Hazardous alcohol use is a major contributor to the burden of disease in China. However, in primary care settings, alcohol-related problems are often under recognized and under treated, and there is a lack of practical guidance to support general practitioners in screening for and preventing excessive drinking in routine care. This paper interprets and analyzes the latest recommendations on hazardous alcohol use from the Royal Australian College of General Practitioners (RACGP) Guidelines for preventive activities in general practice ("Red Book"), and discusses potential barriers to implementing these core recommendations in the Chinese context. We argue that, compared with universal screening, an opportunistic screening strategy triggered by clinical cues is more feasible and realistic in China. Drawing on the Red Book recommendations and considering the realities of primary care in China, we propose integrating opportunistic screening and brief interventions for excessive drinking into the public health service system (family doctor contract services). Through team based family doctor services, incentive mechanisms, and patient empowerment, the identification and management of hazardous drinkers can be embedded into the routine practice of general practitioners.

过度饮酒是造成我国严重疾病负担的主要因素之一。然而，在我国基层医疗服务中对酒精使用问题的识别和干预普遍不足，缺乏指导和支持全科医生在基层诊疗中进行过度饮酒筛查和预防活动的建议。本文对澳大利亚全科医生学会（RACGP）发布的《全科医学的预防活动指南》（简称"红皮书"）第十版中关于过度饮酒的建议进行了解读与分析，讨论了其核心建议在中国可能面临的实施障碍。笔者认为，全科医学服务中不适宜进行酒精使用的全面筛查，而基于临床线索触发的机会性筛查策略在中国更具现实可行性。为此，借鉴红皮书的建议和考虑我国基层医疗的实际背景，将过度饮酒的机会式筛查和简短干预纳入公共卫生服务体系中（家庭医生签约服务），通过家医团队协作服务和激励措施为患者赋能，将"发现和帮助"过度饮酒者的做法纳入全科医生的日常实践。