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HOW TO SCREEN FOR HEAVY DRINKING

STEP 1 Ask About Alcohol Use

Ask: Do you sometimes drink alcoholic beverages?
No or Yes
No
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Yes
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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 a day?
(for men)
4 or more
drinks in a day?
(for women)

Record heavy drinking days in past year and weekly average in chart.

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Is the answer 1 or more times ?
No or Yes
No
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Yes
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  • Advise staying within these limits:
Maximum Drinking Limits
For healthy men up to age 65—
  • no more than 4 drinks in a day AND
  • no more than 14 drinks in a week
For healthy women (and healthy men over age 65)—
  • no more than 3 drinks in a day AND
  • no more than 7 drinks in a week
  • Recommend lower limits or abstinence as medically indicated; for example, for patients who
    • take medications that interact with alcohol
    • have a health condition exacerbated by alcohol
    • are pregnant (advise abstinence.)
  • Rescreen annually.
 
  • Your patient is an at-risk drinker. For a more complete picture of the drinking pattern, determine the weekly average:
  • On average, how many days a week do you have an alcoholic drink?
 
X
  • drinks do you have?
 
  • Record heavy drinking days in the past year and the weekly average in the patient's chart (see page 27 for a downloadable baseline progress note).
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Go To Step 2

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