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Basic History
 
 

Alcohol History-Taking

February 15th, 2021
 
 
 
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Overview

Alcohol abuse, binging and dependence is very common in the community, and can result in significant acute and chronic complications. A tactful history will aid in understanding the patient's pattern of alcohol intake and their attitude toward alcohol.
  • Ask About

  • Everyone

  • Whether they drink alcohol regularly
  • How often - daily, weekly, monthly, or on social occasions only
  • What type of alcohol they drink
  • How many drinks on each occasion / each day
  • The most they drink at any given time
  • Where they drink - restaurants, bars, parties, at home
  • Amount spent on alcohol
  • Heavy Drinkers

  • Withdrawal symptoms - sweating, rigors, nausea, past seizures
  • Alcohol free days
  • Past attempts to quit drinking
  • Willingness to cut down or stop
  • Consequences of Alcohol Abuse

  • Oesophagitis
  • Pancreatitis
  • Alcoholic liver disease - steatosis, hepatitis, cirrhosis
  • Cardiovascular disease - hypertension, dilated cardiomyopathy, atrial fibrillation
  • Neurologic complications - Wernicke encephalopathy, Korsakoff syndrome, cerebellar atrophy, peripheral neuropathy, myopathy
  • Malignancy - mouth, oesophagus, throat, liver, breast
  • Bone marrow suppression
  • Osteoporosis
  • Malnutrition
  • Trauma - high risk behaviour, MVA
  • Psychiatric disorders - depression, anxiety, suicide

The CAGE questionnaire

A screening tool for alcohol dependence.
  • Ask About

  • Cut down - have they ever felt that they should cut down on their drinking?
  • Annoyed - do they get annoyed when other people talk to them about how much they drink?
  • Guilty - have they ever felt guilty about something they did as a result of their drinking
  • Eye opener - do they use alcohol to help them wake up in the morning?

What is a Standard Drink?

One standard drink in Australia contains 10g of alcohol.
  • One Standard Drink

  • Beer

  • 285mL full strength beer (4.8%) - 1.1 standard drinks
  • 375mL full strength beer (4.8%) - 1.4 standard drinks
  • 425mL full strength beer (4.8%) - 1.6 standard drinks
  • 285mL mid strength beer (3.5%) - 0.8 standard drinks
  • 375mL mid strength beer (3.5%) - 1 standard drink
  • 425mL mid strength beer (3.5%) - 1.2 standard drinks
  • 285mL low strength beer (2.7%) - 0.6 standard drinks
  • 375mL low strength beer (2.7%) - 0.8 standard drinks
  • 425mL low strength beer (2.7%) - 0.9 standard drinks
  • Wine

  • 150mL red wine (13%) - 1.5 standard drinks
  • 150mL white wine (11.5%) - 1.4 standard drinks
  • 150mL sparkling wine (12%) - 1.4 standard drinks
  • 60mL port (17.5%) - 1.4 standard drinks
  • Spirits

  • 30mL standard spirit (40%) - 1 standard drink
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