HOW TO HELP PATIENTS WHO DRINK TOO MUCH: A CLINICAL
APPROACH
Assess for Alcohol Use Disorders
Next, determine whether there is a maladaptive pattern of alcohol use,
causing clinically significant impairment or distress. It is
important to assess the severity and extent of all alcohol-related symptoms to
inform your decisions about management. The following list of symptoms is adapted
from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition
(DSM-IV), Revised. Sample assessment questions are available online at www.niaaa.nih.gov/guide.
Determine whether, in the past 12 months, your patient’s drinking has repeatedly
caused or contributed to
(family or friends)
(arrests or
other legal problems)
If yes to one or more
your patient has alcohol abuse.
In either case, proceed to assess for dependence symptoms.
Determine
whether, in the past 12 months, your patient has
(repeatedly
gone over them) (repeated failed attempts)
(needed
to drink a lot more to get the same effect)
(tremors, sweating, nausea, or insomnia when trying to quit or cut down)
(recurrent physical or psychological problems)
(or anticipating or recovering from drinking)
(activities that had been important or pleasurable)
If yes to three
or more
your patient has alcohol dependence.
Does
the patient meet the criteria for alcohol abuse or dependence?
Your
patient is still at risk for developing alcohol-related problems.
National Institute on Alcohol
Abuse and Alcoholism (NIAAA) 5635 Fishers Lane, MSC 9304 Bethesda, MD 20892-9304 email:
Web Sponsor (niaaaweb-r@exchange.nih.gov)