1. Risk-drinking • The use of alcohol that is, or may become harmful, but where no addiction is present.

2. Effects • Risky drinking has large impact on many of the common diagnoses in family medicine, such as hypertension, cardiac arythmia, depression, anxiety, insomnia etc.

3. The risk-drinking patients usually have no problem to cut back alcohol consumption, once they realize the connection to their health problems.

4. GPs agree that it is important that patients with a risk-drinking profile are identified and get advice on changing habits BUT : • 50% ask patients about use of alcohol • 75% think they cannot influence how much their patients drink • 97,1% wish to get more education in the field

5. How to teach GPs an effective approach to achieve changes in their patients habits of alcohol consumption The Risk-drinking Project

6. Three main points of strategy • Forceful economic support by the government both to a national knowledge centre and to all of the country’s health care regions • Use professional organisations • Focus on education and networks

7. Goal • Issues about alcohol habits shall be a natural element in daily health care in such a way that it reflects the importance alcohol has as a source of injuries and illnesses

8. HOW ? • PATIENT-CENTRED approach – is it in the interest of the patient ? • EMPOWERMENT – to summon the powers within the patient. • MI

9. Culture competence • Methodology suited to the daily practices of doctors and nurses

10. Cave! ”commando training”

11. The risk-drinking workshop • An educational model, using the experiences of the practitioner to overcome obstacles and fears when dealing with the risk-drinking patient: • Barriers • Facts/experiences • Methods of Consultation /MI

12. Methodology Combining the risk drinking workshop with training in motivational interviewing has proven to be successful.

13. OPPORTUNITY 1 • Has the patient noticed that his /her problem has a connection to alcohol ?

14. OPPORTUNITY 2 • Offer information in connection to the patients diagnosis

15. OPPORTUNITY 3 • Provide information on treatment .

16. OPPORTUNITY 4 • Introduce the idea of different sensibility.

17. OPPORTUNITY 5 • Test if there is a connection

18. OPPORTUNITY 6 • Lab tests • NB To talk with the patient has a much higher sensitivity and specificity than most labresults

19. How to reach us • www.fhi.se / riskbruksprojektet • English version available at the site • E-mail: asa(.)wetterqvist@fhi.se

20. Seven sub-projects • Motivational Interviewing - MI • General practitioners • Specialist trainee doctors (ST-doctors) • District nurses • Maternity health care • Child health care • Occupational health