Eliciting and Evaluating details on Alcohol consumption from the patient is very vital and a valuable skill
Details like... Type of alcohol, frequency of intake, quantity, alcoholism, dependence, abuse,
withdrawal effects etc
Key Essential Components in eliciting Alcohol History
Develop Rapport: “I will be asking few questions about your drinking habits. This information is very
essential to understand your health”
Ensure Confidentiality: "This information will be kept private andvconfidential. You can feel relaxed
and share the information with me”
Culturally Sensitive: “I respect your religious practices and belief. These questions are essential to
know the impact on your health. Do you smoke cigarettes, consume alcohol, have used illicit drugs?”
Win Patients' Trust and Confidence: 'You are very courageous to tell me about this. I appreciate it’
Ask Open ended questions: 'Tell me about your drinking’
Be Non-confrontational: “Don’t bluff. I don’t think you just drink n1 pint of beer on weekends! You
must be a barrel”
Be Non-judgmental: “Looking at your eyes and big tummy, you must be drinking a lot of late!”
Empathetic: "How can I help you with your drinking?’
What to ask in alcohol history?
Onset: When did you first start drinking?
Progress: Types and amount of alcohol that are consumed – then and now.
Frequency: How many days a week do you drink – then and now? How much alcohol is consumed each
time.
Reason: Under what circumstances do you drink?
Amount/Quantity -Do you need to drink more now?
What time is the first drink of the day?
Do you drink alone or with friends?
Have you tried giving up alcohol? If yes, what happened?
How long could you stay off alcohol?
How to evaluate alcohol dependence?
For screening a patient for alcohol abuse, the CAGE questionnaire can be used :
C- Have you ever felt the need to Cut down drinking
A- Have people Annoyed you by criticizing your drinking
G- Have you felt Guilty about drinking
E- Eye opener- Do you drink the first thing in the morning?
The score of minimum 2 is required to brand as abuse
A 67-year-old man comes to the physician for a routine examination. He does not take any medications. He
drinks 6 to 7 bottles of beer every night, and says he often has a shot of whiskey in the morning “for my
headache.” He was recently fired from his job for arriving late. He says there is nothing wrong with his drinking
but expresses frustration at his best friend no longer returning his calls.
Which of the following is the most appropriate initial response by the physician?
A. I am sorry your friend no longer returns your calls. It seems
that your drinking is affecting your friendship.
B. I am sorry to hear that you lost your job. Drinking the amount
of alcohol you do can have negative effect on your health.
C. I am sorry your friend no longer returns your calls. Why do you
think this is the case?
D. I am sorry to hear that you lost your job. I am concerned about
the amount of alcohol you are drinking.
