National Observatory on Alcohol, National Institute of Health, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2020 Jan;24(2):974-982. doi: 10.26355/eurrev_202001_20083.
Harmful and hazardous alcohol consumption is one of the most significant public health problems in Italy and Europe. Habitual excessive consumption and occasional excessive consumption, known as binge drinking, are the two main risk behaviours related to alcohol. Harmful drinking and alcohol dependence have strong social repercussions in terms of their social and economic impact and contribution to productivity losses. In addition, the terms alcohol abuse and alcohol dependence have been recently substituted by the only term of alcohol use disorder (AUD). The issues presented in this review demonstrate that excessive alcohol consumption is a growing public health concern and an appropriate national action plan is needed to increase the prevention of harmful and hazardous consumption and encourage patients to seek healthcare. To date, the main problem is the under-treatment of the population at risk, manifested as the time-lag between the onset of AUD and the first clinical detection. In order to address this, the Screening, Brief Intervention, and Referral to Treatment (SBIRT) strategy has been shared across countries in Europe and is supported by a Systematic Review of Reviews on SBIRT in primary healthcare. Unfortunately, there are still obstacles in the implementation of this approach. The main problem would appear to be general practitioners' difficulty in carrying out accurate and widespread screening, because they may minimize the problem. A more concerted effort in the training of healthcare professionals could address this by enabling the creation of renewed networks for the early identification of harmful and hazardous drinkers. These networks could prevent the occurrence of avoidable alcohol-related conditions, such as alcohol-related liver disease (ALD), while allowing for the timely implementation of evidence-based brief interventions.
有害和危险的酒精消费是意大利和欧洲最重要的公共卫生问题之一。习惯性过度消费和偶尔过度消费，即 binge drinking，是与酒精相关的两种主要风险行为。有害饮酒和酒精依赖对社会和经济产生了重大影响，导致生产力下降。此外，术语“酒精滥用”和“酒精依赖”最近已被“酒精使用障碍（AUD）”这一术语所取代。本综述中提出的问题表明，过度饮酒是一个日益严重的公共卫生问题，需要制定适当的国家行动计划，以增加对有害和危险消费的预防，并鼓励患者寻求医疗保健。迄今为止，主要问题是高危人群的治疗不足，表现为 AUD 发作和首次临床检测之间的时间滞后。为了解决这个问题，欧洲各国共享了 Screening、Brief Intervention、and Referral to Treatment（SBIRT）策略，并支持对初级保健中 SBIRT 的系统综述。不幸的是，该方法的实施仍然存在障碍。主要问题似乎是全科医生难以进行准确和广泛的筛查，因为他们可能会最小化这个问题。通过对医疗保健专业人员进行更协调的培训，可以解决这个问题，从而为早期识别有害和危险饮酒者创建新的网络。这些网络可以预防可避免的与酒精相关的疾病，如酒精性肝病（ALD），同时允许及时实施基于证据的简短干预措施。
