Innovative Approaches to Intervention for Problem Drinking
Purpose of Review: To critique the recent literature on telephone, correspondence-based, and computerized interventions for alcohol problems, which enhance or substitute for practitioner-delivered treatments.
Recent Findings: There is an unmet need for screening, assessment and intervention for alcohol problems, in part because of the difficulty in accessing such treatment within the current health care system. Research on the efficacy of correspondence or electronic (for example Internet-based) interventions is beginning to emerge. In the period 2003-2004 we identified nine acceptability or feasibility studies of these approaches and seven efficacy trials covering a wide range of settings. These modes of intervention are acceptable to patients and the public, and with careful planning, can be implemented in a variety of settings. Treatment trials demonstrate the efficacy of these interventions in reducing hazardous drinking by university students, in delaying initiation of heavy drinking in children and adolescents, and, intriguingly, in addressing insomnia among recovering alcoholics.
Summary: There is strong support among potential users for alcohol interventions that employ telephone assistance, written correspondence, and the Internet. These new technologies offer the prospect of increasing the reach of interventions for problem drinking and being cost-effective alternatives or supplements to face-to-face health service delivery.

There is growing interest in the use of telephone, correspondence-based and computerized interventions for alcohol problems. This is partly due to the scarcity of time for alcohol interventions within primary care settings. These new technologies may help to overcome some patients' reluctance to discuss their alcohol consumption, as well as ensuring consistent delivery of interventions, and improving access to preventive health care. There is potential to employ these technologies outside the health care system and to extend the reach of interventions to people with undiagnosed or untreated alcohol use disorders. In this paper we review the evidence for these alternative intervention methods for alcohol problems, when used independently or in conjunction with practitioner-delivered therapies. The full spectrum of alcohol problems from hazardous drinking to alcohol dependence is encompassed.