These slight differences in the clinical profiles of dependence and severe AUD suggest no need for major change in adapting existing clinical practices to suit the needs of individuals with DSM-5 severe AUD, with one possible exception. Some of the individuals who screen positive for AUD in primary care or emergency department settings may be classified with a more severe disorder under the DSM-5(severe AUD) than under the DSM-IV (abuse). Thus, some of the individuals who likely would have received a brief intervention under the DSM-IV may now be considered candidates for more intensive treatment modalities. An important area for future research will be to determine whether these individuals respond to recommendations for treatment and whether it offers any benefits beyond those conferred by brief interventions, which have demonstrated effectiveness in reducing harmful drinking practices and associated costs (Fleming, 2000; Havard et al., 2011; Solberg, 2008).
