Although annual screening is recommended,
whether a different screening interval would be
more effective is unknown. Brief interventions have
uncertain effectiveness for heavier drinkers and
in the acute care setting. Simple advice might be
as effective. The usefulness of ultra-brief and
computer-based interventions requires further
study. Whether a strategy of screening, brief
intervention, and referral for treatment works for
persons with alcohol dependence is uncertain,
and predicting which of them can cut back successfully
remains a challenge. The effectiveness
of efforts by primary care clinicians to promote
and monitor remission is also unknown.
Medications for alcohol dependence have shortterm
efficacy, but long-term effectiveness remains
undetermined. Chronic, severe dependence is often
resistant to existing interventions, and effective
strategies are needed to engage and treat patients
with refractory alcohol dependence.