Abstract
BackgroundThe Swedish National Alcohol Helpline was developed with the intention to provide an easily available, low threshold service to hazardous and harmful alcohol users in the community. The primary aim of this study was to describe the 12-month outcome of a cohort of clients and to evaluate whether these varied as a function of the intensity of exposure to the intervention.MethodsThe alcohol use and alcohol problems of a cohort of 191 clients accessing the service between 1 April 2009 and 1 February 2011 were assessed by telephone survey at the time of the first call and after 12 months. Change in AUDIT score between baseline and follow-up was used as primary outcome. Intensity of exposure was defined by number of counselling sessions.ResultsAt 12-month follow-up, respondents had significantly reduced their AUDIT score to half of the baseline values, and one third of the participants were abstinent or consumed alcohol at a low-risk level. Participating in more than one counselling session as compared to one session was associated with a tendency to shift to a lower AUDIT zone at follow-up among women.ConclusionsThe Alcohol Helpline provides a viable community service for harmful and hazardous alcohol users. Future randomized studies including other treatment or control conditions are warranted in order to strengthen our preliminary conclusion of possible effectiveness of the counselling provided at the helpline, as well as to explore further the role of gender in moderating the treatment’s effect.
Highlights
The Swedish National Alcohol Helpline was developed with the intention to provide an available, low threshold service to hazardous and harmful alcohol users in the community
Selected clinical characteristics of the analytical sample at baseline and at follow-up are presented separately by gender. Based on their Alcohol Use Disorders Identification Test (AUDIT) score 68 percent of the men and 57 percent of the women met the criteria for alcohol dependence at baseline while the others were either hazardous or harmful alcohol users
During the 12 months preceding their first contact with the Alcohol Helpline three out of four participants had been in contact with various health care services, but less than half had sought help for alcohol problems
Summary
The Swedish National Alcohol Helpline was developed with the intention to provide an available, low threshold service to hazardous and harmful alcohol users in the community. Most individuals who seek formal treatment for alcohol problems do so at a rather late stage after the onset of alcohol dependence, i.e. after significant psychosocial and medical consequences of their alcohol use have become evident. This delayed help-seeking behaviour is primarily due to a combination of underestimation of risks [1,2], of a lack of motivation [3], of feelings of shame [1,3,4] and of feelings of stigmatisation [2,3]. No previous studies evaluated telephone counselling as a stand-alone intervention for self-referred hazardous and harmful alcohol users in the community. Previous studies on brief interventions have shown inconclusive results regarding gender differences in treatment outcomes [6,7,8,20,21]
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