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BEFORE YOU BEGIN...

Before You Begin…

Decide on a screening method

The Guide provides two methods for screening: a single question (about heavy drinking days) to use during a clinical interview and a written self-report instrument (the AUDIT—see page 11). The single interview question can be used at any time, either in conjunction with the AUDIT or alone. Some practices may prefer to have patients fill out the AUDIT before they see the clinician. It takes less than 5 minutes to complete and can be copied or incorporated into a health history.

Think about clinical indications for screening

Key opportunities include

  • As part of a routine examination
  • Before prescribing a medication that interacts with alcohol (see box on page 29)
  • In the emergency department or urgent care center
  • When seeing patients who
    • are pregnant or trying to conceive
    • are likely to drink heavily, such as smokers, adolescents, and young adults
    • have health problems that might be alcohol induced, such as:
      • cardiac arrhythmia
      • dyspepsia
      • liver disease
      • depression or anxiety
      • insomnia
      • trauma
    • have a chronic illness that isn't responding to treatment as expected, such as:
      • chronic pain
      • diabetes
      • gastrointestinal disorders
      • depression
      • heart disease
      • hypertension

Set up your practice to simplify the process

    • Decide who will conduct the screening (you, other clinical personnel, the receptionist who hands out the AUDIT)
    • Use preformatted progress notes (see "Online Materials" on page 27)
    • Use computer reminders (if using electronic medical records)
    • Keep copies of the pocket guide (provided) and referral information in your examination rooms
    • Monitor your performance through practice audits

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