Korean Journal of Family Medicine

Barriers to alcohol intervention program: a scoping review: Selly Jaimon, Richard Avoi, Mohd Nazri Bin Mohd Daud, Pravina Deligannu, Zulkhairul Naim Bin Sidek Ahmad; Korean J Fam Med 2025;46(4):218-230. Published online July 20, 2025; DOI: https://doi.org/10.4082/kjfm.25.0055

Abstract
PDF

Excess alcohol intake is associated with many negative effects and is a major cause of mortality and morbidity worldwide. World Health Organization has established a global plan with 10 primary policy areas and interventions and six important action areas to reduce alcohol’s negative effects. However, alcohol intervention programs face several challenges that can hinder their success in assisting patients with alcohol consumption reduction and cessation. The objective of this scoping review was to identify the barriers to the implementation of alcohol intervention programs. The Joanna Briggs Institute recommendations and PCC (participants, concepts, context) eligibility criteria were used for the review. A combination of search phrases was used to narrow the literature search to 2014–2024 English-language papers and original research articles with full access. After removing duplication, 3,846 articles remained from the 5,128 found. After further exclusions, 19 eligible studies were included in this review. Five main barriers to care were identified: service-level barriers, barriers to care seeking, stigma, socio-cultural barriers, and external barriers. Robust regulations and implementation are necessary to effectively address service levels and external barriers. To enhance help-seeking behaviors, alcohol screening should be implemented, strict management policies for alcohol use disorders should be enforced, and accessible alternatives should be provided. Additionally, public health initiatives should focus on changing societal perceptions to counteract alcohol normalization. These efforts must involve both communities and workplaces.

Citations

Citations to this article as recorded by

Health behaviors, lifestyle factors, and healthcare challenges in family medicine: a comprehensive review of recent evidence from Asian populations
Joung Sik Son
Korean Journal of Family Medicine.2025; 46(4): 215. CrossRef

1,573 View
44 Download
1 Web of Science
1 Crossref

Epileptic Seizure Due to Disulfiram Treatment: Habib Erensoy, Ahmet Emre Sargin; Korean J Fam Med 2019;40(6):406-408. Published online January 7, 2019; DOI: https://doi.org/10.4082/kjfm.18.0014

Abstract
PDF

Disulfiram has been used for the treatment of alcohol dependence for nearly 65 years and is approved by the Food and Drug Administration. It causes negative reinforcement by accumulating toxic acetaldehyde due to irreversible inhibition of aldehyde dehydrogenase. Disulfiram has very few side effects when taken without alcohol. Epileptic seizure induction is a rare side effect in therapeutic doses, and its mechanism is unknown. We present a patient with a single epileptic seizure which was thought to be due to disulfiram used in the treatment of alcohol dependence. We did not find it ethical to administer disulfiram again because the patient discontinued alcohol use and was afraid of epileptic seizures.

Citations

Citations to this article as recorded by

Disulfiram-Associated Generalized Tonic–Clonic Seizures
Sivapriya Vaidyanathan, Sudharshan Raghunathan, Suma T. Udupa, Ravindra Neelakanthappa Munoli, Malkonahalli Srikanta Manjushree, Samir Kumar Praharaj
American Journal of Therapeutics.2024; 31(4): e422. CrossRef
Anticancer Effects of New Disulfiram Analogs
Omeima Abdullah, Christopher A. Beaudoin, Ziad Omran
Biological and Pharmaceutical Bulletin.2024; 47(11): 1804. CrossRef
Disulfiram-induced epileptic seizures
Violeta Nogueira, Mafalda Azevedo Mendes, Inês Pereira, Joana Teixeira
BMJ Case Reports.2021; 14(3): e236296. CrossRef

9,803 View
189 Download
3 Web of Science
3 Crossref

Usefulness of Heavy Drinking and Binge Drinking for the Diagnosis of Alcohol Use Disorder: Seong Gu Kim, Jong Sung Kim, Han Ju Pack, Han Na Sung; Korean J Fam Med 2016;37(4):214-220. Published online July 21, 2016; DOI: https://doi.org/10.4082/kjfm.2016.37.4.214

Abstract
PDF

Background

This research investigated the sensitivity and specificity of heavy and binge drinking for screening of alcohol use disorder.

