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    Dependenta Alcool

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    Anonymous FXvVwYyakO
    The document provides a clinical approach for helping patients who drink too much. It outlines a 4 step process: 1. Ask patients about their alcohol use through screening questions to determine if they are at risk for heavy drinking. 2. Assess patients who screen positive for at-risk drinking or an AUDIT score over a certain threshold to determine if their drinking pattern meets criteria for alcohol abuse or dependence based on DSM-IV symptoms. 3. Provide recommendations for at-risk patients to stay within safe drinking limits or advise lower limits depending on their situation. 4. For patients meeting criteria for an alcohol use disorder, proceed to steps 3 and 4 which provide different recommendations based on whether they have

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    Dependenta Alcool

    Uploaded by

    Anonymous FXvVwYyakO
    28 views2 pages
    The document provides a clinical approach for helping patients who drink too much. It outlines a 4 step process: 1. Ask patients about their alcohol use through screening questions to determine if they are at risk for heavy drinking. 2. Assess patients who screen positive for at-risk drinking or an AUDIT score over a certain threshold to determine if their drinking pattern meets criteria for alcohol abuse or dependence based on DSM-IV symptoms. 3. Provide recommendations for at-risk patients to stay within safe drinking limits or advise lower limits depending on their situation. 4. For patients meeting criteria for an alcohol use disorder, proceed to steps 3 and 4 which provide different recommendations based on whether they have

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    The document provides a clinical approach for helping patients who drink too much. It outlines a 4 step process: 1. Ask patients about their alcohol use through screening questions to determine if they are at risk for heavy drinking. 2. Assess patients who screen positive for at-risk drinking or an AUDIT score over a certain threshold to determine if their drinking pattern meets criteria for alcohol abuse or dependence based on DSM-IV symptoms. 3. Provide recommendations for at-risk patients to stay within safe drinking limits or advise lower limits depending on their situation. 4. For patients meeting criteria for an alcohol use disorder, proceed to steps 3 and 4 which provide different recommendations based on whether they have

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    28 views2 pages

    Dependenta Alcool

    Uploaded by

    Anonymous FXvVwYyakO
    The document provides a clinical approach for helping patients who drink too much. It outlines a 4 step process: 1. Ask patients about their alcohol use through screening questions to determine if they are at risk for heavy drinking. 2. Assess patients who screen positive for at-risk drinking or an AUDIT score over a certain threshold to determine if their drinking pattern meets criteria for alcohol abuse or dependence based on DSM-IV symptoms. 3. Provide recommendations for at-risk patients to stay within safe drinking limits or advise lower limits depending on their situation. 4. For patients meeting criteria for an alcohol use disorder, proceed to steps 3 and 4 which provide different recommendations based on whether they have

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    of 2

    HOW TO HELP PATIENTS: A CLINICAL APPROACH

    How to Help Patients Who Drink Too Much: A Clinical Approach

    STEP 1 Ask About Alcohol Use

    Prescreen: Do you sometimes drink beer, wine, or other alcoholic beverages?

    NO YES

    Screening complete. Ask the screening question about


    heavy drinking days:
    How many times in the past year
    have you had . . .
    5 or more drinks in 4 or more drinks in
    a day? (for men) a day? (for women)

    One standard drink is equivalent to 12 ounces of beer, 5 ounces


    of wine, or 1.5 ounces of 80-proof spirits—see chart on page 24.

    If the patient used a written self- Is the screening positive?


    report (such as the AUDIT, p. 11), 1 or more heavy drinking days or
    START HERE AUDIT score of ≥ 8 for men or
    ≥ 4 for women

    NO YES

    Advise staying within these limits: Your patient is an at-risk drinker. For a more
    Maximum Drinking Limits complete picture of the drinking pattern,
    determine the weekly average:
    For healthy men up to age 65—
    • no more than 4 drinks in a day AND • On average, how many days a
    • no more than 14 drinks in a week week do you have an alcoholic
    For healthy women (and healthy men over drink?
    X
    age 65)—
    • On a typical drinking day, how
    • no more than 3 drinks in a day AND
    many drinks do you have?
    • no more than 7 drinks in a week
    Weekly average
    Recommend lower limits or abstinence as
    medically indicated: for example, for patients Record heavy drinking days in the past year and
    who the weekly average in the patient’s chart (see page
    • take medications that interact with alcohol 27 for a downloadable baseline progress note).
    • have a health condition exacerbated by
    alcohol
    • are pregnant (advise abstinence)
    Express openness to talking about alcohol use GO TO
    and any concerns it may raise STEP 2
    Rescreen annually

    4
    HOW TO HELP PATIENTS: A CLINICAL APPROACH

    STEP 2 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
    risk of bodily harm (drinking and driving, operating machinery, swimming)
    relationship trouble (family or friends)
    role failure (interference with home, work, or school obligations)
    run-ins with the law (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


    not been able to stick to drinking limits (repeatedly gone over them)
    not been able to cut down or stop (repeated failed attempts)
    shown tolerance (needed to drink a lot more to get the same effect)
    shown signs of withdrawal (tremors, sweating, nausea, or insomnia when trying to quit or
    cut down)
    kept drinking despite problems (recurrent physical or psychological problems)
    spent a lot of time drinking (or anticipating or recovering from drinking)
    spent less time on other matters (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?

    NO YES

    Your patient is still


    Your patient has an
    at risk for developing
    alcohol use disorder
    alcohol-related problems

    GO TO GO TO
    STEPS 3 & 4 STEPS 3 & 4
    for AT-RISK for ALCOHOL USE
    DRINKING, DISORDERS,
    page 6 page 7

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