The U.S. Preventive Services Task Force (USPSTF) recommends screening adults for unhealthy alcohol use and providing brief behavioral counseling interventions for those engaged in risky drinking. These recommendations form the basis of a draft recommendation statement published online Aug. 5.

Researchers examined evidence on the benefits and harms of screening and interventions to identify and reduce unhealthy alcohol use. Data were obtained from one stepped-wedge randomized controlled trial (RCT) on the benefits of screening among pregnant women, 15 diagnostic accuracy studies, and 84 RCTs of interventions to reduce unhealthy alcohol use (five involving adolescents; 79 involving adults).

The researchers found no differences in alcohol consumption in the trial of screening. Use of several brief screeners was supported by diagnostic accuracy studies for identifying youth with alcohol use disorder. In a pooled analysis of RCTs conducted among adults to test interventions to reduce alcohol use, those in the intervention groups reduced alcohol consumption more than those in control groups.

Based on these findings, the USPSTF recommends screening adults aged 18 years or older for unhealthy alcohol use in primary care settings and providing brief behavioral counseling interventions to reduce unhealthy alcohol use for those engaged in risky or hazardous drinking (B recommendation). For adolescents aged 12 to 17 years, the current evidence is insufficient to assess the balance of benefits and harms of screening and brief behavioral counseling interventions (I statement).

“While adolescent alcohol use is a serious concern, there is not enough evidence to determine whether or not screening and counseling in primary care helps to reduce alcohol use in teens, so we are calling for more research,” USPSTF member John Ruiz, Ph.D., from the University of Arizona in Tucson, said in a statement.

“In the absence of evidence, health care professionals should use their judgment when determining whether or not to screen their teen patients.”

The draft recommendation statement and draft evidence review have been posted for public comment. Comments can be submitted through Sept. 2, 2025.

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