Alcohol use disorder can be screened for and treated in primary care

An American Family Physician review summarises primary care for alcohol use disorder, one of the commonest chronic conditions general practitioners meet. It carries risks across the liver, heart and nervous system, and is tied to depression, anxiety, suicide and injury.

The review supports screening adults with a short tool such as AUDIT-C, as the US Preventive Services Task Force recommends. Evaluation can include a focused examination, blood tests, assessment of liver function and fibrosis, and an assessment of withdrawal risk. It states that treatment in primary care is effective: everyone with the disorder should receive a brief counselling intervention, with treatment or referral where indicated. Treating co-occurring mental illness improves the chance of recovery from both. Routine vaccines, including pneumococcal vaccine, should be offered.

This is a narrative clinical review, and its US framing does not map exactly onto Indian services. But the structure — ask, advise, assess, offer treatment, follow up — fits a short consultation and does not depend on specialist services being available.

• Ask adults about alcohol with a short validated tool such as the three AUDIT-C questions.
• Give a brief, non-judgemental counselling intervention to everyone who screens positive.
• Assess withdrawal risk before advising a patient to stop abruptly.
• Check liver function and look for depression and anxiety, which make recovery harder if untreated.
• Offer pneumococcal and other routine vaccines to adults with alcohol use disorder.

Why it matters

Treatment for alcohol use disorder is often treated as someone else's job when it can start in a ten-minute consultation.

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