Brief interventions with substance-abusing patients.

Brief interventions to change alcohol use have proven effective in different primary care settings. Current data show decreases in consumption as well as a decreased utilization of some health resources and decreased mortality. The process of changing drinking or substance abuse behavior requires a series of predictable steps. The key to changing behavior is ambivalence about current behavior. Understanding the stages of behavioral change and assessing the patient's readiness to change are important for effective interventions. Brief interventions include giving the patient feedback about a behavior, clearly recommending a change in behavior, presenting options to achieve this change, checking and responding to the patient's reaction, and providing follow-up care. Effective interventions help develop the patient's sense of motivation and self-efficacy for behavioral change. In approaching a patient with a substance abuse problem, using techniques of motivational enhancement is more effective than a confrontational approach.