What is USPSTF's approach to screening for alcohol misuse?

• A. Do not screen for alcohol misuse.
• B. Screen adults for alcohol misuse and provide brief counseling or referral as appropriate.
• C. Screen only teenagers for alcohol misuse.
• D. Screen adults for alcohol misuse but never provide counseling.

Answer: (B)

Screening adults for unhealthy alcohol use in primary care, with brief counseling or referral as appropriate, is USPSTF’s recommended approach. This is the SBIRT model—Screen, Brief Intervention, and Referral to Treatment. The idea is to routinely identify risky drinking soon through quick, validated tools (like AUDIT-C) and then deliver a short, focused counseling session that motivates change. If the screening reveals more severe misuse or dependence, a referral to specialized treatment is appropriate. This approach aims to reduce harmful drinking and related health risks by integrating prevention and intervention into standard care.

Choosing not to screen ignores opportunities to identify people at risk; focusing only on teenagers misses the adult benefit; and screening adults but never offering counseling or referral does not align with the evidence showing that brief interventions and appropriate referrals improve outcomes.