Early Detection of Alcohol and Drug Problems — Why?

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Abstract
The early detection of alcohol and drug problems has emerged as a major emphasis in the 1980s in many countries throughout the world. The World Health Organization collaborative project involving some 11 nations is a concrete illustration of this new perspective. This paper addresses three basic questions regarding early intervention. First, why should we do it? The following reasons are considered: most “excessive” drinkers do not seek treatment for their alcohol problems, socially stable individuals at early stages of drinking problems have better prognosis, health professionals in primary care settings are in an excellent position to identify problem drinkers, and brief interventions by health professionals can be effective in reducing alcohol abuse. Second, why are we not doing it? A primary reason is widespread pessimism among health professionals about being able to intervene effectively. In addition, there is confusion regarding appropriate roles about who is responsible for confronting alcohol/ drug problems, uncertainty about the proper target population (problem drinkers versus alcoholics), and lack of appropriate treatment programs, philosophies and practical training. Third, how can it be done effectively? A basic strategy on early intervention must be adopted by health professionals. Also, practical techniques and training for early intervention need to be made widely available. Finally, one must convince key people to implement such programs. Despite the growing enthusiasm and expectations regarding early intervention, certain caveats are raised regarding the uncritical adoption of such programs.