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Problem

Unhealthy alcohol use is the Nation’s third leading cause of preventable death, affecting almost a third of adults. It is associated with adverse effects on physical and mental health. In addition, unhealthy alcohol use has detrimental socioeconomic consequences, with an estimated annual economic burden of over $250 billion.

The COVID-19 pandemic has added to the problem with increased isolation, unemployment, and other stresses contributing to increased alcohol use. Evidence-based guidelines recommend routine screening and brief intervention for unhealthy alcohol use, as well as medication-assisted treatment for alcohol use disorder. However, implementing this approach in primary care has proved challenging.

Solution

In 2019, AHRQ launched the to raise awareness about the evidence for and support the implementation of:

• Screening for unhealthy alcohol use.
• Brief interventions and referral to treatment for those who screen positive.
• Medication-assisted treatment for those diagnosed with alcohol use disorder.

AHRQ has funded six grantees who will use the EvidenceNOW model of external support to improve primary care. As part of this external support, the grantees will use practice facilitation to disseminate and implement evidence-based practices for screening and treatment of unhealthy alcohol use in primary care practices across the United States. In addition, AHRQ has funded a contractor to help understand cross-grantee impact and to support the grantees in their work through identification of helpful clinical tools and sharing and creation of learning communities for peer-to-peer learning.

Program Goals

Designed to help primary care practices use patient-centered outcomes research to address unhealthy alcohol use, this initiative aims to:

• Raise awareness about the evidence for screening, diagnosis, and treatment of unhealthy alcohol use.
• Augment rates of screening for unhealthy alcohol use in primary care.
• Increase rates of brief intervention and referral for treatment in patients who screen positive for unhealthy alcohol use in primary care.
• Increase use of medication-assisted treatment for patients meeting diagnostic criteria for alcohol use disorder in primary care.

Grantees

The EvidenceNOW: Managing Unhealthy Alcohol Use Initiative has funded from diverse states across the country. The project is being implemented in small- and medium-sized primary care practices representing rural, suburban, and urban practices that serve diverse communities of patients.