol misuse in the past year evaluates the participants' readiness to change their alcohol habits.

What This Study Found Most participants indicated some readiness to change. Contrary to a stereotype that patients with alcohol misuse will deny concerns about their drinking, most patients in this study who reported alcohol misuse indicated that they drank more than they should or had considered or tried decreasing drinking. Those with more severe alcohol misuse were more likely to report readiness to change.

Implications

• Primary care clinicians sometimes expect patients to deny their alcohol misuse. Such denial is often thought to be common among patients with the most severe alcohol dependence. The findings in this study suggest that the opposite is true. The more a patient drinks and the more severe his problems because of drinking, the more likely he will report considering or wanting to change his drinking.
• Based on this and other research, the authors suggest that patients with the least severe alcohol misuse may benefit most from brief alcohol-related advice from their primary care clinicians.