NICE guidance (2010) identifies alcohol-related harm as a major public health problem and alcohol misuse is estimated to cost the NHS £2.7bn a year. A significant international evidence base shows that early detetection and intervention, by providing both Identification and Brief Advice (IBA), are effective. This is the primary area where community pharmacy has a role to play in order to deliver the High Impact Changes to reduce alcohol-related health harm.

In recognition of this issue a Direct Enhanced Service (DES) was established to tackle alcohol-related harm. Some PCT's have now extended the DES into a Local Enhanced Service (LES) which targets Identification and Brief Advice (IBA) at particular high risk groups in various settings including pharmacy.

"Pharmacists are well placed to identify those at risk and offer advice and support to improve public health outcomes especially." [Royal Pharmaceutical Society 2010]

What Can Pharmacists Do ?

The NICE guidance recommends that NHS professionals should routinely carry out alcohol screening as an integral part of practice. Pharmacists, as NHS professionals, could implement IBA when screening for other conditions and when managing chronic disease or carrying out a medicine review. These discussions should also take place when promoting sexual health, when seeing someone for an antenatal appointment and when treating minor injuries.

The NICE guidance states that NHS professionals should focus on groups that may be at an increased risk of harm from alcohol and those with an alcohol-related condition. This includes people:

  • with relevant physical conditions (such as hypertension and gastrointestinal or liver disorders)
  • with relevant mental health problems (such as anxiety, depression or other mood disorders)
  • who have been assaulted at risk of self-harm who regularly experience accidents or minor traumas
  • who regularly attend GUM clinics or repeatedly seek emergency contraception.

The Royal Pharmaceutical Society states the following:

Who should take action?

  • All pharmacists should routinely carry out alcohol screening (Identification and Brief Advice) as an integral part of practice. They are ideally placed to identify patients at risk of alcohol misuse.
  • Those concerned about their own alcohol consumption or that of relatives, friends or colleagues.
  • Those wishing to find out about tools used to assess alcohol consumption

For further information: