In comparison to your colleagues:

Diagnosis & Treatment

Screening and brief intervention for alcohol problems in primary health care

In 1980, a WHO expert committee stressed the need for efficient methods to identify persons with harmful and hazardous alcohol consumption before health and social consequences become pronounced. There was an urgent call for the development of strategies that could be applied in primary health care settings with a minimum of time and resources. Within this context, the WHO Collaborative Project on Identification and Treatment of Persons with Harmful Alcohol Consumption was initiated in 1982 to develop a scientific basis for screening and brief interventions in primary care settings. The project linked six collaborating centers representing a broad variety of cultural groups in developing a simple instrument to screen for persons at high risk of alcohol problems in both developing and developed countries. The result was the introduction of the Alcohol Use Disorders Identification Test (AUDIT).


Cover of AUDIT manual

AUDIT manual (English) pdf, 158kb

AUDIT manual (Spanish) pdf, 158kb

Brief Intervention manual (English) pdf, 205kb

Brief Intervention (Spanish) pdf, 205kb




Screening for alcohol use: why AUDIT?

The AUDIT was developed as a simple method of screening for excessive drinking and to assist in brief assessment. It can help identify excessive drinking as the cause of the presenting illness. It provides a framework for intervention to help risky drinkers reduce or cease alcohol consumption and thereby avoid the harmful consequences of their drinking. The AUDIT also helps to identify alcohol dependence and some specific consequences of harmful drinking. Of utmost importance for screening is the fact that people who are not dependent on alcohol may stop or reduce their alcohol consumption with appropriate assistance and effort. The manual is particularly designed for health care practitioners and a range of health settings, but with suitable instructions it can be self-administered or used by non-health professionals.

Brief Intervention

Brief interventions are those practices that aim to identify a real or potential alcohol problem and motivate an individual to do something about it. Brief interventions have become increasingly valuable in the management of individuals with alcohol-related problems. During the past 20 years, there have been numerous randomized trials of brief interventions in a variety of health care settings. Studies have been conducted in Australia, Bulgaria, Mexico, the United Kingdom, Norway, Sweden, the United States and many other countries. Results from these studies show that there is clear evidence that well-designed brief intervention strategies are effective, low-cost and easy to administer.

Because research has shown that brief interventions are low in cost and have proven to be effective across the spectrum of alcohol problems, health workers and policy-makers have increasingly focused on them as tools to fill the gap between the primary prevention efforts and more intensive treatment for persons with serious alcohol use disorders. It is worth noting that brief interventions are not designed to treat persons with alcohol dependence, which generally requires greater expertise and more intensive clinical management. However, they might serve well as an initial treatment for severely dependent patients seeking extended treatment.

Along with the companion publication on the AUDIT, WHO has also produced a manual to aid primary health care workers in administering brief interventions to persons whose alcohol consumption has become hazardous or harmful to their health. Together, these manuals describe a comprehensive approach to alcohol screening and brief intervention (SBI) that is designed to improve the health of the population and patient groups as well as individuals.


 The WHO ASSIST package

Manuals for the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the ASSIST-linked brief interventions

The World Health Organization has developed the ASSIST package of screening and brief interventions to help health professionals detect and respond to alcohol, tobacco and other psychoactive substance use.

The ASSIST package, which consists of a brief questionnaire, a guide for health professionals on how to use the questionnaire in detecting and responding to substance use and also a self-help manual for cutting down or stopping substance use, is the result of more than 10-years work by WHO and an international group of researchers in the framework of the WHO ASSIST project. It is WHO’s response to the growing demand for guidance on how to best manage problems of substance use in non-specialist health care settings. This approach, quick and easy to learn, useful for all substances including alcohol and tobacco, but also cannabis, amphetamine-type stimulants, cocaine and opioids, and with its effectiveness demonstrated in different cultural settings, is set to become a keystone in the health care response to substance use.

The package includes three different materials:

Front cover ASSIST manualThe Alcohol, Smoking and Substance involvement Screening Test (ASSIST): manual for use in primary care pdf, 1.5Mb.
This manual introduces the ASSIST and describes how to use it in health care settings - particularly community based primary health care settings – to identify people who are using substances and assess the health risks associated with substance use, so that a brief discussion or a referral to specialist centre can be provided as appropriate.




Front cover of ASSIST-linked brief interventionThe ASSIST-linked brief intervention for hazardous and harmful substance use: a manual for use in primary care pdf 1.1Mb
This manual explains the rational for providing brief discussion based interventions in health care settings and describes how health care workers can conduct brief interventions for clients whose substance use is putting their health at risk.




Front cover self-help strategies Self-help strategies for cutting down or stopping substance use: a guide, pdf 2.2Mb
This guide was developed to assist patients who are at risk because of their substance use to weigh up their substance use behavior and to change it using self-help strategies.





The ASSIST screening test and feedback card

The Involvement of Nurses and Midwives in Screening and Brief Interventions for Hazardous and Harmful Use of Alcohol and other Psychoactive Substances [pdf 447kb]


Research Tools

There are several standardized instruments that are frequently used in our research. Several of these instruments have been translated into a number of different languages according to the location of participating research centres. The instruments below may be useful to researchers, clinicians and other health professionals.