Alcohol History-Taking
February 15th, 2021
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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