to patients who met both DSM-IV and DSM-5 criteria, despite having similar demographic characteristics. This association between alcohol-related symptom burden and readiness to change has been previously described [28], but the finding that DSM-5 identifies more of these patients with milder alcohol-related symptoms who report less readiness to change may have clinical implications for primary care. Given the lower burden of mental health symptoms reported by patients with DSM-5 AUD alone, and their greater confidence in their ability to change their drinking, patients meeting DSM-5 criteria alone may be more likely to respond to brief opportunistic interventions in primary care compared to those who meet criteria for both DSM-IV and DSM-5 AUD. On the other hand, these patients tended to report less treatment-seeking and placing less importance on changing their drinking than those meeting both DSM-IV and DSM-5 AUD criteria and they were less likely to report that they were ready to change. These characteristics may make patients meeting criteria for DSM-5 alone more successful at self-change, but more challenging to engage in opportunistic primary care interventions—like the CHOICE trial intervention–which seek to engage patients repeatedly over time and/or interest them in medications for AUD [29, 30]. Future research will
