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HOW TO HELP PATIENTS WHO DRINK TOO MUCH: 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


(family or friends)

(arrests or other legal problems)

If yes to one or more Arrow pointing right 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 Arrow pointing right your patient has alcohol dependence.

Arrow pointing down
Does the patient meet the criteria for alcohol abuse or dependence?
No or Yes
No
Arrow pointing down
Yes
Arrow pointing down
Your patient is still at risk for developing alcohol-related problems.
Your patient has an alcohol use disorder.
Arrow pointing down
Go To Steps 3 &4 for Alcohol Use Disorders

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