酒精使用障碍一级预防的政策选择可分为相互重叠的两类:公共的和机构的。[25]Toomey TL, Wagenaar AC. Policy options for prevention: the case of alcohol. J Public Health Policy. 1999;20(2):192-213.http://www.ncbi.nlm.nih.gov/pubmed/10408171?tool=bestpractice.com 例如可通过酒精控制政策降低酒精的可获得性(例如消费税、立法制定合法饮酒年龄和销售时间),目的是减少酒精相关问题(例如交通事故、肝硬化和暴力)。[25]Toomey TL, Wagenaar AC. Policy options for prevention: the case of alcohol. J Public Health Policy. 1999;20(2):192-213.http://www.ncbi.nlm.nih.gov/pubmed/10408171?tool=bestpractice.com 研究发现,这些策略联合禁止酒精广告的措施,对减少酒精相关危害是有效的。[26]Anderson P, Chisholm D, Fuhr DC. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet. 2009 Jun 27;373(9682):2234-46.http://www.ncbi.nlm.nih.gov/pubmed/19560605?tool=bestpractice.com
家庭干预方式对减少青少年人群开始饮酒和降低酒精使用频率效果有轻微作用;但是该方法的效果可持续存在,即使在 48 个月后仍然有效。[27]Smit E, Verdurmen J, Monshouwer K, et al. Family interventions and their effect on adolescent alcohol use in general populations; a meta-analysis of randomized controlled trials. Drug Alcohol Depend. 2008 Oct 1;97(3):195-206.http://www.ncbi.nlm.nih.gov/pubmed/18485621?tool=bestpractice.com
旨在减少酒精使用的基于互联网的干预措施,在干预后长达 12 个月比对照干预更有效。[28]Donoghue K, Patton R, Phillips T, et al. The effectiveness of electronic screening and brief intervention for reducing levels of alcohol consumption: a systematic review and meta-analysis. J Med Internet Res. 2014 Jun 2;16(6):e142.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060043/http://www.ncbi.nlm.nih.gov/pubmed/24892426?tool=bestpractice.com
研究表明,在初级保健机构开展常规筛查致使由执业医师采取早期干预措施能有效减少有害饮酒者/酒精滥用者的酒精使用和相关后果。[29]Kypri K, Langley JD, Saunders JB, et al. Randomized controlled trial of web-based alcohol screening and brief intervention in primary care. Arch Intern Med. 2008 Mar 10;168(5):530-6.http://www.ncbi.nlm.nih.gov/pubmed/18332300?tool=bestpractice.com减少危险性饮酒:有高质量证据表明,与筛查联合信息手册相比,筛查联合单次基于网络的动机性干预可更好地减少危险性饮酒。[29]Kypri K, Langley JD, Saunders JB, et al. Randomized controlled trial of web-based alcohol screening and brief intervention in primary care. Arch Intern Med. 2008 Mar 10;168(5):530-6.http://www.ncbi.nlm.nih.gov/pubmed/18332300?tool=bestpractice.com系统评价或者受试者>200名的随机对照临床试验(RCT)。 在一项研究中,急诊科护士采取的筛查、简短干预和转诊治疗的措施可以减少酒精使用量和急诊科就诊次数。[30]Désy PM, Howard PK, Perhats C, et al. Alcohol screening, brief intervention, and referral to treatment conducted by emergency nurses: an impact evaluation. J Emerg Nurs. 2010 Nov;36(6):538-45.http://www.ncbi.nlm.nih.gov/pubmed/21078465?tool=bestpractice.com