1. Risk-drinking The use of alcohol that is, or may become harmful, but where no addiction is present.

2. Effects Risky drinking has large impact on many of the common diagnoses in family medicine, such as hypertension, cardiac arythmia, depression, anxiety, insomnia etc.

3. The risk-drinking patients usually have no problem to cut back alcohol consumption, once they realize the connection to their health problems.

4. GPs agree that it is important that patients with a risk-drinking profile are identified and get advice on changing habits BUT : 50% ask patients about use of alcohol 75% think they cannot influence how much their patients drink 97,1% wish to get more education in the field

5. The Risk-drinking Project How to teach GPs an effective approach to achieve changes in their patients habits of alcohol consumption

6. Three main points of strategy Forceful economic support by the government both to a national knowledge centre and to all of the country’s health care regions Use professional organisations Focus on education and networks

7. Issues about alcohol habits shall be a natural element in daily health care in such a way that it reflects the importance alcohol has as a source of injuries and illnesses Goal

8. HOW ? PATIENT-CENTRED approach – is it in the interest of the patient ? EMPOWERMENT – to summon the powers within the patient. MI

9. Culture competence Methodology suited to the daily practices of doctors and nurses

10. Cave! ”commando training”

11. The risk-drinking workshop An educational model, using the experiences of the practitioner to overcome obstacles and fears when dealing with the risk-drinking patient:  Barriers  Facts/experiences  Methods of Consultation /MI

12. Methodology Combining the risk drinking workshop with training in motivational interviewing has proven to be successful.

13. OPPORTUNITY 1 Has the patient noticed that his /her problem has a connection to alcohol ?

14. OPPORTUNITY 2 Offer information in connection to the patients diagnosis

15. OPPORTUNITY 3 Provide information on treatment.

16. OPPORTUNITY 4 Introduce the idea of different sensibility.

17. OPPORTUNITY 5 Test if there is a connection

18. OPPORTUNITY 6 Lab tests NB To talk with the patient has a much higher sensitivity and specificity than most labresults

19. How to reach us www.fhi.se / riskbruksprojektetwww.fhi.se English version available at the site E-mail: asa(.)wetterqvist@fhi.se

20. Seven sub-projects Motivational Interviewing - MI General practitioners Specialist trainee doctors (ST-doctors) District nurses Maternity health care Child health care Occupational health