Internet-Based Screening and Feedback: An Efficient Tool for Reducing Unhealthy Alcohol Use

Few people with unhealthy alcohol use seek in-person treatment services. This makes sense for many, since such services are generally oriented towards dependence versus nondependent unhealthy use. Adults who reported unhealthy alcohol use* in a large population-based survey were recruited for a randomized controlled trial of the internet-based Check Your Drinking (CYD) screen, which provides graphical feedback on how individual drinking compares with that of others who are demographically similar. Most had screening scores consistent with nondependent unhealthy use. Those in the intervention group completed the 10-minute CYD screen online in their homes or another setting of choice rather than in a clinical setting. The control group received a pamphlet on drinking behaviors. Ninety-two percent of the 185 participants completed baseline, 3-month, and 6-month follow-up surveys. 

• People in the intervention group reduced their weekly alcohol consumption by an average of 6–7 drinks per week (30%) and also had significant reductions in AUDIT-C scores despite the fact that one-third of the group never accessed the CYD.
• People in the control group reduced their weekly alcohol consumption by an average of 1 drink per week and had no significant reductions in AUDIT-C scores.
• People with lower risk consumption† had no significant reduction in weekly drinking or AUDIT-C scores regardless of group assignment.

* Score of 4 or more on the 3-item Alcohol Use Disorders Identification Test—Consumption (AUDIT-C).
† Full AUDIT score of 4–10 at baseline.

Comments by Michael G. Boyle, MA
Recent discussion in the treatment community has focused on harm reduction for unhealthy alcohol use as a viable option to abstinence only. The CYD tool has the potential to reach many people who cannot, will not, or do not need to seek traditional alcohol dependence treatment. Although many people in the intervention group did not access the CYD, its brevity, immediate feedback, and privacy of use make it an attractive alternative or complement to brief physician interventions.