Methods

This retrospective study was conducted with 976 adults who visited the Sun Health Screening Center for health screenings in 2015. Daily drinking amount, drinking frequency per week, and weekly drinking amount were investigated. Using criteria from the National Institute on Alcohol Abuse and Alcoholism, participants were classified as normal drinkers, heavy drinkers, or binge drinkers, and grouped by age and sex. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of heavy and binge drinking were compared for the diagnosis of alcohol abuse and alcohol dependence using the Diagnostic and Statistical Manual of Mental Disorders (DSM) 4th edition-text revision and alcohol use disorder using the DSM 5th edition.

Results

The sensitivity of heavy and binge drinking for the diagnosis of alcohol abuse, alcohol dependence, and alcohol use disorder were 51.7%, 43.8%, and 35.3%, and 69.0%, 62.5%, and 48.2%, respectively. The specificity of these were 90.1%, 91.7%, and 95.5%, and 84.3%, 86.8%, and 91.2%, respectively. The PPV of these were 24.8%, 40.5%, and 72.7%, and 21.7%, 38.0%, and 65.2%, respectively. The NPV of these were 96.7%, 92.6%, and 81.2%, and 97.8%, 94.7%, and 83.7%, respectively.

Conclusion

Heavy and binge drinking did not show enough diagnostic power to screen DSM alcohol use disorder although they did show high specificity and NPV.

Citations

Citations to this article as recorded by

Normative Data for Timed-Up-and-Go and One-Leg-Standing for 66-Year-Old Koreans: A Nationwide Study
Jeehae Chung, Matthew Smuck, Ruopeng Sun, Seonjeong Byun
Journal of the American Medical Directors Association.2025; 26(9): 105773. CrossRef
ELSA cohort 2014: association of age of first drink and progression from first drink to drunkenness on alcohol outcomes in Argentinean college freshmen
Belén del Valle Vera, Angelina Pilatti, Ricardo Marcos Pautassi
The American Journal of Drug and Alcohol Abuse.2020; 46(1): 58. CrossRef
ELSA 2014 Cohort: Risk Factors Associated With Heavy Episodic Drinking Trajectories in Argentinean College Students
Belén del Valle Vera, Angelina Pilatti, Ricardo Marcos Pautassi
Frontiers in Behavioral Neuroscience.2020;[Epub] CrossRef
High Alcohol–Preferring Mice Show Reaction to Loss of Ethanol Reward Following Repeated Binge Drinking
Cherish E. Ardinger, Nicholas J. Grahame, Christopher C. Lapish, David N. Linsenbardt
Alcoholism: Clinical and Experimental Research.2020; 44(9): 1717. CrossRef
Diagnostic Usefulness of Korean Standard on Heavy Drinking for the DSM-5 Alcohol Use Disorder
Seong Gu Kim, Jong Sung Kim, Han Ju Pack, Han Na Sung
Korean Journal of Health Promotion.2017; 17(2): 91. CrossRef

5,365 View
31 Download
5 Web of Science
5 Crossref

Usefulness of Alcohol-screening Instruments in Detecting Problem Drinking among Elderly Male Drinkers: Young Il Ryou, Jong Sung Kim, Jin Gyu Jung, Sung Soo Kim, Dong Hyun Choi; Korean J Fam Med 2012;33(3):126-133. Published online May 24, 2012; DOI: https://doi.org/10.4082/kjfm.2012.33.3.126

Abstract
PDF

Background

In Korea, few studies have been performed on screening instruments for the detection of at-risk drinking and alcohol use disorders in the elderly. This study evaluated the validity of three screening instruments in elderly male drinkers.

Methods

The subjects were 242 Korean men aged ≥ 65 years. Face-to-face interviews were used to identify at-risk drinking and alcohol use disorders. At-risk drinking was defined according to the criteria for heavy or binge drinking of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV-text revision. The Alcohol Use Disorder Identification Test (AUDIT), Short Michigan Alcoholism Screening Test-geriatric version (SMAST-G), and cut down, annoyed, guilty, eye-opener (CAGE) questionnaire were used as the alcohol-screening instruments. Based on the diagnostic interview results, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of the instruments were compared.

Results

For identification of at-risk drinking, the AUDIT AUROC demonstrated greater diagnostic power than did those of SMAST-G and CAGE (both P < 0.001). In screening for alcohol use disorders, the AUDIT AUROC was also significantly higher than those of SMAST-G and CAGE (both P < 0.001). The sensitivity and specificity of screening for at-risk drinking with an AUDIT score ≥ 7 were 77.3% and 85.1%, respectively, whereas those for the alcohol use disorders with an AUDIT score ≥ 11 were 91.3% and 90.8%, respectively.

Conclusion

The results suggest that the AUDIT is the most effective tool in identifying problem drinkers among elderly male drinkers.

