The drug, alcohol and mental health treatment charity Humankind has just published an interesting new secondary prevention alcohol toolkit aimed mainly at young adults. The toolkit is designed to provide a more sophisticated assessment tool than the current most common alcohol assessment tool – AUDIT (Alcohol Use Disorders Identification Test). Humankind recognises the value of AUDIT but says that two people may score the same on the test but their journeys with alcohol may follow different paths. The Predicting Risk in Drinkers: Drinking and You (PRIDDY) Toolkit is designed to help workers identify individual risk factors that may suggest a person is more likely to experience harm from alcohol. It also brings the evidence base together into one tool with the aim of equipping workers to deliver more personalised and meaningful advice. 

Humankind describes the toolkit as a missing piece in the range of alcohol treatment interventions. At one end of the scale is:

• Alcohol Identification and Brief Advice which offers a primary prevention approach using population-wide screening followed by brief advice to those who require it.
• Early Intervention in the form of Extended Brief Interventions (EBI) offered to increasing and higher risk drinkers in  face to face clinics and online.

At the other end of the scale are the tertiary interventions offered by: Alcohol treatment services and interventions like the Blue Light Project which target change resistant and dependent drinkers

The toolkit is designed to sit between these two points. It offers a secondary prevention approach targeting advice at people who appear at greater risk of developing an alcohol problem in the future. This approach may identify people who require alcohol treatment but it is mainly advising those who are pre-treatment and are on a journey that could take them to treatment.

Rationale

The toolkit works on the basis that although anyone can be harmed by alcohol, but some people are more at risk than others. The toolkit is designed to help professionals talk to people about their individual risks. It “colours in” the picture of alcohol related risk provided by other assessment tools and helps to develop a constructive conversation about change.

The key to this approach is that it allows workers to offer people more specific and personalised advice. General statements about the risks associated with alcohol are less motivational than statements which are specific to the person:

• A woman whose mother has had breast cancer, increases her own risk if she drinks heavily
• A man whose father had liver cancer, increases his own risk if he drinks heavily.

Specific pieces of knowledge help people explain to themselves and others why they need to moderate their drinking: “My dad had problems with alcohol and I know I have to be careful with drink.”