Citations

Citations to this article as recorded by

Alcohol and substance use in older adults with treatment‐resistant depression
Maytinee Srifuengfung, Eric J. Lenze, Steven P. Roose, Patrick J. Brown, Helen Lavretsky, Jordan F. Karp, Charles F. Reynolds, Michael Yingling, Naratip Sa‐nguanpanich, Benoit H. Mulsant
International Journal of Geriatric Psychiatry.2024;[Epub] CrossRef
Screening Tools for Alcohol Use Disorder Among Older Adults: A Scoping Review
Lynn Greenleaf Brown, Pamela R. Short, Adelia Grabowsky
Journal of Gerontological Nursing.2024; 50(11): 21. CrossRef
Pragmatic Screening of Anxiety, Depression, Suicidal Ideation, and Substance Misuse in Older Adults
Sean A. Lauderdale, Kelly J. Martin, Kobi R. Oakes, Jenna M. Moore, Reynolds J. Balotti
Cognitive and Behavioral Practice.2022; 29(1): 105. CrossRef
Validation of the AUDIT and AUDIT-C for Hazardous Drinking in Community-Dwelling Older Adults
Yannic van Gils, Erik Franck, Eva Dierckx, Sebastiaan P. J. van Alphen, John B. Saunders, Geert Dom
International Journal of Environmental Research and Public Health.2021; 18(17): 9266. CrossRef
Validated scales for substance use disorders in the geriatric population
Siddharth Sarkar, Esha Sood, Roshan Bhad, Ashwani Mishra
Journal of Geriatric Mental Health.2021; 8(2): 70. CrossRef
Uživanje alkohola med starostniki v domačem okolju: rezultati presejalnega testa SMAST-G
Radojka Kobentar, Zoran Kusić
Obzornik zdravstvene nege.2017;[Epub] CrossRef
Alcohol Use and the Older Adult Woman
Nancy S. Goldstein, Nancy Hodgson, Christine Savage, Benita Walton-Moss
The Journal for Nurse Practitioners.2015; 11(4): 436. CrossRef
Reliability and Validity of Alcohol Use Disorder dentification Test-Korean Revised Version for Screening At-risk Drinking and Alcohol Use Disorders
Chang-Gi Kim, Jong Sung Kim, Jin-Gyu Jung, Sung-Soo Kim, Seok-Joon Yoon, Hae-Sun Suh
Korean Journal of Family Medicine.2014; 35(1): 2. CrossRef
Detecting alcohol problems in older adults: can we do better?
Christine Taylor, Katy A Jones, Tom Dening
International Psychogeriatrics.2014; 26(11): 1755. CrossRef
Comments on Statistical Issues in July 2012
Yong Gyu Park
Korean Journal of Family Medicine.2012; 33(4): 247. CrossRef

5,037 View
33 Download
10 Crossref

Narrative Analysis of Illness Experiences of Alcohol Abuse Patients.: Eal Whan Park, Jong Sung Kim; J Korean Acad Fam Med 2004;25(2):138-145. Published online February 10, 2004

Abstract
PDF

Background
: Patients' Illness experiences are described in the 4 categories;
meanings or patients' thoughts, patients' feelings, patients' expectations, and influence of
illness on patients' lives. The purpose of this study is to collect patients' stories when they are
interviewed in a family medicine clinic, and analyze to make a systematic database of the
patients' illness experiences. Method: We recorded and analyzed illness narratives of the 19
alcohol abuse patients. One of the researchers interviewed the patients directly to collect
narrative data by using a semi-structured questionnaire.

Results : The meanings that they had
in alcohol abuse were making a social relationship, vitality, forgetting, anesthetic drugs to
relief emotional pain, means to relief thirst, hunger, depressed mood. They told that the
physical effects of alcohol drinking were gastrointestinal disturbance and change in body
weight. Psychosocial or behavioral changes were sleep disturbance, loss of memory, drinking
alone, absence from work after drinking, avoidance of related persons and guilty feeling.
The patients concerned about their chronic drinking habit, physical symptoms, behavioral
changes, deterioration in physical health, withdrawal in social roles, and sick persons
among their families, As for the expectations for a physician's support patients told that
they had to stop by himself, and some patients talked about good medicines or strong
medicines, or checking blood tests.

Conclusion : In conclusion the patients had the positive
reasons for alcohol drinking, but they had also negative experiences after drinking. Deducing
from the expressed denials, we can guess that the negative experiences might have no effect
on the patients' behavior change.

1,436 View
14 Download

Improvement of insight in patients with alcohol dependence by treatmen programs.: Jong Sung Kim, Byoung Kang Park, In Sul Yu, Mi Kyeung Oh; J Korean Acad Fam Med 2000;21(9):1180-1187. Published online September 1, 2000

Abstract
PDF

Background
: The first step for the recovery of alcoholics is the formation of true insight which enables them to admit that they are alcoholic. This study was designed to analyze the changes in insight status by treatment programs.

Methods : The subjects were 214 alcohol dependents who participated in the insight-oriented treatment programs for at least 1 week. Their insight status were measured through HAIS before and after treatment.

Results : Of 214 sjbjects, 83(38.3%) were in poor-, 103 (48.1%) in fair-, and 28 (13.1%) in good-insight before treatment, and 56 (26.2%) in poor-, 97(45.3%) in fair-, and 61(28.5%) in good-insight after treatment. Mean HAIS scores of the subjects were 5.35 (SD=8.04) after treatment. The magnitude of insight-improvement was negatively correlated with the HAIS scores before treatment in poor-insight group and positively correlated with the duration of participation in treatment in fair-insight group.

Conclusion : We confirmed the fact that the insight status of patients could be improved by treatment. It was also suggested that the therapeutic strategy needed an individual approach according to the insight state of a patient.

1,531 View
29 Download

Screening criteria of alcoholism by alcohol use disorders identification test(AUDIT) in Korea.: Jong Sung Kim, Mi Kyung Oh, Byoung Kang Park, Min Kyu Lee, Gap Jung Kim; J Korean Acad Fam Med 1999;20(9):1152-1159. Published online September 1, 1999

Abstract
PDF

Background
: Such screening tools for alcoholism as MAST, NAST, CAGE focused on the alcohol related psychosocial problems. But some men can be excluded in a study using these tools whereas they might be at risk for alcohol-related physical problems. From this perspective the new tools focusing under quantity and frequency of intake for detection of early-stage drinkers not yet manifesting evident psychosocial problems but having alcohol-related potential harms, are being developed to provide n these aspects, 10-itemed AUDIT was developed by WHO and this study was developed to provide standard points for screening alcohol problems in Korea with cultural difference through AUDIT.
Method : The subjects were 85 drinking men and 11 male alcohol dependents who visited Kangnumg hospital of Asan foundation from July until August 1998. The team composed of 2 family physicians and 1 psychiatrist, who delivered structured interviews based on DSM-IV criteria in terms of psychosocial problems, and examined them and reviewed the patient records in terms of alcohol-related physical problems. Accordingly the subjects were classified into 'normal', 'physical problems-related drinkers' without psychosocial problems, and 'alcohol abuse' and 'alcohol dependent' according to DSM-IV criteria. Aside from physicians’ diagnostic procedures, they were again made to complete a questionnaire including all the items of AUDIT, MAST, NAST and CAGE.

Results : As regards physicians' diagnostic results, 31 were normal 8 had physical problems without psychosocial problems, 36 abused alcohol, and 21 were alcohol-dependent. The mean AUDIT scores of all the subjects were 17.5(±9.5) and the mean AUDIT scores of each group were 7.1(±4.3), 16.6(±3.4), 19.9(±5.0), 29.3(±5.1), respectively and revealed significant difference among them. AUDIT scores were significantly correlated with those marked from physician's diagnostic results and also significantly correlated with MAST, NAST and CAGE, respectively. After consideration of means AUDIT scores and standard deviations of each group according to diagnostic results, the preliminary standard AUDIT problems were most possible 12,13,14 points. Their sensitivity and specificity were 96.9% and 87.1% in 12 points, 92.3 and 90.3% in 13 points, and 90.8% and 90.3% in 14 points, respectively. The preliminary standard AUDIT scores concerning 'alcohol use disorders' based on DSM-IV criteria were most possibly 14,15,16 with its sensitivity and specificity of 91.2% and 74.4% in 14 points, 89.5% and 79.5% in 15 points, and 84.2% and 84.6% in 16 points. The preliminary standard AUDIT scores for 'alcohol dependence' were most possibly 25,26,27 with its sensitivity and specificity of 85.7% and 90.7% in 25 points, 85.7% and 93.3% in 26 points, and 71.4% and 94.7% in 27 points.

Conclusion : The authors recommend AUDIT cut-off scores of 12 points as the standard value for a broader sense of 'problem drinking' including physical as well as psychosocial problems, 15 for 'alcohol use disorders' based on DSM-IV criteria, and 26 for 'alcohol dependence' in Korea.